Number
|
Publication Name
|
Issue Date |
| 27-25-42 |
Adoption of the American Academy of Pediatric Dentistry's Dental Periodicity Schedule |
10/7/2025 |
| 00-25-03 |
Electronic Visit Verification Manual Edits Noncompliance in the Fee-for-Service Delivery and Managed Care Delivery Systems |
8/29/2025 |
| 27-25-40 |
Implementation of Updated Dental Benefit Limit Exception Form |
6/25/2025 |
| 99-25-03 |
Updates to Screening Guidelines for Prior Authorization |
6/24/2025 |
| 99-25-06 |
2025 Healthcare Common Procedure Coding System (HCPCS) Updates, Fee Adjustments, and Other Procedure Code Changes |
6/23/2025 |
| 33-25-38 |
Statewide Preferred Drug List (PDL) Updates - Pharmacy Services |
6/12/2025 |
| 99-25-05 |
Pennsylvania Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program Periodicity Schedule |
5/21/2025 |
| 99-25-04 |
2025 Recommended Child and Adolescent Immunization Schedule |
5/15/2025 |
| 99-25-02 |
Medical Assistance (MA) Program Fee Schedule Revisions |
4/16/2025 |
| 8/25/1935 |
Federally Qualified Health Center and Rural Health Clinic Procedure Codes |
4/16/2025 |
| 31-25-35 |
Application of Topical Fluoride Varnish |
4/8/2025 |
| 8/25/2001 |
Federally Qualified Health Center and Rural Health Clinic Alternative Payment Methodology for Long-Acting Reversible Contraceptives |
4/3/2025 |
| 31-25-36 |
Screening Diagnostic and Targeted Case Management Services for Eligible Juveniles Enrolled in Medical Assistance Prior to Release from Carceral Setting |
2/18/2025 |
| 99-25-01 |
Limited English Proficiency Requirements |
1/16/2025 |
| 3/25/1933 |
Update to the Admissions Notice Packet (MA 401) |
1/10/2025 |
| 33-25-34 |
Prior Authorization of Anticonvulsants-Pharmacy Services |
1/10/2025 |
| 33-25-33 |
Coverage of and Payment for Doula Services in the Medical Assistance Program |
12/23/2024 |
| 99-24-09 |
Medical Assistance Program Vaccine Desk Reference Updates |
11/19/2024 |
| 33-25-32 |
Prior Authorization of Ulcerative Colitis Agents -Pharmacy Services |
11/14/2024 |
| 33-25-31 |
Prior Authorization of Thrombopoietic -Pharmacy Services |
11/14/2024 |
| 33-25-26 |
Prior Authorization of Pulmonary Hypertension Agents, Oral and Inhaled-Pharmacy Services |
11/13/2024 |
| 33-25-28 |
Statewide Preferred Drug List (PDL) Updates -Pharmacy Services |
11/13/2024 |
| 33-25-30 |
Prior Authorization of Thalidomide and Derivatives-Pharmacy Services |
11/13/2024 |
| 33-25-25 |
Prior Authorization of Phosphate Lowering Agents (Formerly Phosphate Binders)-Pharmacy Services |
11/13/2024 |
| 33-25-27 |
Prior Authorization of Skeletal Muscle Relaxants-Pharmacy Services |
11/13/2024 |
| 33-25-29 |
Prior Authorization of Stimulants and Related Agents-Pharmacy Services |
11/13/2024 |
| 33-25-12 |
Prior Authorization of Colony Stimulating Factors-Pharmacy |
11/12/2024 |
| 33-25-23 |
Prior Authorization of Oncology Agents, Oral-Pharmacy Services |
11/12/2024 |
| 33-25-16 |
Prior Authorization of Immunomodulators, Atopic Dermatitis-Pharmacy |
11/12/2024 |
| 33-25-21 |
Prior Authorization of Natalizumab -Pharmacy Services |
11/12/2024 |
| 33-25-17 |
Prior Authorization of Lipotropics, Other-Pharmacy |
