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PA Bulletin, Doc. No. 16-880


Proposed Rates for Expanded Services Added to the Adult Autism Waiver

[46 Pa.B. 2634]
[Saturday, May 21, 2016]

 The purpose of this notice is to announce the proposed rates for expanded services that will be funded through the Department of Human Services' (Department) Adult Autism Waiver, effective July 1, 2016.


 As part of its renewal of the Adult Autism Waiver, the Department has proposed that several expanded services be added to the Adult Autism Waiver. The Department has set rates for these services in accordance with the approved methodology in Appendix I of the Adult Autism Waiver. The Department will use the proposed payment rates to process claims submitted to the Provider Reimbursement and Operations Management Information System (PROMISe) in electronic format for services provided until a notice announcing final rates is published. A notice will be published announcing the final rates after the renewal of the Adult Autism Waiver is approved by the Centers for Medicare and Medicaid Services and funds have been appropriated by the General Assembly for Fiscal Year (FY) 2016-2017.

Fee Schedule Rates

 The following procedure codes, modifiers, provider types, specialty codes, unit and fees for Adult Autism Waiver services are being added to the Medical Assistance Program Fee Schedule:

Service Procedure
Unit Rate
Systematic Skill Building,  Plan Development W7214 51 510 Unit $491.76
Systematic Skill Building,  Ongoing Support W7215 51 510 15 min. $15.37
Systematic Skill Building,  Consultation W7216 51 510 15 min. $15.37
 Residential Habilitation,   Family Living Home,    Medium W7054 52 522 Day $117.44
  Community Support
  1 staff:2 participants
W7204 51 510 15 min. $5.00
  Community Support
  1 staff:3 participants
W7205 51 510 15 min. $3.33
Supported Employment,  Intensive Job Coaching,  Direct W7206 53 531 15 min. $10.95
Supported Employment,  Intensive Job Coaching,  Indirect W7207 53 531 15 min. $10.95
Supported Employment,  Extended Employment  Supports, Indirect W7202 53 531 15 min. $10.95

Fiscal Impact

 There is no change in estimated costs for FY 2016-2017 as a result of the proposed renewal of the Adult Autism Waiver.

Public Comment

 The Department has made the proposed rates for the expanded services added to the Adult Autism Waiver available at

 Copies of this notice can also be obtained by contacting the Bureau of Autism Services at the following address or e-mail.

 Interested persons are invited to submit written comments regarding this notice. Comments should be addressed to Lea Sheffield, Department of Human Services, Bureau of Autism Services, Office of Developmental Programs, 625 Forster Street, Room 605, Harrisburg, PA 17120. Comments may also be submitted to the Department at Comments must be submitted within 30 calendar days of the date of this notice.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).


Fiscal Note: 14-NOT-1017. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 16-880. Filed for public inspection May 20, 2016, 9:00 a.m.]

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