MedicaidAdministrativeHigh impact
Microsoft Word - Bulletin Cover Letter FNL LtrHD.1.doc
Pennsylvania Medicaid (DHS)·PA · Psychiatry, Pediatrics, Family Medicine·Provider Bulletin
Effective date
Jul 1, 2005
We identified it
Jun 20, 2026
Summary
Pennsylvania is transitioning behavioral health treatment services for children in child welfare and juvenile justice systems from traditional child welfare funding to Medical Assistance (Medicaid) Program reimbursement. This affects billing for psychological evaluations, therapy services, day treatment, drug/alcohol services, and residential treatment for eligible children.
Action Required
By July 1, 2005: Pennsylvania providers serving children in child welfare/juvenile justice systems must verify Medical Assistance eligibility before billing behavioral health services. Billing team must ensure providers are enrolled in Medical Assistance Program and services meet medical necessity criteria. For non-enrolled providers or ineligible children, continue using child welfare funding mechanisms and document reasons in case records.