MedicaidBilling CodesHigh impact
New implementation date for Skilled Nursing and Personal Care Shift Services & MA & MP.PA.050.1
UPMC Health Plan·PA · Pediatrics, Palliative Care, Geriatrics·Coding
Effective date
Oct 1, 2023
We identified it
Aug 7, 2026
Summary
Effective October 1, 2023, Pennsylvania DHS is discontinuing HCPCS code T1019 and replacing it with G0156 used with modifiers U7, SC, and TT to differentiate between pediatric aide services, legally responsible versus non-legally responsible relatives, and home health/hospice settings. The billing team must update all systems, templates, and workflows to use the new code-modifier combinations before the implementation date.
Action Required
By September 30, 2023: Billing team must update billing software, encounter forms, and claim submission templates to discontinue use of HCPCS code T1019. Replace all instances with G0156 and the appropriate modifiers: U7 (non-legally responsible relative), U7/SC (legally responsible relative), U7 TT (non-legally responsible relative in home health/hospice – extra patient), and U7 SC TT (legally responsible relative in home health/hospice – extra patient). Audit all pending and scheduled claims for T1019 usage and correct before October 1, 2023. Notify providers and clinical staff of the coding change. Claims submitted with T1019 on or after October 1, 2023 will be denied by Pennsylvania DHS and UPMC Health Plan.