MedicaidBilling CodesMedium impact
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
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
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.