MedicaidBilling CodesMedium impact
d 005501
Pennsylvania Medicaid (DHS)·PA · Anesthesiology, Orthopedics, General Surgery +1 more·Provider Bulletin
Effective date
Jul 13, 2009
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid has added new 2008 HCPCS procedure codes and updated existing codes with new fee schedules, modifiers, and place of service requirements effective July 13, 2009. The update includes anesthesia codes, spine procedures, TMJ manipulation, elbow tenotomy procedures, and femoral fracture treatments with specific reimbursement rates and billing limitations.
Action Required
Update billing system with new Pennsylvania Medicaid fee schedules for the affected procedure codes. Ensure proper modifier usage (RT/LT, 80, SG) and place of service requirements are programmed. Verify frequency limitations are enforced (e.g., 'once per day', 'once per R side and once per L side per day'). Train billing staff on new anesthesia and surgical procedure reimbursement rates.