NOTICES
DEPARTMENT OF
PUBLIC WELFARE
Fee Increase for Selected Dental Services
[30 Pa.B. 6953] The Department of Public Welfare announces that the fees for the following selected dental services are increased, effective with dates of service on and after January 1, 2001.
The General Appropriations Act of 2000 provided funds for an increase in fees for adult dental services, but did not specify which services should be increased or the amount of increase for any service. After consulting with dental providers and the Pennsylvania Dental Association, the Department has determined which services should be targeted for fee increases and the rates at which the fees should be established, as follows:
Procedure Increased Fee
Code Description Current Fee Effective 1/1/2001
D0120 periodic oral evaluation $17 $20 D0150 comprehensive oral evaluation 15 20 D0210 intraoral--complete series 32 45 (including bitewings) D0220 intraoral--periapical--first film $7 $8 D0230 intraoral--periapical--each 7 8 additional film D0250 extraoral--first film 4 8 D0260 extraoral--each additional film 4 8 D0270 bitewing--single film 7 8 D0272 bitewings--two films 14 16 D0274 bitewings--four films 16 28 D0330 panoramic film 35 37 D1110 prophylaxis 30 34 D2131 amalgam--four or more 34 60 surfaces, primary D2161 amalgam--four or more 34 60 surfaces, permanent D2337 resin-based composite crown, 60 145 anterior--permanent D2380 resin-based composite--one 20 45 surface, posterior--primary D2381 resin-based composite--two 27 55 surfaces, posterior--primary D2382 resin-based composite--three 34 60 or more surfaces, posterior-- primary D2385 resin-based composite--one 20 45 surface, posterior--permanent D2386 resin-based composite--two 27 55 surfaces, posterior--permanent D2387 resin-based composite--three 34 60 or more surfaces, posterior-- permanent D2710 crown--resin, laboratory 90 150 D2721 crown--resin with predominantly 147 200 base metal D2751 crown--porcelain fused to 170 300 predominantly base metal D2791 crown--full cast predominantly 170 300 base metal D2910 recement inlay 5 25 D2920 recement crown 5 25 D2932 prefabricated resin crown 35 50 D2952 cast post and core in addition to 34 75 crown D2954 prefabricated post and core in 34 75 addition to crown D2980 crown repair 10 42 D3230 pupal therapy (resorbable filling)-- 73 150 anterior,primary tooth (excluding final restoration) D3310 anterior (excluding final restoration) 90 180 D3320 bicuspid (excluding final restoration) 130 225 D3330 molar (excluding final restoration) 175 270 D5110 complete upper 220 320 D5120 complete lower 220 320 D5130 immediate upper 220 320 D5140 immediate lower 220 320 D5211 maxillary partial denture--resin 80 200 base (including any conventional clasps, rests and teeth) D5212 mandibular partial denture--resin 80 200 base (including any conventional clasps, rests and teeth) D5213 maxillary partial denture--cast 220 330 metal framework with resin denture bases (including any conventional clasps, rests and teeth) D5214 mandibular partial denture--cast 220 330 metal framework with resin denture bases (including any conventional clasps, rests and teeth) D5410 adjust complete denture--maxillary $4 $20 D5411 adjust complete denture--mandibular 4 20 D5421 adjust partial denture--maxillary 4 20 D5422 adjust partial denture--mandibular 4 20 D5510 repair broken complete denture base 29 50 D5520 replace missing or broken teeth-- 29 45 complete denture (each tooth) D5610 repair resin denture base 29 50 D5620 repair cast framework 35 60 D5630 repair or replace broken clasp 35 60 D5640 replace broken teeth -- per tooth 29 45 D5650 add tooth to existing partial denture 29 50 D5660 add clasp to existing partial denture 35 50 D5730 reline complete maxillary denture 25 70 (chairside) D5731 reline complete mandibular denture 25 70 (chairside) D5740 reline maxillary partial denture 20 70 (chairside) D5741 reline mandibular partial denture 20 70 (chairside) D5750 reline complete maxillary denture 50 100 (laboratory) D5751 reline complete mandibular denture 50 100 (laboratory) D5760 reline maxillary partial denture 40 100 (laboratory) D5761 reline mandibular partial denture 40 100 (laboratory) D6930 recement fixed partial denture 15 30 D6980 fixed partial denture repair 20 35 D7210 surgical removal of erupted 21 45 tooth requiring elevation of mucoperitoseal flap and removal of bone and/or section of tooth D7220 removal of impacted tooth--soft 30 60 tissue D7230 removal of impacted tooth--partially 75 120 bony D7240 removal of impacted tooth-- 100 140 completely bony D9220 general anesthesia 70 210 D9241 intravenous sedation/analgesia 60 150 D9930 treatment of complications (post 4 15 surgical)--unusual circumstances
In addition, participants of the Dental Summit held in May 1999, recommended the Department change its procedure coding system to the Current Dental Terminology to be consistent with other third party payors. In response to this recommendation, the Department is converting its procedure coding system from the HCFA Common Procedure Coding System (HCPCS) to the Current Dental Terminology, third edition, version 2000 (CDT-3/2000), effective January 1, 2001.
The fiscal note was prepared under provision of section 612 of the Administrative Code of 1929 (71 P. S. § 232).
Contact Person
A copy of this notice is available for review at local county assistance offices. Interested persons are invited to submit written comments to this Notice within 30 days of this publication. These comments should be sent to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Deputy Secretary's Office, Attention: Regulations Coordinator, Room 515 Health and Welfare Building, Harrisburg, PA 17120. Any comments received will be considered for subsequent fee schedule updates.
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 should contact Thomas Vracarich in the Office of Legal Counsel at (717) 783-2209.
FEATHER O. HOUSTOUN,
SecretaryFiscal Note: 14-NOT-268. (1) General Fund;
MA-Outpatient MA-Capitation (2) Implementing Year 2000-01 is $ 737,000 $1,957,000 (3) 1st Succeeding Year 2001-02 is $1,879,000 $3,834,000 2nd Succeeding Year 2002-03 is $1,762,000 $3,964,000 3rd Succeeding Year 2003-04 is $1,762,000 $3,964,000 4th Succeeding Year 2004-05 is $1,762,000 $3,964,000 5th Succeeding Year 2005-06 is $1,762,000 $3,964,000
MA-Outpatient MA-Capitation (4) 1999-00 Program-- $622,669,000 $1,384,763,000 1998-99 Program-- $695,935,000 $1,026,075,000 1997-98 Program-- $662,740,000 $ 959,266,000 (7) MA-Outpatient and MA-Capitation; (8) recommends adoption. Funds are available in the department's budget to cover the cost increase caused by this proposed rate change.
[Pa.B. Doc. No. 00-2276. Filed for public inspection December 29, 2000, 9:00 a.m.]
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