NOTICES
DEPARTMENT OF
PUBLIC WELFARE
Established Fee for Methadone Take-Home Services
[34 Pa.B. 646] By this notice and in accordance with 55 Pa. Code § 1150.61(a) (relating to guidelines for fee schedule changes), the Department of Public Welfare (Department) announces the addition of the payment for methadone take-home services to the Medical Assistance (MA) Program Fee Schedule.
Methadone take-home services will be available for MA recipients who meet Federal and State criteria for obtaining the services (see 42 CFR 8.12(i) and 28 Pa. Code § 715.6 (relating to physician staffing)). The services must be provided by a methadone maintenance clinic that complies with the requirements established in 55 Pa. Code Chapter 1223 (relating to outpatient drug and alcohol clinic services), is certified in accordance with 42 CFR Chapter 1, Part 8 and is licensed in accordance with 28 Pa. Code Chapters 701, 704, 705 and 715 and, as applicable, 28 Pa. Code Chapter 709 or Chapter 711 (relating to standards for licensure of freestanding treatment facilities; and standards for certification of treatment activities which are a part of a health care facility).
Effective February 1, 2004, the Department has established a procedure code, unit of service and fee for methadone maintenance take-home services as follows:
Procedure Code Modifier Description Fee Unit of Service H0020 * HG Alcohol and/or drug services; methadone administration and/or service (take-home) $7.50 One unit/day (whether single or split dose) The fee for this service will be effective with dates of service on or after February 1, 2004. The Department will issue an MA Bulletin to affected service providers before the effective date of the fee.
* The modifier HG is required only for claims submitted after PROMISe, the Department's new claims payment system, is implemented. The modifier may not be used in submitting claims under MAMIS.
Fiscal Impact
The estimated net State savings for Fiscal Year 2003-2004 is $0.223 million ($0.114 million in State funds). The estimated State savings for Fiscal Year 2004-2005 is $0.422 million ($0.213 million in State funds).
Public Comment
Interested persons are invited to submit written comments regarding this notice within 30 days of publication in the Pennsylvania Bulletin. Comments received will be reviewed and considered in subsequent revisions to the MA Program Fee Schedule. 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. Persons with a disability may use the AT&T Relay Service by calling (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-379. (1) General Fund; (2) Implementing Year 2003-04 is $10,000; (3) 1st Succeeding Year 2004-05 is $34,000; 2nd Succeeding Year 2005-06 is $34,000; 3rd Succeeding Year 2006-07 is $34,000; 4th Succeeding Year 2007-08 is $34,000; 5th Succeeding Year 2008-09 is $34,000; (4) 2002-03 Program--$668,832,000; 2001-02 Program--$705,750,000; 2000-01 Program--$668,586,000; (7) Medical Assistance--Outpatient; (8) recommends adoption. The additional costs outlined provide for increased usage of clinics on Sundays and holidays. The costs would be offset by anticipated savings in the Medical Assistance Transportation Program. These savings are estimated at $124,000 for 2003-04 and $247,000 annually thereafter.
[Pa.B. Doc. No. 04-191. Filed for public inspection January 30, 2004, 9:00 a.m.]
No part of the information on this site may be reproduced for profit or sold for profit.This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.