11/12/2024 |
| 33-25-24 |
Prior Authorization of Pancreatic Enzymes-Pharmacy Services |
11/12/2024 |
| 33-25-07 |
Prior Authorization of Antifibrotic Respiratory Agents -Pharmacy Services |
11/8/2024 |
| 33-25-09 |
Prior Authorization of Antiparkinsons"s Agents -Pharmacy Services |
11/8/2024 |
| 33-25-08 |
Prior Authorization of Monoclonal Antibodies (MABS) - Anti-IL, Anti-IgE, Anti-TSLP--Pharmacy Services |
11/8/2024 |
| 33-25-11 |
Prior Authorization of Botulinum Toxins-Pharmacy Services |
11/8/2024 |
| 33-25-10 |
Prior Authorization of Antipsychotics -Pharmacy Services |
11/8/2024 |
| 33-25-04 |
Prior Authorization of Anticonvulsants-Pharmacy Services |
11/8/2024 |
| 33-25-02 |
Prior Authorization of Analgesics, Opioid Long-Acting-Pharmacy Services |
11/7/2024 |
| 33-25-22 |
Prior Authorization of Neuropathic Pain Agents-Pharmacy Services |
11/7/2024 |
| 33-25-05 |
Prior Authorization of Antidepressants, Other-Pharmacy Services |
11/7/2024 |
| 33-25-01 |
Prior Authorization of Analgesics, Non-Opioid Barbiturate Combinations -Pharmacy Services |
11/7/2024 |
| 33-25-03 |
Prior Authorization of Analgesics, Opioid Short - Acting-Pharmacy Services |
11/7/2024 |
| 33-25-13 |
Prior Authorization of Cytokine and CAM Antagonists -Pharmacy Services |
11/6/2024 |
| 33-25-15 |
Prior Authorization of Hereditary Angioedema (HAE) -Pharmacy Services |
11/6/2024 |
| 33-25-19 |
Prior Authorization of Migraine Prevention Agents-Pharmacy Services |
11/6/2024 |
| 33-25-18 |
Prior Authorization of Migraine Acute Treatment Agents -Pharmacy Services |
11/6/2024 |
| 33-25-14 |
Prior Authorization of Hepatic and Biliary Agents (formerly Bile Salts)-Pharmacy Services |
11/6/2024 |
| 33-25-20 |
Prior Authorization of Multiple Sclerosis Agents-Pharmacy Services |
11/6/2024 |
| 8/24/2016 |
Updates to the Promise Provider Handbook/CMS-1500 Claim Form, Appendix E-FQHC/RHC Handbook |
11/1/2024 |
| 99-24-08 |
Pennsylvania Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program Periodicity Schedule |
10/29/2024 |
| 99-24-06 |
MA Program Fee Schedule Updates for Certain Ophthalmology Procedure Codes |
9/16/2024 |
| 35-24-01 |
School-Based ACCESS Program Provider Handbook |
9/16/2024 |
| 99-24-07 |
Medical Assistance (MA) Program Fee Schedule Revisions |
9/9/2024 |
| 33-24-13 |
MA Program Fee Schedule Updates For Certain Family Planning Procedure Codes |
9/9/2024 |
| 00-24-02 |
Updated Electronic Visit Verification Manual Edits Compliance Percentage Requirements in the Fee-for-Service Delivery and Managed Care Delivery Systems |
8/23/2024 |
| 33-24-12 |
Prior Authorization of Obesity Treatment Agents - Pharmacy Services |
8/7/2024 |
| 33-24-11 |
Prior Authorization of Hypoglycemics, Incretin Mimetics/Enhancers- Pharmacy Services |
8/7/2024 |
| 99-24-05 |
Ophthalmology Fee Updates |
7/8/2024 |
| 27-24-03 |
2024 Medical Assistance Program Dental Fee Schedule Update |
6/5/2024 |
| 99-24-03 |
2024 Healthcare Common Procedure Coding System (HCPCS) Updates, Fee Adjustments, and Other Procedure Code Changes |
5/28/2024 |
| 33-24-06 |
Updates to the Family Planning Services Program Fee Schedule |
