Pennsylvania’s Medicaid Fee Schedule Updated with 2018 HCPCS Procedure Codes

Last Updated: Jul 11, 2018

computers-ipad-papers-articlePennsylvania’s Medicaid program – known as Medical Assistance (MA) – has updated its MA Fee Schedule to reflect the implementation of 2018 Healthcare Common Procedure Coding System (HCPCS) procedure codes. A new Family Planning Services covered services chart has also been issued to reflect code changes.

The updates are effective for dates of service on or after July 2, 2018, and they apply to health care providers who offer services to beneficiaries in the MA fee-for-service delivery system. Physicians and other health care providers who render services in the MA managed care program should direct any coding questions to the appropriate managed care organization (MCO).

The Pennsylvania Department of Human Services (DHS) notes that some of the procedure codes added to the MA Program Fee Schedule will require prior authorization.

Check out these Medical Assistance Bulletins for details on code updates:

The schedules are also available via this DHS MA Fee Schedules webpage.

If you have questions, you can find contact phone numbers and email addresses via DHS’ Contact Information page.

Pennsylvania Medical Society members with questions can also contact our Knowledge Center at 855-PAMED4U (855-726-3348) or

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