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PA Bulletin, Doc. No. 01-557

NOTICES

Office of Medical Assistance Programs; Addition of Periodontal Services

[31 Pa.B. 1810]

   By this notice, the Department of Public Welfare announces that it is adding selected periodontal services to its list of covered dental services, effective March 1, 2001, as follows:

Procedure MA
Code Description Fee
D4210Gingivectomy or gingivoplasty--per quadrant $125.00
D4341 Periodontal scaling and root planing--per quadrant     75.00
D4355Full mouth debridement to enable comprehensive periodontal evaluation and diagnosis     60.00
D4910 Periodontal maintenance procedures (following active treatment)     44.00

   Section 443.6(b)(7) of the Public Welfare Code (62 P. S. § 443.6(b)(7)) authorizes the Department of Public Welfare to add items and services to its list of services requiring prior authorization by publication of notice in the Pennsylvania Bulletin. All periodontal services, except Procedure Code D4355, will require prior authorization. Procedure Code D4355 will require post-operative review.

   The proposed adoption of these services and the requirement of prior authorization was presented to the Medical Assistance Advisory Committee (MAAC) at its January 25, 2001 meeting. The Department received no written comments from the MAAC regarding the proposed addition of periodontal services and the requirement of prior authorization.

Fiscal Impact

   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. 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,   
Secretary

   Fiscal Note: 14-NOT-273. (1) General Fund.

MA-OutpatientMA-Capitation
(2)Implementing Year 2000-01 is$112,000$691,000
(3)1st Succeeding Year 2001-02 is$1,142,000$2,242,000
2nd Succeeding Year 2002-03 is$822,000$2,465,000
3rd Succeeding Year 2003-04 is$822,000$2,465,000
4th Succeeding Year 2004-05 is$822,000$2,465,000
5th Succeeding Year 2005-06 is$822,000$2,465,000
MA-OutpatientMA-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$959,286,000

(7)  Medical Assistance-Outpatient and Medical Assistance-Capitation; (8) recommends adoption. Funds are included in the budget for these changes.

[Pa.B. Doc. No. 01-557. Filed for public inspection March 30, 2001, 9:00 a.m.]


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