5/28/2024 |
| 99-24-02 |
Medical Assistance (MA) Program Fee Schedule Revisions |
4/29/2024 |
| 26-24-0 |
Ambulance Services |
4/18/2024 |
| 99-24-04 |
2024 Recommended Child and Adolescent Immunization Schedule |
4/16/2024 |
| 33-24-04 |
Over-the-Counter Oral Contraceptives |
4/10/2024 |
| 8/24/2004 |
Updates to The Promise Provider Handbook Professional/CMS-1500 Claim Form |
3/1/2024 |
| 31-24-02 |
Pharmacist Billing |
2/13/2024 |
| 33-24-03 |
Prior Authorization of Opioid Use Disorder Treatments-Pharmacy Services |
2/6/2024 |
| 10/24/2002 |
Pharmacist Enrollment in the Medical Assistance Program |
2/1/2024 |
| 33-24-01 |
Medical Assistance Program Vaccine Desk Reference |
1/24/2024 |
| 33-24-02 |
Pasteurized Donor Human Milk Coverage Updates |
1/19/2024 |
| 13-24-01 |
Doula Enrollment in the Medical Assistance Program |
1/10/2024 |
| 99-23-10 |
Payment for Services Associated with Qualifying Clinical Trials |
12/28/2023 |
| 33-24-01 |
Interprofessional Consultation Services |
12/27/2023 |
| 33-23-46 |
Prior Authorization of Obesity Treatment Agents - Pharmacy Services |
11/14/2023 |
| 33-23-49 |
Statewide Preferred Drug List (PDL) Updates- Pharmacy Services |
11/14/2023 |
| 33-23-32 |
Prior Authorization of Bone Density Regulators - Pharmacy Services |
11/13/2023 |
| 33-23-26, |
Prior Authorization of Antibiotics, GI and Related Agents - Pharmacy Services |
11/13/2023 |
| 33-23-36 |
Prior Authorization of Estrogens - Pharmacy Services |
11/13/2023 |
| 33-23-39 |
Prior Authorization of Hypoglycemics, Incretin Mimetics/Enhancers- Pharmacy Services |
11/13/2023 |
| 33-23-29 |
Prior Authorization of Antipsychotics - Pharmacy Services |
11/13/2023 |
| 33-23-48 |
Prior Authorization of Sedative Hypnotics- Pharmacy Services |
11/9/2023 |
| 33-23-43 |
Prior Authorization of Migraine Prevention Agents |
11/9/2023 |
| 33-23-50 |
Prior Authorization of Tubeless Insulin Delivery Devices - Pharmacy Services |
11/9/2023 |
| 33-23-47 |
Prior Authorization of Pituitary Suppressive Agents, LHRH - Pharmacy Services |
11/9/2023 |
| 33-23-40 |
Prior Authorization of Immunomodulators, Atopic Dermatitis- Pharmacy Services |
11/8/2023 |
| 33-23-31 |
Prior Authorization of Anxiolytics - Pharmacy Services |
11/8/2023 |
| 33-23-41 |
Prior Authorization of Lipotropics, Other - Pharmacy Services |
11/8/2023 |
| 33-23-42 |
Prior Authorization of Macular Degeneration Agents - Pharmacy Services |
11/8/2023 |
| 33-23-27 |
Prior Authorization of antidepressants, Other - Pharmacy Services |
11/8/2023 |
| 33-23-37 |
Prior Authorization of Hereditary Angioedema (HAE) Agents- Pharmacy Services |
11/7/2023 |
| 33-23-28 |
Prior Authorization of Antihemophilia Agents- Pharmacy Services |
11/7/2023 |
| 33-23-38 |
Prior Authorization of Hepatitis C Agents- Pharmacy Service |
11/7/2023 |
| 33-23-35 |
Prior Authorization of Dupixent (dupilumab)- Pharmacy Services |
11/7/2023 |
| 33-23-25 |
Prior Authorization of Androgenic Agents- Pharmacy Services |
11/7/2023 |
| 33-23-30 |
Prior Authorization of Antivirals, CMV-Pharmacy Services |
11/6/2023 |
| 33-23-33 |
