Pennsylvania Medicaid Program Overview
Enrollment, funding, and managed care facts for Pennsylvania Medicaid.
Get Pennsylvania's Medicaid Fee Schedule →Enrollment
Pennsylvania Medicaid covered approximately 2.96-2.97M people. Two independent sources give very close total Pennsylvania Medicaid/CHIP enrollment figures: KFF's state indicator (2,963,790, May 2026) and CMS's 2024 Medicaid Managed Care Enrollment and Program Characteristics report (2,967,715 total Medicaid enrollees, ~2024 data). A third source, healthinsurance.org, cites 3,012,566 (October 2025).
Funding & federal match
Pennsylvania has adopted ACA Medicaid expansion, effective 2015-01-01.
For FFY2026 (Oct 1, 2025 - Sep 30, 2026), Pennsylvania's Federal Medical Assistance Percentage (FMAP) is 56.06%.
Delivery system & managed care
A large share of Pennsylvania Medicaid is delivered through managed care organizations (MCOs) rather than fee-for-service — estimates range from 92.55-93.1% of Medicaid enrollees.
Frequently Asked Questions
Get Pennsylvania's Free Medicaid Fee Schedule
Request actual Pennsylvania Medicaid reimbursement rates by billing code — free, delivered as a CSV.
Sources
- KFF State Health Facts - Total Monthly Medicaid & CHIP Enrollment
- CMS - Medicaid Managed Care Enrollment and Program Characteristics, 2024
- Federal Register / GPO - Federal Financial Participation in State Assistance Expenditures, FFY2026 FMAP Notice (2024-27910)
- KFF State Health Facts - Federal Matching Rate (FMAP) for Medicaid
- KFF - Status of State Medicaid Expansion Decisions
- healthinsurance.org - Medicaid eligibility and enrollment in Pennsylvania
- MACPAC - MACStats Medicaid and CHIP Data Book, Exhibit 29 (Percentage of Medicaid Enrollees in Managed Care by State, July 1, 2022)
Data last verified 2026-09-17. Also see our free Medicaid Fee Schedule tool.