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PA Bulletin, Doc. No. 05-2180

NOTICES

Medical Assistance Program Fee Schedule Revisions

[35 Pa.B. 6468]

   The purpose of this notice is to announce the end-dating of the following procedure codes from the Medical Assistance (MA) Program Fee Schedule effective with dates of service January 1, 2006:

   *  90701, diphtheria, tetanus toxoids and whole-cell pertussis vaccine (DTP), for intramuscular use.

   *  90712, poliovirus vaccine, any type, (OPV), live, for oral use.

   *  90720, diphtheria, tetanus toxoids and whole cell pertussis vaccine and Hemophilus influenza B vaccine (DTP+Hib), for intramuscular use.

   These procedure codes were used for the administration of the DTP, OPV and DTP+Hib vaccines, respectively. MA-enrolled providers billed the Department of Public Welfare (Department) for the related vaccine products by indicating the National Drug Code (NDC) for the corresponding drug or vaccine on the billing form. The Department end-dated the NDCs on the PROMISeTM Drug/NDC Fee Schedule when it was advised that the vaccine products were no longer being manufactured.

   The vaccines are no longer recommended for use. The Centers for Disease Prevention and Control's Advisory Committee for Immunization Practices (ACIP) recommended that, beginning in the year 2000, only intravenous polio vaccine should be used for routine immunizations due to the progress in global poliomyelitis eradication and the reduction of the burden of vaccine-associated paralytic polio. In addition, ACIP recommended that acellular pertussis vaccines combined with diphtheria and tetanus toxoids (DTaP), rather than whole-cell pertussis DTP, be used for all five doses of the vaccine series because of the lower frequency of adverse effects. Currently, only DTaP is available in the United States.

   The Pennsylvania Chapter of the American Academy of Pediatrics was contacted and confirmed that the end-dating of these procedure codes would not adversely affect their pediatric practices as providers are not currently using these vaccines.

Fiscal Impact

   The end-dating of these obsolete procedure codes will have no fiscal impact.

Public Comments

   Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Medical Assistance Programs, Attention: Regulations Coordinator, P. O. Box 2675, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered for any subsequent revision of the notice.

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

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note:  14-NOT-450. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 05-2180. Filed for public inspection November 23, 2005, 9:00 a.m.]


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