MedicaidCoverageMedium impact
Environmental Lead Investigations MAB 01-16-29
Pennsylvania Medicaid (DHS)·PA · Pediatrics, Family Medicine, General Practice·Provider Bulletin
Effective date
Sep 13, 2016
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance now covers comprehensive environmental lead investigations for children under 21 with blood lead levels ≥5 μg/dL. New procedure code T1029 pays $350.00 per dwelling investigation when ordered by enrolled MA providers with specific lead toxicity diagnosis codes.
Action Required
Immediately: Providers treating children with elevated blood lead levels (≥5 μg/dL) can now order environmental lead investigations using procedure code T1029. Billing team must verify Environmental Lead Investigation (ELI) providers are enrolled in MA Program before ordering. Use required lead toxicity diagnosis codes (R78.71 or T56.0X series) on claims. Maintain copies of orders for 4 years. Only one investigation per household covered regardless of number of children.