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PA Bulletin, Doc. No. 24-163

NOTICES

DEPARTMENT OF HUMAN SERVICES

Medical Assistance Program Fee Schedule: Procedure Code Additions and Deletions for Pharmacist Services

[54 Pa.B. 699]
[Saturday, February 10, 2024]

 In accordance with 55 Pa. Code § 1150.61(a) (relating to guidelines for fee schedule changes), the Department of Human Services (Department) announces the addition and end-dating of the following procedure codes to and from the Medical Assistance (MA) Program Fee Schedule for pharmacist services. These changes are effective for dates of service on and after March 1, 2024.

 The Department is adding the following procedure codes for pharmacists.

Procedure
Code		National Code DescriptionMA Fee
99408Alcohol or substance (other than tobacco), or both abuse structured screening (for example, AUDIT, DAST), and brief intervention (SBI) services; 15 to 30 minutes$24.93
99605Medication therapy management services provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial
15 minutes, new patient		$44.80
99606Medication therapy management services provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial
15 minutes, established patient		$29.18
99607Medication therapy management services provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; each additional 15 minutes (List separately in addition to code for primary service)$27.96

 The Department is end-dating the following procedure codes for pharmacists. Pharmacists should refer to the MA Program Fee Schedule for the appropriate vaccine administration procedure codes.

Procedure
Code		National Code Description
90471Immunization administration (includes percutaneous, intradermal, subcutaneous or intramuscular injections); one vaccine (single or combination vaccine/toxoid)
90472Immunization administration (includes percutaneous, intradermal, subcutaneous or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition
to code for primary procedure)

 The Department has issued an MA Bulletin advising providers of the new Current Procedural Terminology code additions to the MA Program Fee Schedule.

Fiscal Impact

 There is minimal fiscal impact associated with the addition and deletion of these procedure codes.

Public Comment

 Interested persons are invited to submit written comments regarding these procedure code additions and deletions to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, P.O. Box 2675, Harrisburg, PA 17120 or at RA-PWMAProgComments@pa.gov. Comments received within 30 days will be reviewed and considered for any subsequent revision to the MA Program Fee Schedule.

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

VALERIE A. ARKOOSH, 
Secretary

 Fiscal Note: 14-NOT-1608. No fiscal impact; recommends adoption.

[Pa.B. Doc. No. 24-163. Filed for public inspection February 9, 2024, 9:00 a.m.]


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