Prior Authorization of Continuous Glucose Monitoring Products-Pharmacy Services |
11/6/2023 |
| 33-23-34 |
Prior Authorization of Cytokine and CAM Antagonists-Pharmacy Services |
11/6/2023 |
| 28-23-03 |
Addition of a Procedure Code for Sexually Transmitted Infection Test Kits |
11/2/2023 |
| 27-23-16 |
2023 Medical Assistance Program Dental Fee Schedule Update and Dental Provider Handbook Update |
10/23/2023 |
| 33-23-22 |
Addition of Procedure Codes for Vaccine Administration |
9/29/2023 |
| 37-23-01 |
Street Medicine |
9/29/2023 |
| 27-23-15 |
Pediatric Dental Periodicity Schedule Updates |
9/28/2023 |
| 7/23/2002 |
Update to Electronic Visit Verification Requirements for Pediatric Home Health Aide Services in FFS and Managed Care Delivery |
9/20/2023 |
| 33-23-24 |
Updates for Childhood Nutrition and Weight Managment Services |
9/13/2023 |
| 7/23/2001 |
Pediatric Shiftcare Service for Beneficiaries Under 21 |
9/11/2023 |
| 99-23-09 |
2023 Healthcare Common Procedure Coding System (HCPCS) Updates, Fee Adjustments, and Other Procedure Code Changes |
9/5/2023 |
| 33-23-21 |
Updates to the Family Planning Services Program Fee Schedule |
9/1/2023 |
| 99-23-08 |
Updates to Guidelines for the Delivery Physical Health Services via Telehealth |
8/2/2023 |
| 31-23-22 |
Updated Sterilization Consent Form |
7/25/2023 |
| 33-23-08 |
Street Medicine |
7/5/2023 |
| 33-23-18 |
Prior Authorization of Opioid Use Disorder Treatments - Pharmacy Service |
6/30/2023 |
| 33-23-19 |
Prior Authorization of Progestational Agents- Pharmacy Services |
6/30/2023 |
| 33-23-20 |
Prior Authorization of Tepezza (teprotumumab-trbw) - Pharmacy Services |
6/30/2023 |
| 33-23-14 |
Clinical Prior Authorization of Non-PDL Durgs - Pharmacy Services |
6/30/2023 |
| 33-23-12 |
Prior Authorization of Antiemetic/Antivertigo Agents- Pharmacy Services |
6/29/2023 |
| 33-23-16 |
Prior Authorization of Cough and Cold Medications - Pharmacy Services |
6/29/2023 |
| 33-23-13 |
Prior Authorization of Antiparasitics, Topical -Pharmacy Services |
6/29/2023 |
| 33-23-15 |
Prior Authorization of Compounded Prescriptions - Pharmacy Service |
6/29/2023 |
| 33-23-17 |
Prior Authorization of Hepatitis C Agents - Pharmacy Services |
6/29/2023 |
| 33-23-11 |
Prior Authorization of Analgesics, Opioid Short-Acting - Pharmacy Services |
6/28/2023 |
| 33-23-09 |
Prior Authorization of Amyloid-Targeted Monoclonal Antibodies (MABs) - Pharmacy Services |
6/28/2023 |
| 99-23-07 |
Pennsylvania's Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program Periodicity Schedule |
6/27/2023 |
| 33-23-07 |
MA Program Fee Schedule Update for an Additional Bivalent Dose of the SARS-CoV-2 Vaccine Manufactured by Pfizer, Inc. |
6/20/2023 |
| 28-23-01 |
End-Dating COVID -19 Pharmacy Specimen Collection and Laboratory Testing Procedure Codes |
6/12/2023 |
| 33-23-06 |
Billing Updates for COVID-19 Vaccine Counseling Only Visits for Beneficiaries Under the Age of 21 |
6/12/2023 |
| 33-23-05 |
Billing Updates for Vaccine Counseling Only Visits for Beneficiaries Under the Age of 21 |
6/12/2023 |
| 99-23-06 |
Evaluation and Management Fee Adjustments and Code Updates |
6/1/2023 |
| 33-23-04 |
