340B | Department of Human Services | Commonwealth of Pennsylvania
Source: https://www.pa.gov/agencies/dhs/resources/pharmacy-services/340b
Archived: 2026-04-23 17:39
340B | Department of Human Services | Commonwealth of Pennsylvania
Pharmacy Services
Information for 340B-Covered Entities
The following Medical Assistance (MA) Bulletin applies to 340B covered entities that bill the MA Fee-for-Service (FFS) program and/or a MA Program managed care organization (MCO) for drugs purchased under the 340B Drug Pricing Program and dispensed to MA program beneficiaries:
MAB 99-13-08: 340B Drug Pricing Program Provider Requirements and Billing Instructions
The following MA Bulletins apply to 340B covered entities that bill the MA FFS program for 340B purchased drugs:
MAB 99-17-09: Payment for Covered Outpatient Drugs
MAB 24-18-21: Professional Dispensing Fee
2026 Pennsylvania Medical Assistance BIN/PCN/Group Numbers
FFS/MCO
BIN
PCN
Group Number
Fee-For-Service
600760
N/A
N/A
AmeriHealth Caritas Pennsylvania
019595
01940000
N/A
AmeriHealth Community Health Choices
019595
07630000
N/A
Geisinger Health Plan (Effective 1/1/2024)
026010
MCDG
N/A
Health Partners of Philadelphia
004336
MCAIDADV
RX3892
Highmark Wholecare (Medicaid Primary)
004336
MCAIDADV
RX2338
Highmark Wholecare (Medicaid Secondary to Medicare)
012114
MCAIDADV
RX2338
Highmark Wholecare (Medicaid Secondary to Commercial Insurance)
013089
MCAIDADV
RX2338
Keystone First Community Health Choices
019595
07630000
N/A
Keystone First
019595
01940000
N/A
Pennsylvania Health & Wellness (Effective 1/1/2024)
003858
MA
2FBA
United Healthcare Community Plan
610494
4200
ACUPA
UPMC for You
003858
A4
PMDM
Last Updated: December 15, 2025
Pharmacy Services
Information for 340B-Covered Entities
The following Medical Assistance (MA) Bulletin applies to 340B covered entities that bill the MA Fee-for-Service (FFS) program and/or a MA Program managed care organization (MCO) for drugs purchased under the 340B Drug Pricing Program and dispensed to MA program beneficiaries:
MAB 99-13-08: 340B Drug Pricing Program Provider Requirements and Billing Instructions
The following MA Bulletins apply to 340B covered entities that bill the MA FFS program for 340B purchased drugs:
MAB 99-17-09: Payment for Covered Outpatient Drugs
MAB 24-18-21: Professional Dispensing Fee
2026 Pennsylvania Medical Assistance BIN/PCN/Group Numbers
FFS/MCO
BIN
PCN
Group Number
Fee-For-Service
600760
N/A
N/A
AmeriHealth Caritas Pennsylvania
019595
01940000
N/A
AmeriHealth Community Health Choices
019595
07630000
N/A
Geisinger Health Plan (Effective 1/1/2024)
026010
MCDG
N/A
Health Partners of Philadelphia
004336
MCAIDADV
RX3892
Highmark Wholecare (Medicaid Primary)
004336
MCAIDADV
RX2338
Highmark Wholecare (Medicaid Secondary to Medicare)
012114
MCAIDADV
RX2338
Highmark Wholecare (Medicaid Secondary to Commercial Insurance)
013089
MCAIDADV
RX2338
Keystone First Community Health Choices
019595
07630000
N/A
Keystone First
019595
01940000
N/A
Pennsylvania Health & Wellness (Effective 1/1/2024)
003858
MA
2FBA
United Healthcare Community Plan
610494
4200
ACUPA
UPMC for You
003858
A4
PMDM
Last Updated: December 15, 2025