MedicaidReimbursementHigh impact
p 035853
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, Pediatrics·Provider Bulletin
Effective date
Jan 1, 2013
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is offering increased reimbursement rates (matching 2013-2014 Medicare rates) for primary care E&M services and vaccine administration codes for qualifying physicians. Physicians must complete an attestation form and either be board certified in family medicine, internal medicine, or pediatrics, or have at least 60% of their Medicaid billings from qualifying E&M and vaccine codes.
Action Required
By December 31, 2013: Qualifying primary care physicians (family medicine, internal medicine, pediatrics) must complete and submit the Physician Attestation Form to receive increased Medicaid reimbursement rates. Providers must either provide board certification documentation or attest that 60% of Medicaid billings are from E&M codes 99201-99499 and vaccine administration codes 90460, 90461, 90471, 90472. Submit via ePEAP portal, email (Ra-ProvApp@pa.gov), fax (717-265-8284), or mail. Update provider enrollment to include required specialty designation (PS 316 for family medicine, PS 322 for internal medicine, PS 345 for pediatrics). Without attestation and proper enrollment, increased fees will not be paid.