The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Pennsylvania drugs schedule has 1 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
- Email alerts when a state changes its rates
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Published codes
1
Drugs procedures on the 2009 schedule
Median % of Medicare
--
no national Medicare comparator for this category
Effective vintage
2009
latest effective year on the schedule
Common drugs procedures and what Pennsylvania Medicaid pays
A curated sample of recognizable procedures from the 1-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.
| Code | Procedure | Pennsylvania rate | % of Medicare |
|---|
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * show the schedule's representative published variant.
More Pennsylvania Medicaid fee schedules
- Pennsylvania physician fee schedule · 4,676 codes
- Pennsylvania lab & imaging fee schedule · 1,500 codes
- Pennsylvania dme & supplies fee schedule · 1,408 codes
- Pennsylvania other services fee schedule · 62 codes
- Pennsylvania vision fee schedule · 40 codes
- Pennsylvania behavioral health fee schedule · 26 codes
Drugs rates in neighboring states
Frequently asked questions
What does Pennsylvania Medicaid pay for physician-administered drugs?
Pennsylvania Medicaid publishes 1 drugs procedure rates effective 2009 on its fee-for-service schedule. The schedule covers injectable and infused medications billed under HCPCS J-codes. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.
How do Pennsylvania's drugs rates compare with Medicare?
Most drugs codes in this category have no direct national Medicare comparator (Medicare prices these services through different mechanisms), so a median comparison is not published here.
Do drugs services need prior authorization in Pennsylvania?
Pennsylvania does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".
Where do these rates come from?
Directly from Pennsylvania's published Medicaid fee-for-service schedule (effective 2009), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.
Get an email the next time Pennsylvania changes these rates.