Additional Bivalent SARS-CoV-2 Vaccine Doses Manufactured by Merna, Inc. and Pfizer, Inc. |
4/13/2023 |
| 33-23-03 |
Implementation of ADA Claim Form- Version 2019 |
4/4/2023 |
| 99-23-01 |
Medical Assistance Program Fee Schedule Revisions |
4/1/2023 |
| 33-23-03 |
Administration of Booster Dose of SARS-CoV-2 Vaccine Manufactures by Novavax |
3/24/2023 |
| 16-23-01 |
Coverage of Case Specific Training/Shadow Nursing for Private Duty/Shift Nursing Services for MA Beneficiaries Under 21 Years of Age |
1/1/2023 |
| 99-22-11 |
Reinstatement of Provider Enrollment Requirements |
12/29/2022 |
| 33-22-75 |
340B Drug Pricing Program - Dispensing 340B Purchased Drugs |
12/22/2022 |
| 33-22-60 |
Prior Authorization of Hypoglycemics, Incretin Mimetics, Enhancers – Pharmacy Services |
12/13/2022 |
| 33-22-76 |
Disposable Breast Milk Collection and Storage Bags and Breast Pump |
12/13/2022 |
| 33-22-67 |
Coverage and Prior Authorization of Obesity Treatment Agents – Pharmacy Services |
12/9/2022 |
| 33-22-72 |
Statewide Preferred Drug List (PDL) Updates – Pharmacy Services |
12/9/2022 |
| 33-22-47 |
Prior Authorization of Monoclonal Antibodies – Anti- IL, Anti-IgE, Anti-TSLP (Formerly Monoclonal Antibodies – Anti-IL, Ant |
12/9/2022 |
| 33-22-70 |
Prior Authorization of Platelet Aggregation Inhibitors- Pharmacy Services |
12/8/2022 |
| 33-22-62 |
Prior Authorization of Hypoglycemics, SGLT2 Inhibitors – Pharmacy Services |
12/8/2022 |
| 33-22-68 |
Prior Authorization of Ophthalmics, Anti-Inflammatories – Pharmacy Services |
12/8/2022 |
| 33-22-69 |
Prior Authorization of Pituitary Suppressive Agents, LHRH – Pharmacy Services |
12/8/2022 |
| 33-22-65 |
Prior Authorization of Lipotropics, Other – Pharmacy Services |
12/7/2022 |
| 33-22-71 |
Prior Authorization of Stimulants and Related Agents– Pharmacy Services |
12/7/2022 |
| 26-22-07 |
2023 Ambulance Fee Increases |
11/10/2022 |
| 24-22-32 |
At-Home Over-The-Counter COVID-19 Test |
11/10/2022 |
| 33-22-54 |
Prior Authorization of Dry Eye Treatments (Formerly Ophthalmics, Immunomodulators) – Pharmacy Services |
11/10/2022 |
| 33-22-61 |
Prior Authorization of Hypoglycemics, Insulin and Related Agents – Pharmacy Services |
11/10/2022 |
| 33-22-63 |
Prior Authorization of Hypoglycemics, TZDs – Pharmacy Services |
11/10/2022 |
| 33-22-64 |
Prior Authorization of Immunomodulators, Atopic Dermatitis – Pharmacy Services |
11/10/2022 |
| 33-22-66 |
Prior Authorization of NSAIDs – Pharmacy Services |
11/10/2022 |
| 33-22-55 |
Prior Authorization of Dupixent (dupilumab) – Pharmacy Services |
11/9/2022 |
| 33-22-56 |
Prior Authorization of GI Motility, Chronic Agents – Pharmacy Services |
11/9/2022 |
| 33-22-58 |
Prior Authorization of Glucocorticoids, Oral – Pharmacy Services |
11/9/2022 |
| 33-22-57 |
Prior Authorization of Glucocorticoids, Inhaled – Pharmacy Services |
11/9/2022 |
| 33-22-59 |
Prior Authorization of Hepatitis C Agents – Pharmacy Services |
11/9/2022 |
| 33-22-46 |
Prior Authorization of Antihemophilia Agents – Pharmacy Services |
11/9/2022 |
| 33-22-37 |
Prior Authorization of Angiotensin Modulator Combinations – Pharmacy Services |
