SB 537 Pennsylvania Senate · 2025-2026 Regular Session

An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, providing for medical assistance payments for orthotics and prosthetics.

SB 537 would require Pennsylvania's Medicaid program to reimburse providers for custom orthotics (like braces) and prosthetics (like artificial limbs) at rates no lower than the current Medicare fee schedule. This change directly affects Medicaid recipients needing these medical devices and the healthcare providers who supply them. The bill mandates that the state update its reimbursement rates quarterly to match Medicare's current rates for all applicable codes. This policy aligns Pennsylvania's Medicaid payments more closely with federal Medicare standards for these specific medical equipment items.
Bill status in committee 1 of 4 stages cleared
Introduction
Apr 2025
Committee Review
Floor Vote
Governor
Introduced Apr 4, 2025 Last action Apr 4, 2025