MedicaidAdministrativeMedium impact
Medical Assistance Bulletin 17-99-02
Pennsylvania Medicaid (DHS)·PA · Psychiatry, Pediatrics·Provider Bulletin
Effective date
Dec 3, 1999
We identified it
Jun 20, 2026
Summary
Pennsylvania licensed Mental Retardation providers (PT 50) can now bill Mobile Therapy (MT) and Behavioral Specialist Consultant (BSC) services directly from the MA Program Fee Schedule without waiver requests. Therapeutic Staff Support (TSS) services can also be billed directly for newly initiated cases up to 4 months, but continuation beyond 4 months still requires waiver approval.
Action Required
Immediately: Pennsylvania PT 50 providers must file service descriptions with DPW before billing MT and BSC services directly from MA Fee Schedule. Update billing procedures to bill MT/BSC directly when requirements are met and frequency/dollar limits aren't exceeded. For TSS services, bill directly only for newly initiated cases within first 4 months; continue using 1150 waiver process for existing TSS cases and all services beyond 4 months.