The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Pennsylvania other services schedule has 62 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
$29/mo after the trial. Cancel anytime.
Published codes
62
Other Services procedures on the 2025 schedule
Median % of Medicare
77.2%
vs national Medicare, GPCI-neutral
Effective vintage
2025
latest effective year on the schedule
Common other services procedures and what Pennsylvania Medicaid pays
A curated sample of recognizable procedures from the 62-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 |
|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | $57.00* | -- |
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 vision fee schedule · 40 codes
- Pennsylvania behavioral health fee schedule · 26 codes
- Pennsylvania hearing fee schedule · 24 codes
Other Services rates in neighboring states
Frequently asked questions
What does Pennsylvania Medicaid pay for other covered services?
Pennsylvania Medicaid publishes 62 other services procedure rates effective 2025, paying a median 77.2% of the national Medicare amount for the same services. The schedule covers clinic encounters, screenings, and state-specific service 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 other services rates compare with Medicare?
Across other services codes with a national Medicare comparator, Pennsylvania Medicaid pays a median 77.2% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.
Do other services 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 2025), 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.