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United Way of Lancaster County


Pa. expands categories of ‘street medicine’ eligible for Medicaid reimbursement

Lancaster EMS staffs and operates the Refresh Lancaster mobile unit, providing access to basic medical care as well as hygiene services. The trailer is seen here in the parking lot of Union Community Care’s downtown Lancaster location. (Source: One United Lancaster file photo)

Pennsylvania is expanding the types of practitioners who can bill Medicaid for “street medicine,” Human Services Secretary Dr. Val Arkoosh announced Friday.

Effective Oct. 1, the following providers are now eligible, Arkoosh said:

  • Centers of Excellence for opioid use disorders
  • Dentists
  • Family based mental health services
  • Federally qualified health centers
  • Intensive behavioral health services
  • Mental health crisis intervention
  • Mental health targeted case management
  • Peer support services
  • Podiatrists
  • Rural health clinics
  • Substance use disorder services
  • Tobacco cessation providers 

“All Pennsylvanians deserve access to high quality, compassionate health care that meets them where they are to provide support as they work through barriers to good health and a better quality of life,” said Arkoosh said.

Pennsylvania Human Services Secretary Dr. Val Arkoosh, foreground, discusses street medicine with staff at Project HOME in Philadelphia on Friday, Oct. 20, 2023. (Source:

“Street medicine” refers to care provided outside a clinical setting such as a hospital or doctor’s office. Advocates say providing care to homeless individuals in their everyday context lowers barriers, improves outcomes and reduces the burden on emergency rooms.

The Department of Human Services initially announced in July that it would allow Medicaid billing for certain street medicine services. It listed the following categories of provider:

  • Certified nurse midwives
  • Certified registered nurse practitioners
  • Physicians
  • Physician assistants
  • Psychologists
  • Mobile mental health treatment providers

At the time, local providers said the DHS’ policy change had the potential to allow for expanded services here.

There are several street medicine initiatives in Lancaster County, including care provided in conjunction with the hygiene services offered by the Refresh Lancaster mobile shower trailer, a partnership between the Lancaster County Homelessness Coalition and Lancaster EMS.

The trailer’s operations are always being evaluated, and additional funding availability could certainly lead to more deployments, Lancaster EMS Executive Director Bob May said Friday.

Arkoosh made Friday’s announcement during a visit to Project HOME in Philadelphia, an anti-poverty nonprofit that operates a street medicine program.