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Services
Services
Assistance
Children
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Mental Health in PA
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Publications
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About
About
DHS Online Services
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Regulations Handbooks Guides and Manuals
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Regulations, Handbooks, Guides and Manuals
If you are having difficulty finding the information you need, please contact DHS.
CMS-1500 Reference Guide for PROMISe
™ (PDF download)
Contact Information/Help for Medical Assistance Providers
Copayment Desk Reference Rev 6/17
DRG Relative Value Tables (Acute Care - Inpatient)
APR DRG v39 (Dates of Discharge on or after 10/1/21)
APR DRG v38 (Dates of Discharge on or after 10/1/20
)
APR DRG v37 (Dates of Discharge on or after 10/1/19
)
APR DRG v36 (Dates of Discharge on or after 10/1/18)
APR DRG v35 (Dates of Discharge on or after 10/1/17)
APR DRG v34 (Dates of Discharge on or after 10/1/16)
APR DRG v33 (Dates of Discharge on or after 10/1/15)
APR DRG v31 (Dates of Discharge on or after 7/1/15)
APR DRG v27 (Dates of Discharge 7/1/10 - 6/30/15)
DRG v23 (Dates of Discharge 10/1/05 - 6/30/10)
Early Learning Resource Center (ELRC) Audit Guidelines for Fiscal Year 2020-2021
Early Learning Resource Center (ELRC) Audit Guidelines for Fiscal Year 2021-2022
EPSDT Program Periodicity Schedule and Coding Matrix, Effective September 19, 2022
EPSDT - 2008 Age Range Requirements for Screening Visits Desk Guide, Effective September 1, 2008
(PDF download)
EPSDT Immunization Guidelines (MAB 99-22-03 PDF download)
Fraud and Abuse Information and Prevention
Frequently Asked Questions
(MA Providers)
Disproportionate Share Hospital (DSH) Upper Payment Limit (UPL) Information
FY2019-2020 Frequently Asked Questions Related to CMS Disproportionate Share Hospital Report and Audit
FY2018-2019 Frequently Asked Questions Related to CMS Disproportionate Share Hospital Report and Audit
FY2017-2018 Frequently Asked Questions Related to CMS Disproportionate Share Hospital Report and Audit
FY2016-2017 Frequently Asked Questions Related to CMS Disproportionate Share Hospital Report and Audit
FY2015-2016 Frequently Asked Questions Related to CMS Disproportionate Share Hospital Report and Audit
FY2014-2015 Frequently Asked Questions Related to CMS Disproportionate Share Hospital Report and Audit
FY2013-2014 Frequently Asked Questions Related to CMS Disproportionate Share Hospital Report and Audit
FY2012-2013 Frequently Asked Questions Related to CMS Disproportionate Share Hospital Report and Audit
FY2011-2012 Frequently Asked Questions Related to CMS Disproportionate Share Hospital Report and Audit
DSH UPL Training Document – May 2015
Cost Center and Revenue Code Groupings (FY 2013-14 through 2017-18)
Cost Center Groupings for Retrospective DSH Limit Report
Revenue Code Groupings for Retrospective DSH Limit Report
Healthcare Benefits Packages Reference Chart
(MA 446; PDF download)
HIPAA Privacy Information
Introduction to DHS Audit Policy
Medical Assistance Eligibility Handbook
Medical Assistance Forms
Medical Assistance Regulations
PROMISe™ Provider Handbooks and Billing Guide
Single Audit Supplement - 2019
Single Audit Supplement - 2020-2021