Providers
To our providers and their staff: Thank you for your dedication, bravery, and commitment to the care of our members during this difficult time.
Coronavirus (COVID-19)
Important information regarding COVID-19 vaccines
- MAB-01-21-51: Pediatric SARS-CoV-2 Vaccine Manufactured by Pfizer, Inc. (PDF)
- MAB-01-21-55: Administration of a Booster Dose of the SARS-CoV-2 Vaccines (PDF)
- Expansion of providers for the administration of SARS-CoV-2 vaccines and monoclonal antibody therapy (PDF)
- Administration and payment of SARS-CoV-2 vaccines for homebound members (PDF)
- MAB 01-21-04: SARS-CoV-2 Vaccine Administration for Beneficiaries Who Are Homebound (PDF)
- MAB 01-21-11: Expansion of Providers for the Administration of SARS-CoV-2 Vaccines and Monoclonal Antibody Therapy (PDF)
- COVID-19 vaccine reimbursement April update (PDF)
- MAB 01-21-03: Fee increase for the administration of SARS-CoV-2 vaccines (PDF)
- Updated CPT Codes for the Administration of SARS-CoV-2 Vaccines (PDF)
- Pennsylvania Department of Health COVID-19 Vaccination Information
Important information for providers regarding COVID-19
- Prior authorization waived for patient transfers (PDF)
- Prior authorization requirements reinstated for certain services (PDF)
- MAB 99-21-03: Reinstatement of Prior Authorization Requirements for Certain Services (PDF)
- Teledentistry billing update during COVID-19 (PDF)
- Reminder for dental providers: Providers may not charge members for Medicaid-covered services (PDF)
- COVID-19 care kit now available (PDF)
- Therapy telemedicine date extension (PDF)
- COVID-19 telemedicine update (PDF)
- DHS Quick Tip: Telemedicine guidelines related to COVID-19 (PDF)
- Keystone First to follow DHS Provider Quick Tips #241 and #243 during COVID-19 pandemic (PDF)
- DHS Quick Tip: Prior authorization changes for some services during COVID-19 emergency (PDF)
- DHS Quick Tip: Use of the CR modifier and DR condition code for COVID-19 related claims (PDF)
- DHS guidelines for DME prior authorization during COVID-19 outbreak (PDF)
- DHS guidelines for CT scans during COVID-19 pandemic (PDF)
- FCC telehealth funding notice (PDF)
- Therapy telemedicine April notice (PDF)
- Ranitidine recall and hydroxychloroquine limits (PDF)
- Telemedicine care for coronavirus (COVID-19) (PDF)
- LabCorp COVID-19 testing information and instructions
- CDC information and alerts
- Coronavirus (COVID-19) ICD-10-CM coding guidelines from CDC (PDF)
- Keystone First COVID-19 provider announcement (PDF)
- Coronavirus (COVID-19) Account Executive notice (PDF)
- FQHC IDS Provider Telemedicine March notice (PDF)
Looking for Keystone First Community HealthChoices (CHC)?
Latest updates
- 2022 medical provider claims filing instructions now available (PDF)
- Prior authorization submission tip sheet (PDF)
- Update to home accessibility durable medical equipment (DME) coverage and billing (PDF)
- March issue of our provider newsletter, Connections, now online (PDF)
- Update to Modifier 25 policy (PDF)
Let's improve health outcomes for members with diabetes.
Diabetes remains a leading cause of death in the United States, with total direct and indirect medical costs estimated at $245 billion, according to the American Diabetes Association (ADA). The ADA reports that an increased number of cases are reported every year.
Learn more about our diabetes programs
Healthy Families, Safe Communities - Keystone First Putting Safety First
We invite you to partner with Keystone First and join us in making a long-term commitment to being anti-violence advocates. We are launching Healthy Families, Safe Communities, an education campaign including materials and resources for both members and providers.
This program will address many issues, including gun safety, dating safety, and prescription medicine abuse.
Healthy Families, Safe Communities
Let Us Know
Learn about our program developed to assist your practice in engaging and managing the healthcare needs of chronically ill Keystone First members.
Contact us
Provider Services
1-800-521-6007
Email (for providers only)
Contact account executive (PDF)
Dental department territories (PDF)
If the provider directory is not available, please contact Provider Services at 1-800-521-6007.