Medical Society Lobbies for Medicaid Increase

Medicaid reimbursement for allergen immunotherapy (CPT 95165) will nearly triple on July 13, 2009, from $2.88 per dose to $8.22.  

The Pennsylvania Medical Society and the Pennsylvania Allergy and Asthma Association provided cost data to the Department of Public Welfare (DPW) that demonstrated the need  to increase reimbursement for this service. 

DPW announced many other changes to its fee schedule, effective July 13.  

More than 200 codes will be added to the schedule, including administration of the DTaP-IPV vaccine to children ages 4 to 6 (CPT 90696 ) and administration of the oral rotavirus vaccine (CPT 90681). 

Medicaid will no longer reimburse for about 230 codes, including genioplasty (CPT 21120) and rhinoplasty (30400). 

Nearly 25 procedures—including cardiac MRIs (CPT 75557) and cardiac MRIs with stress imaging (CPT 75559)—will now require preauthorization. 

For the full list, visit the DPW website.

Add Your Comments


The Pennsylvania Medical Society encourages lively debate, but please behave courteously and responsibly. Comments that include profanity, personal attacks (including language that could potentially identify an individual), or any other inappropriate, offensive, or illegal material will be removed. For more information, please see our Terms of Use.

Display name as (optional):

Comments (max 2000 characters):




Comments: 0



Last Updated: 7/8/2009
From: 
Email:  
To: 
Email:  
Subject: 
Message: