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MedicaidBilling CodesMedium impact

991710 Merge attachment

Pennsylvania Medicaid (DHS)·PA · Pediatrics, Family Medicine·Provider Bulletin
Effective date
Aug 7, 2017
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medical Assistance updated their EPSDT (Early and Periodic Screening, Diagnosis and Treatment) program periodicity schedule effective August 7, 2017, adding new screening requirements and ICD-10 diagnosis codes Z00.00 and Z00.01 for beneficiaries aged 15-21 years.

Action Required

Action needed
By August 7, 2017: Billing teams must update billing systems to include ICD-10 diagnosis codes Z00.00 and Z00.01 for EPSDT screenings for Medical Assistance beneficiaries aged 15-21 years. Update encounter forms to reflect new screening requirements including maternal depression screening (CPT 96160) at 1, 2, 4, and 6 month visits, and adolescent depression screening beginning at age 12. Ensure providers use the updated Pennsylvania EPSDT Program Periodicity Schedule and Coding Matrix for all Medical Assistance claims.

Affected Billing Codes

99460
99463
99381
99382
99391
99392
96160
96110
99173
92551
92552
85013
85018
83655
Z00.00
Z00.01