MedicaidReimbursementMedium impact
Microsoft Word - MAB 010704.doc
Pennsylvania Medicaid (DHS)·PA · Family Medicine, OB-GYN, Infectious Disease +1 more·Provider Bulletin
Effective date
Jan 2, 2007
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid corrected the reimbursement rates for two laboratory procedure codes (87491 and 87591) for Chlamydia and Gonorrhea testing. The correct fee for both codes is $23.19, and providers can resubmit claims for adjustments if they were paid at the incorrect previous rate.
Action Required
Immediately: Update billing system with correct fee of $23.19 for CPT codes 87491 and 87591. Family Planning Clinics must use FP modifier when billing these codes. Inpatient Hospitals and Laboratories should use FP modifier when providing family planning services. Consider resubmitting claims for adjustment if previously paid at incorrect rate - reference Provider Handbooks for claim adjustment procedures.