# Pennsylvania Medicaid OB modifiers



## astough (Aug 10, 2011)

Good Morning!  I am hoping to get some help with PA Medicaid modifiers for OB patients.  Can someone please tell me what modifiers I need to use for Gateway, Amerihealth Mercy, United Health Care Community Plan and plain old Medicaid for routine prenatal visits and also for the deliveries.  I seem to get alot of rejections because of these "invalid modifiers" and I can't get a straight answer from my reps!!  Please help!


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## maggiekocher (Sep 19, 2011)

*modifiers*

Medicaid always has exceptions to all of their rules.  When billing prenatal office visits - use the TH modifier for MA, the U9 modifier for Gateway.  UHC does not like any modifiers and will deny a claim if you use a TH on a prenatal visit. We are not par with Aetna Better Health but have submitted as nonpar and have used the TH modifier.  If the Medicaid patient has HCB15 - select plan for women - you need to use the FP modifier or they will reject your gyn visits.  Hope this info helps.


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