NOTICES

DEPARTMENT OF PUBLIC WELFARE

Medical Assistance Program Fee Schedule Revisions; 1997 HCPCS Updates

[27 Pa.B. 2201]

   By this notice, the Department of Public Welfare announces effective January 1, 1997 that changes have been made to the Medical Assistance Program Fee Schedule as a result of implementing the 1997 updates to the Health Care Financing Administration Common Procedure Coding System (HCPCS). The Federally required updates add new procedure codes which are compensable beginning January 1, 1997. The procedure codes being deleted from the fee schedule as a result of those updates will not be compensable for services provided after March 31, 1997.

Changes to the Medical Assistance Program Fee Schedule Effective May 1, 1997
for Provider Types 05, 19 and 23

FEE CHANGES:

Type of Service	Procedure Code	Description	MA Fee	Change
9R	E0570	Nebulizer with Compressor	$72.82	$18.82
9R	E0651	Pneumatic Compressor Segmental Home Model Without Calibrated Gradient Pressure	$70.68	$70.69
9R	K0005	Ultralight Wheelchair	$162.47	$162.48

Additions Effective January 1, 1997

TOS	Procedure Code	Fee	TOS	Procedure Code	Fee
AE, 55	A6196	6.62	AE, 55	A6224	3.25
AE, 55	A6197	14.81	AE, 55	A6228	2.51
AE, 55	A6198	19.42	AE, 55	A6229	3.25
AE, 55	A6199	4.76	AE, 55	A6234	5.89
AE, 55	A6203	3.01	AE, 55	A6235	15.16
AE, 55	A6204	5.61	AE, 55	A6236	24.54
AE, 55	A6205	4.68	AE, 55	A6237	7.12
AE, 55	A6206	.99	AE, 55	A6238	20.53
AE, 55	A6207	6.61	AE, 55	A6239	18.70
AE, 55	A6209	6.75	AE, 55	A6240	11.03
AE, 55	A6210	17.94	AE, 55	A6241	2.31
AE, 55	A6211	26.46	AE, 55	A6242	5.47
AE, 55	A6212	8.74	AE, 55	A6243	11.10
AE, 55	A6213	11.60	AE, 55	A6244	35.38
AE, 55	A6214	9.27	AE, 55	A6245	6.54
AE, 55	A6216	.07	AE, 55	A6246	8.93
AE, 55	A6217	.39	AE, 55	A6247	21.42
AE, 55	A6218	.59	AE, 55	A6248	14.63
AE, 55	A6219	.86	AE, 55	A6251	1.80
AE, 55	A6220	2.32	AE, 55	A6252	2.93
AE, 55	A6221	3.63	AE, 55	A6253	5.72
AE, 55	A6222	1.91	AE, 55	A6254	1.07
AE, 55	A6223	2.17	AE, 55	A6255	2.73
AE, 55	A6256	1.53	AE, 55	A6402	.12
AE, 55	A6257	1.38	AE, 55	A6403	.40
AE, 55	A6258	3.87	AE, 55	A6405	.31
AE, 55	A6259	9.85	AE, 55	A6406	.74
AE, 55	A6266	1.73
9P	K0268	99.28
AE, 55	K0419	15.93	AE, 55	K0428	8.93
AE, 55	K0420	44.14	AE, 55	K0429	4.73
AE, 55	K0421	3.98	AE, 55	K0430	6.24
AE, 55	K0422	28.53	AE, 55	K0431	3.73
AE, 55	K0423	13.94	AE, 55	K0432	4.05
AE, 55	K0424	34.63	AE, 55	K0433	5.77
AE, 55	K0425	4.28	AE, 55	K0434	8.92
AE, 55	K0426	22.84	AE, 55	K0435	6.56
AE, 55	K0427	26.16	AE, 55	K0436	6.17
			AE, 55	K0437	8.51
AE, 55	L4390	107.39	AM, 55	L4396	114.15
AE, 55	K4392	16.01	AM, 55	L4398	52.55
AE, 55	K4394	11.68

End-dated March 31, 1997

TOS	Procedure Code	TOS	Procedure Code	TOS	Procedure Code
AE, 55	K0223	AE, 55	K0243	AE, 55	K0257
AE, 55	K0224	AE, 55	K0244	AE, 55	K0258
AE, 55	K0228	AE, 55	K0245	AE, 55	K0259
AE, 55	K0229	AE, 55	K0246	AE, 55	K0266
AE, 55	K0234	AE, 55	K0247	AE, 55	K0275
AE, 55	K0235	AE, 55	K0248	AE, 55	K0276
AE, 55	K0236	AE, 55	K0249	AE	K0402
AE, 55	K0237	AE, 55	K0251	AE	K0403
AE, 55	K0238	AE, 55	K0252	AE	K0405
AE, 55	K0239	AE, 55	K0253	AE	K0406
AE, 55	K0240	AE, 55	K0254	AE, 55	L4200
AE, 55	K0241	AE, 55	K0255
AE, 55	K0242	AE, 55	K0256

