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MedicaidBilling CodesMedium impact

Updates to the Medical Assistance Program Fee Schedule for HHA Nursing Visits MAB 05-16-01

Pennsylvania Medicaid (DHS)·PA·Reimbursement
Effective date
Mar 1, 2016
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania's Medical Assistance Program is replacing procedure code G0154 with two new codes for home health nursing visits: G0299 for RN services and G0300 for LPN services, both reimbursed at $88 per visit. The change separates billing based on nurse license type and includes visit limits after the first 28 days.

Action Required

Action needed
Immediately: Home health agencies must stop using code G0154 for nursing visits. Update billing system to use G0299 for registered nurse visits and G0300 for licensed practical nurse visits. Configure system to allow unlimited visits for first 28 days, then limit to 15 visits per month thereafter with UD modifier. Update encounter forms and train staff on new code requirements.

Affected Billing Codes

G0154
G0299
G0300