11/9/2022 |
| 31-22-39 |
Prior Authorization of Bile Salts – Pharmacy Services |
11/9/2022 |
| 33-22-53 |
Prior Authorization of Cytokine and CAM Antagonists – Pharmacy Services |
11/9/2022 |
| 33-22-44 |
Prior Authorization of Antibiotics, GI and Related Agents – Pharmacy Services |
11/8/2022 |
| 33-22-45 |
Prior Authorization of Antifibrotic Respiratory Agents (Formerly Idiopathic Pulmonary Fibrosis (IPF) Agents) – Pharmacy Services |
11/8/2022 |
| 99-22-05 |
2022 Healthcare Common Procedure Coding System (HCPCS) Updates and Other Procedure Code ChangePrior Authorization of Antivirals, CMV – Pharmacy Services |
11/8/2022 |
| 33-22-52 |
Prior Authorization of Corticotropin (formerly H.P. Acthar Gel) – Pharmacy Services |
11/8/2022 |
| 33-22-40 |
Prior Authorization of Acne Agents, Oral – Pharmacy Services |
11/4/2022 |
| 99-22-10 |
Enrollment of Providers for Medicare Cost-Sharing Only |
11/4/2022 |
| 33-22-48 |
Prior Authorization of Antipsoriatics, Topical - Pharmacy Services |
11/4/2022 |
| 33-22-43 |
Prior Authorization of Antianginal Agents - Pharmacy Services |
11/4/2022 |
| 33-22-41 |
Prior Authorization of Alcohol Use Disorder Agents - Pharmacy Services |
11/4/2022 |
| 33-22-16 |
SARS-CoV-2 Vaccine Booster Manufactured by Moderna Inc |
10/17/2022 |
| 33-22-37 |
Updates to Pediatric SARS-CoV-2 Vaccines Manufactured by Pfizer, Inc. and Moderna, Inc. |
9/28/2022 |
| 07-22-02 |
Additions to the Medical Assistance Fee Schedule for Private Duty Nursing Services Provided to Beneficiaries Under the Age |
9/26/2022 |
| 33-22-12 |
Vaccine Counseling Only Visits for Beneficiaries Under 21 |
9/20/2022 |
| 33-22-36 |
Administration of SARS-CoV-2 Vaccine Manufactured by Novavax |
9/19/2022 |
| 99-22-07 |
Pennsylvania’s Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program Periodicity Schedule |
9/19/2022 |
| 35-22-02 |
School-Based ACCESS Program Provider Handbook |
9/15/2022 |
| 33-22-39 |
Adult Vaccine Procedure Code Updates and Additions1 |
9/14/2022 |
| 33-22-37 |
Updates to Pediatric SARS-CoV-2 Vaccines |
9/8/2022 |
| 27-22-27 |
2022 Medical Assistance Program Dental Fee Schedule Update. |
9/7/2022 |
| 31-22-39 |
Addition of Behavioral Health Providers to Certain Procedure Codes and other Procedure Code Changes |
8/26/2022 |
| 99-22-05 |
2022 Healthcare Common Procedure Coding System (HCPCS) Updates and Other Procedure Code Change |
8/26/2022 |
| 33-22-13 |
Adult Vaccine Procedure Code Updates and Additions |
8/26/2022 |
| 33-22-04 |
SARS-CoV-2 (COVID-19) Oral Antiviral Treatments with emergency use authorization (EUA) from the U.S. Food and Drug Administ |
1/25/2022 |
| 33-22-02 |
Prior Authorization of Aduhelm (aducanumab) – Pharmacy Services |
1/12/2022 |
| 33-22-03 |
Prior Authorization of Xyrem (sodium oxybate) Xywav (calcium, magnesium, potassium, and sodium oxybates) Pharmacy Service |
1/11/2022 |
| 33-22-05 |
Billing Procedure Update for Certified Registered Nurse Practitioners and Physician Assistants |
1/7/2022 |
| 1/12/2026 |
Newborn Payment Policy for Acute Care General Hospital |
5/12/2012 |
| 99-10-14 |
Missed Appointments |
12/1/2010 |
