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Microsoft Word - MAB Bulletin for POPS codes _B.Decker_.doc

Pennsylvania Medicaid (DHS)·PA · Orthopedics, PM&R (Physical Medicine & Rehab), Physical Therapy·Provider Bulletin
Effective date
Dec 1, 2005
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medicaid is adding 33 new prosthetic, orthotic and medical supply procedure codes (A-codes and L-codes) to their fee schedule effective December 1, 2005. These codes were previously only available through administrative waivers and some require prior authorization.

Action Required

Action needed
By December 1, 2005: Billing team must update Pennsylvania Medicaid billing system to include the 33 new prosthetic and orthotic procedure codes (A5500-A5511 and L-codes as listed). Verify which codes require prior authorization using the attached fee schedule document. Stop using administrative waiver process (1150 forms) for these codes. Update encounter forms for orthotics and prosthetics providers.

Affected Billing Codes

A5500
A5501
A5503
A5504
A5505
A5506
A5510
A5511
L0984
L1200
L1844
L1846
L1858
L2275
L2397
L2627
L2628
L3010
L3340
L3350
L3530
L3540
L3807
L4350
L5700
L5701
L5704
L5705
L5706
L5707
L5972
L5974
L5995
L7520