Changes to the Medical Assistance Program Fee Schedule for Provider Types 01, 03, 04, 10, 11, 12, 15, 16, 17, 20, 30, 43, 49 and 50:

Additions Effective January 1, 1997

TOS	Procedure Code	Fee	TOS	Procedure Code	Fee
20	11010	340.00	20	24341	600.10
27	11010	776.00	27	24341	776.00
40	11010	136.00	40	24341	240.04
20	11011	405.24	20	26185	376.74
27	11011	776.00	27	26185	776.00
40	11011	162.10	40	26185	150.70
20	11012	563.23	10	26546	139.26
27	11012	776.00	20	26546	696.31
40	11012	225.29	27	26546	776.00
20	11720	20.00	40	26546	278.52
20	11721	20.00
10	15756	200.00	10	26551	200.00
20	15756	1000.00	20	26551	1000.00
27	15756	776.00	27	26551	776.00
40	15756	400.00	40	26551	400.00
10	15757	200.00	10	26553	200.00
20	15757	1000.00	20	26553	1000.00
27	15757	776.00	27	26553	776.00
40	15757	400.00	40	26553	400.00
10	15758	200.00	10	26554	200.00
20	15758	1000.00	20	26554	1000.00
27	15758	776.00	27	26554	776.00
40	15758	400.00	40	26554	400.00
10	20150	200.00	10	26556	200.00
20	20150	1000.00	20	26556	1000.00
27	20150	776.00	27	26556	776.00
40	20150	400.00	40	26556	400.00
10	20956	200.00	20	27036	982.42
20	20956	1000.00	27	27036	776.00
27	20956	776.00	40	27036	392.97
40	20956	400.00	20	49021	474.45
10	20957	200.00	27	49021	776.00
20	20957	1000.00	40	49021	189.78
27	20957	776.00	20	52301	364.49
40	20957	400.00	27	52301	776.00
10	24149	200.00	40	52301	145.80
20	24149	1000.00	10	61586	200.00
27	24149	776.00	20	61586	1000.00
40	24149	400.00	40	61586	400.00
10	24341	120.00
54	92978	245.12	80	93315	264.00
RD	92978	150.13	AZ	93316	126.81
57	92978	94.99	AY	93317	137.19
20	G0051	39.04	54	G0062	24.94
20	G0052	12.51	RD	G0062	35.35
20	G0053	214.86	57	G0062	10.91
54	G0063	115.96
RD	G0063	101.81
57	G0063	14.15

End-dated March 31, 1997

TOS	Procedure Code	TOS	Procedure Code
86	Q0116	20, 27, 40	68800
20	11700	20, 27, 40	68820
20	11701	20, 27, 40	68825
10, 20, 27, 40	15755	20, 27, 40	68830
10, 20, 40	20960	80	93201
10, 20, 40	20971	80	93202
10, 20, 27, 40	25330	80	93204
10, 20, 40	25331	80	93205
10, 20, 40	26552	AY	93208
10, 20, 40	26557	AZ	93209
10, 20, 40	26558	80	93220
10, 20, 40	26559	AY	93221
10, 20, 27, 40	42880	AZ	93222
20, 40	53640	80, AY, AZ	94160
10, 20, 27, 40	56360	60, PT	97500
10, 25, 27, 40	56361	60, ED, RT	97501
		60, ED, RT	97521

   The fiscal note was prepared under provision of section 612 of The Administrative Code of 1929 (71 P. S. § 232).

   Price changes made to the Medical Assistance Fee Schedule are routinely included in carryforward budget estimates.

Contact Person

   Interested persons are invited to submit written comments to this notice within 30 days of this publication. Comments should be sent to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120.

   Persons with a disability may use the AT&T Relay Service by calling (800) 654-5984 (TDD users) or (800) 654-5988 (Voice users). Persons who require another alternative format should contact Thomas Vracarich at (717) 783-2209.

FEATHER O. HOUSTOUN,   
Secretary

   Fiscal Note: 14-NOT-143. No fiscal impact; (8) recommends adoption. Price changes to the Medical Assistance Fee Schedule are included in the Medical Assistance--Outpatient appropriations in the General Appropriations Act and the Governor's Budget.

[Pa.B. Doc. No. 97-693. Filed for public inspection May 2, 1997, 9:00 a.m.]

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