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Billing and Claims FAQ - Department of Human Services

    https://www.dhs.pa.gov/providers/FAQs/Pages/Billing-and-Claims-FAQ.aspx
    Payment for medical supplies and equipment is made only to pharmacies and medical suppliers participating in the Medical Assistance program. Physicians must bill drug claims using the electronic 837 Professional Drug transaction if using proprietary or third party …

Billing Information - Department of Human Services

    https://www.dhs.pa.gov/providers/Providers/Pages/Billing-Information.aspx
    Department of Human Services > For Providers > Providers > Billing Information. Billing Information. Beginning July 2019, claims may deny due to common billing issues. Please …

Medical Assistance for Providers - Department of Human …

    https://www.dhs.pa.gov/providers/Providers/Pages/Medical-Assistance-for-Providers.aspx
    Medical Assistance. Welcome to the section of the DHS Web site containing information on how to conduct business with the Office of Medical Assistance Programs (OMAP). 1099 …

Medical Assistance - Department of Human Services

    https://www.dhs.pa.gov/Services/Assistance/Pages/Medical-Assistance.aspx
    Medical Assistance. Medical Assistance (MA), also known as Medicaid, pays for health care services for eligible individuals. How to Apply. There are different ways to apply for MA. Please choose the option that suits you …

MA Fee Schedule - Department of Human Services

    https://www.dhs.pa.gov/providers/Providers/Pages/Health%20Care%20for%20Providers/MA-Fee-Schedule.aspx
    MA Fee Schedules. Search the Outpatient and Dental Fee Schedule Database; Downloadable MA Program Outpatient Fee schedule - The PROMISe™ Outpatient Fee …

Medical Assistance Regulations - Department of Human …

    https://www.dhs.pa.gov/docs/For-Providers/Pages/Medical-Assistance-Regulations.aspx
    You can find Medical Assistance regulations in the Pennsylvania Code. Visit the links below for specific regulations. County Nursing Facility Services (Chapter 1189) Opens In …

Downloadable Medical Assistance Provider Forms

    https://www.dhs.pa.gov/docs/Publications/Pages/Medical-Assistance-Provider-Forms.aspx
    The Office of Medical Assistance Programs (OMAP) produces and distributes over 70 forms and envelopes for provider use at no charge to the provider. There may be a limit …

MA General Eligibility - Department of Human Services

    https://www.dhs.pa.gov/Services/Assistance/Pages/MA-General-Eligibility.aspx
    Medical Assistance eligibility is grouped by: Modified Adjusted Gross Income (MAGI) Children aged 18 and under. Pregnant women. Parents and caretakers of children under …

Medicaid – Pennsylvania Society of Physician Assistants

    https://pspa.net/resources/reimbursement/medicaid/
    Physician Assistants (PAs) who order, refer, or prescribe items or services to Pennsylvania Medical Assistance (MA) beneficiaries need to enroll as participating providers in the …

Reimbursement – Pennsylvania Society of Physician Assistants

    https://pspa.net/resources/reimbursement/medicare/
    Medicare rules require that services provided by physician assistants (PAs) be reimbursed at 85 percent of the physician fee schedule unless in specific billing exceptions (“incident …



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