New implementation date for Skilled Nursing and Personal Care Shift Services & MA & MP.PA.050.1

Jul. 2023Important Notices
We previously communicated in the July Provider Partner Update that effective Aug. 1, 2023, per Pennsylvania DHS, HCPCS T1019 will be discontinued and replaced with the following HCPCS codes and modifiers:
  • G0156 with modifier U7 for pediatric aide services by a non-legally responsible relative
  • G0156 with modifiers U7/SC for pediatric aide services by a legally responsible relative
  • G0156 U7 TT – Services of home health/hospice aide in home health or hospice settings, each 15 minutes (services by a non-legally responsible relative) – extra patient
  • G0156 U7 SC TT – Services of home health/hospice aide in home health or hospice settings, each 15 minutes (services by a legally responsible relative) – extra patient

Please be aware that due to an additional and more recent communication from PA DHS, the implementation date was changed to Oct. 1, 2023 (previously communicated in the July PPU as Aug. 1, 2023).

Recent Announcements

Voluntary nationwide recall: Atorvastatin (Alkem – October)

Ascend Laboratories LLC is recalling multiple lots of Atorvastatin Calcium Tablets USP. Atorvastatin is used for the treatment of high cholesterol and to reduce the risk of certain cardiovascular events, such as heart attack and stroke.
Nov. 2025Pharmacy Updates

October 2025 UPMC for You and UPMC Community HealthChoices formulary update

Effective Oct. 1, 2025, Xifaxan and Retin-A (cream, gel) will no longer be covered by UPMC for You and UPMC Community HealthChoices due to nonparticipation in the Medicaid Drug Rebate Program.
Oct. 2025Pharmacy Updates

Voluntary nationwide recall: Ocaliva (Intercept – September)

Intercept Pharmaceuticals, Inc. is voluntarily withdrawing Ocaliva® (obeticholic acid) from the market. Ocaliva is used to treat a rare liver disease called primary biliary cholangitis (PBC).
Oct. 2025Pharmacy Updates