MedicaidBilling CodesMedium impact
d 005312
Pennsylvania Medicaid (DHS)·PA · OB-GYN, Family Medicine·Provider Bulletin
Effective date
Jul 1, 2008
We identified it
Jun 20, 2026
Summary
Pennsylvania updated the SelectPlan for Women Covered Services Chart with revised pricing modifiers (U7) for select office visit procedure codes on the Title XIX Family Planning Fee Schedule. Providers must use the new Attachment A chart when billing for SelectPlan for Women recipients and refer to it for correct limits, as the previous bulletin contained incorrect limits on some procedure codes.
Action Required
Immediately: Pennsylvania providers must update billing systems to use the revised SelectPlan for Women Covered Services Chart (Attachment A) for all SelectPlan recipients. Update procedure code limits per the new chart as previous limits were incorrect. Ensure billing staff continue using FP modifier or V25.0x-V25.9x diagnosis codes on claims. Failure to use correct procedure codes, modifiers, or place of service will result in inappropriate payments or claim denials.