MedicaidBilling CodesMedium impact
MAB2020052602
Pennsylvania Medicaid (DHS)·PA · Pediatrics, Family Medicine·Provider Bulletin
Effective date
May 26, 2020
We identified it
Jun 20, 2026
Summary
Pennsylvania updated its EPSDT periodicity schedule for Medicaid patients, adding specific CPT codes 96127 for depression screening (ages 12-20), 96160 for substance use assessment (ages 11-20), and enhanced requirements for caregiver screening and maternal depression screening.
Action Required
Immediately: Billing teams must update encounter forms and billing systems to use CPT 96127 for depression screening (ages 12-20) and CPT 96160 for tobacco/alcohol/drug use assessment (ages 11-20) during EPSDT visits. Providers must document use of standardized screening tools. Update EMR templates to include caregiver anxiety screening and maternal depression screening components.