NOTICES
Medical Assistance Program Fee Schedule Procedure Code Changes for Laboratory Services
[35 Pa.B. 6711] The Department of Public Welfare (Department) announces several changes to the Medical Assistance (MA) Program Fee Schedule for laboratory services.
Fee Schedule Revisions
The Department is end-dating local procedure codes for laboratory services. Local procedure codes Z0832, Z2100, Z2101, Z2102, Z2103, Z2105, Z2106, Z8227, Z8294, Z8309, Z8503, Z8555, Z8556, Z8557, Z8604, Z8627, Z8631, Z8636, Z8637, Z8704, Z8708, Z8712 and Z8713 were end-dated effective with dates of service on or after December 1, 2005.
Effective with dates of service on or after December 1, 2005, the Department added the following National procedure codes to the MA Program Fee Schedule to replace the following specific local procedure codes that were end-dated:
National Procedure Code Applicable Pricing Modifier MA Fee for
the National Procedure CodeEnd-Dated Local Procedure Code 80100 $10.00 Z2105 80100 U7 $15.00 Z2106 80101 $ 3.00 Z2105 81025 $ 4.00 Z0832 82055 $12.00 Z2101 82055 $12.00 Z2102 Services rendered on or after December 1, 2005, must be billed using the National procedure code.
Local procedure codes Z8020, Z8374 and Z8391 are being end-dated effective with dates of service on or after December 12, 2005.
Effective with dates of service December 12, 2005, the Department is adding the following National procedure codes to the MA Program Fee Schedule to replace the following specific local procedure codes that are being end-dated:
National Procedure Code Applicable Pricing Modifier MA Fee for
the National Procedure CodeEnd-Dated Local Procedure Code 87391 $10.50 Z8020 80299 $15.30 Z8374 80299 $15.30 Z8391 Services rendered on or after December 12, 2005, must be billed using the National procedure code.
A Medical Assistance Bulletin has been issued to providers of laboratory services that includes a crosswalk of all of the local procedure codes that are being end-dated and the National procedure codes that are replacing them.
Fiscal Impact
The conversion from local to National procedure codes is anticipated to be budget neutral; therefore, these changes will have no fiscal impact.
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, 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 Services at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-452. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 05-2281. Filed for public inspection December 9, 2005, 9:00 a.m.]
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