Department of Human Services Medical Assistance Program Fee Schedule Revisions; Prior Authorization Requirements; Unit and Limitation Updates

The Department of Human Services (Department) announces changes to the Medical Assistance (MA) Program Fee Schedule. The Department is adding procedure codes based upon clinical review or provider requests to the MA Program Fee Schedule. The Department is end-dating procedure codes based upon clinical review. Additionally, the Department is making changes to units and limitations to procedure codes based upon the National Correct Coding Initiative (NCCI) recommendations. For a list of procedure codes and modifiers impacted by the changes, please review the link included below.

For more information, please review the November 1, 2025 edition of the Pennsylvania Bulletin.