Medical Assistance Bulletins

Medical Assistance Bulletins
Number	Publication Name	Issue Date
33-22-05	Billing Procedure Update for Certified Registered Nurse Practitioners and Physician Assistants	1/7/2022
33-22-03	Prior Authorization of Xyrem (sodium oxybate) Xywav (calcium, magnesium, potassium, and sodium oxybates) Pharmacy Service	1/11/2022
33-22-02	Prior Authorization of Aduhelm (aducanumab) – Pharmacy Services	1/12/2022
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
01-22-39	Updates to Pediatric SARS-CoV-2 Vaccines Manufactured by Pfizer, Inc. and Moderna, Inc.	09/28/22
01-22-39	Updates to Pediatric SARS-CoV-2 Vaccines	09/8/22
08-22-44	Addition of Behavioral Health Providers to Certain Procedure Codes and other Procedure Code Changes	08/26/22
99-22-05	2022 Healthcare Common Procedure Coding System (HCPCS) Updates and Other Procedure Code Change	08/26/22
01-22-15	Adult Vaccine Procedure Code Updates and Additions	08/26/22
27-22-27	2022 Medical Assistance Program Dental Fee Schedule Update.	9/7/2022
*01-22-42	Adult Vaccine Procedure Code Updates and Additions1	9/14/2022
35-22-02	School-Based ACCESS Program Provider Handbook	9/15/2022
1/22/1938	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
1/22/2014	Vaccine Counseling Only Visits for Beneficiaries Under 21	9/20/22
1/22/2012	COVID-19 Vaccine Counseling Only Visits for Beneficiaries Under 21	9/23/2022
5/22/2008	Additions to the Medical Assistance Fee Schedule for Private Duty Nursing Services Provided to Beneficiaries Under the Age	9/26/2022
1/22/1939	Updates to Pediatric SARS CoV2 Vaccines Manufactured by Pfizer Inc and Moderna Inc	9/28/2022
1/22/2018	SARS-CoV-2 Vaccine Booster Manufactured by Moderna Inc	10/17/2022
1/22/1943	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
1/22/1951	Prior Authorization of Antipsoriatics, Topical - Pharmacy Services	11/4/2022
1/22/1946	Prior Authorization of Antianginal Agents - Pharmacy Services	11/4/2022
1/22/1944	Prior Authorization of Alcohol Use Disorder Agents - Pharmacy Services	11/4/2022
1/22/1947	Prior Authorization of Antibiotics, GI and Related Agents – Pharmacy Services	11/8/2022
1/22/1948	Prior Authorization of Antifibrotic Respiratory Agents (Formerly Idiopathic Pulmonary Fibrosis (IPF) Agents) – Pharmacy Services	11/8/2022
1/22/1948	Prior Authorization of Antifibrotic Respiratory Agents (Formerly Idiopathic Pulmonary Fibrosis (IPF) Agents) – Pharmacy Ser	11/8/2022
1/22/1952	Prior Authorization of Antipsychotics – Pharmacy Services	11/8/2022
1/22/1953	2022 Healthcare Common Procedure Coding System (HCPCS) Updates and Other Procedure Code ChangePrior Authorization of Antivirals, CMV – Pharmacy Services	11/8/2022
1/22/1955	Prior Authorization of Corticotropin (formerly H.P. Acthar Gel) – Pharmacy Services	11/8/2022
1/22/1958	Prior Authorization of Dupixent (dupilumab) – Pharmacy Services	11/9/2022
1/22/1959	Prior Authorization of GI Motility, Chronic Agents – Pharmacy Services	11/9/2022
1/22/1961	Prior Authorization of Glucocorticoids, Oral – Pharmacy Services	11/9/2022
1/22/1960	Prior Authorization of Glucocorticoids, Inhaled – Pharmacy Services	11/9/2022
1/22/1962	Prior Authorization of Hepatitis C Agents – Pharmacy Services	11/9/2022
1/22/1949	Prior Authorization of Antihemophilia Agents – Pharmacy Services	11/9/2022
1/22/1945	Prior Authorization of Angiotensin Modulator Combinations – Pharmacy Services	11/9/2022
1/22/1954	Prior Authorization of Bile Salts – Pharmacy Services	11/9/2022
1/22/1956	Prior Authorization of Cytokine and CAM Antagonists – Pharmacy Services	11/9/2022
26-22-07	2023 Ambulance Fee Increases	11/10/2022
24-22-32	At-Home Over-The-Counter COVID-19 Test	11/10/2022
1/22/1957	Prior Authorization of Dry Eye Treatments (Formerly Ophthalmics, Immunomodulators) – Pharmacy Services	11/10/2022
1/22/1964	Prior Authorization of Hypoglycemics, Insulin and Related Agents – Pharmacy Services	11/10/2022
1/22/1966	Prior Authorization of Hypoglycemics, TZDs – Pharmacy Services	11/10/2022
1/22/1967	Prior Authorization of Immunomodulators, Atopic Dermatitis – Pharmacy Services	11/10/2022
1/22/1969	Prior Authorization of NSAIDs – Pharmacy Services	11/10/2022
1/22/1968	Prior Authorization of Lipotropics, Other – Pharmacy Services	12/7/2022
1/22/1974	Prior Authorization of Stimulants and Related Agents– Pharmacy Services	12/7/2022
1/22/1973	Prior Authorization of Platelet Aggregation Inhibitors- Pharmacy Services	12/8/2022
1/22/1965	Prior Authorization of Hypoglycemics, SGLT2 Inhibitors – Pharmacy Services	12/8/2022
1/22/1971	Prior Authorization of Ophthalmics, Anti-Inflammatories – Pharmacy Services	12/8/2022
1/22/1972	Prior Authorization of Pituitary Suppressive Agents, LHRH – Pharmacy Services	12/8/2022
1/22/1970	Coverage and Prior Authorization of Obesity Treatment Agents – Pharmacy Services	12/9/2022
1/22/1975	Statewide Preferred Drug List (PDL) Updates – Pharmacy Services	12/9/2022
1/22/1950	Prior Authorization of Monoclonal Antibodies – Anti- IL, Anti-IgE, Anti-TSLP (Formerly Monoclonal Antibodies – Anti-IL, Ant	12/9/2022
1/22/1963	Prior Authorization of Hypoglycemics, Incretin Mimetics, Enhancers – Pharmacy Services	12/13/2022
5/22/2014	Disposable Breast Milk Collection and Storage Bags and Breast Pump	12/13/2022
1/22/1978	340B Drug Pricing Program - Dispensing 340B Purchased Drugs	12/22/2022
99-22-11	Reinstatement of Provider Enrollment Requirements	12/29/2022

Prior DHS Medical Assistance Bulletins are available on the DHS website at:https://www.dhs.pa.gov/docs/For-Providers/Pages/Bulletin-Search.aspx

This information is issued on behalf of Highmark Wholecare, coverage by Gateway Health Plan, which is an independent licensee of the Blue Cross Blue Shield Association. Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central Pennsylvania, as well as, to Blue Cross Blue Shield members in 14 counties in western Pennsylvania. Highmark Wholecare serves Medicare Dual Special Needs plans (D-SNP) to Blue Shield members in 14 counties in northeastern Pennsylvania, 12 counties in central Pennsylvania, 5 counties in southeastern Pennsylvania, and to Blue Cross Blue Shield members in 27 counties in western Pennsylvania.