2026 Healthcare Common Procedure Coding System Updates; Fee Adjustments and Other Procedure Code Changes

The Department of Human Services (Department) announces changes to the Medical Assistance (MA) Program Fee Schedule. The Department is adding and end-dating procedure codes as a result of the 2026 updates published by the Centers for Medicare & Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS) and as a result of clinical review. The Department is also adding other procedure codes and making changes to procedure codes currently on the MA Program Fee Schedule, to include setting limitations and making fee adjustments. As outlined in bulletin, certain procedure codes being added to the MA Program Fee Schedule will require prior authorization.

These changes are effective for dates of service on and after August 1, 2026.

Public Comment

Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, P.O. Box 2675, Harrisburg, PA 17120 or at RA-PWMAProgComments@pa.gov. Comments received within 30 days will be reviewed and considered for any subsequent revision to the MA Program Fee Schedule.

For more information, please review the July 25, 2026, edition of the Pennsylvania Bulletin.