NOTICES
DEPARTMENT OF PUBLIC WELFARE
Medical Assistance Program Fee Increases for Select Dental Procedure Codes Purpose of Notice
[37 Pa.B. 5862]
[Saturday, October 27, 2007]The Department of Public Welfare (Department) announces that it will increase the fees paid by the Medical Assistance (MA) Program for select dental procedure codes effective with dates of service on or after November 1, 2007. The Department consulted with the Pennsylvania Dental Association, other key stakeholders and dentists in determining which existing fees for dental services should be increased to support enhanced access to dental services by MA recipients. The Department is increasing the fees for the following dental procedure codes:
Procedure
CodeProcedure Description Current Fee Fee Effective
November 1, 2007D1110 Prophylaxis--Adult (12 years of age or older ) $34.00 $36.00 D1120 Prophylaxis--Child (0 through 11 years of age) $22.00 $30.00 D1203 Topical Application of Fluoride (Prophylaxis Not Included)--Child $17.00 $18.00 D2740 Crown--Porcelain/Ceramic Substrate $300.00 $350.00 D2751 Crown--Porcelain Fused to Predominantly Base Metal $300.00 $350.00 D2791 Crown--Full Cast Predominantly Base Metal $300.00 $350.00 D2930 Prefabricated Stainless Steel Crown--Primary Tooth $90.00 $99.00 D2934 Prefabricated Esthetic Coated Stainless Steel Crown--Primary Tooth $90.00 $99.00 D3220 Therapeutic Pulpotomy (Excluding Final Restoration) $50.00 $57.00 D3310 Anterior (Excluding Final Restoration) $180.00 $210.00 D3320 Bicuspid (Excluding Final Restoration) $225.00 $270.00 D3330 Molar (Excluding Final Restoration) $270.00 $345.00 D5110 Complete Denture--Maxillary $320.00 $355.00 D5120 Complete Denture--Mandibular $320.00 $355.00 D5130 Immediate Denture--Maxillary $320.00 $355.00 D5140 Immediate Denture--Mandibular $320.00 $355.00 D5211 Upper Partial--Resin Based $200.00 $250.00 D5212 Lower Partial--Resin Based $200.00 $250.00 D5213 Maxillary Partial Denture--Cast Metal Framework with Resin Denture Bases $330.00 $370.00 D5214 Mandible Partial Denture--Cast Metal Framework with Resin Denture Bases $330.00 $370.00 D7140 Extraction, Erupted Tooth or Exposed Root $45.00 $60.00 D7210 Surgical Removal of Erupted Tooth Requiring Elevation of Mucoperiosteal Flap and Removal of Bone and/or Section of Tooth $45.00 $60.00 D7220 Removal of Impacted Tooth--Soft Tissue $60.00 $65.00 Fiscal Impact
These changes will result in increased costs of $1.631 million ($0.754 million in State funds) in the MA-Outpatient program in Fiscal Year (FY) 2007-2008, and $3.263 million ($1.512 million in State funds) in FY 2008-2009.
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 to the MA Program Outpatient Fee Schedule.
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) 654-5899 (voice users).
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-530. (1) General Fund; (2) Implementing Year 2007-08 is $754,000; (3) 1st Succeeding Year 2008-09 is $1,512,000; 2nd Succeeding Year 2009-10 is $1,512,000; 3rd Succeeding Year 2010-11 is $1,512,000; 4th Succeeding Year 2011-12 is $1,512,000; 5th Succeeding Year 2012-13 is $1,512,000; (4) 2006-07 Program--$671,472,000; 2005-06 Program--$945,950,000; 2004-05 Program--$842,991,000; (7) Medical Assistance--Outpatient; (8) recommends adoption. Funds have been included in the budget to cover these increases.
[Pa.B. Doc. No. 07-2004. Filed for public inspection October 26, 2007, 9:00 a.m.]
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