NOTICES
Medical Assistance Program Outpatient Fee Schedule Revisions for Speech Generating Devices
[37 Pa.B. 6238]
[Saturday, November 24, 2007]The Department of Public Welfare (Department) announces that it is revising fees on the Medical Assistance (MA) Program Outpatient Fee Schedule for select speech generating devices, effective with dates of service on and after December 1, 2007.
Background
Procedure codes E2504, E2506, E2508 and E2510 were added to the MA Outpatient Fee Schedule for services provided on or after October 1, 2005. Some of the speech generating devices that fit the procedure code descriptions contain options that increase their cost. In addition, for some of the procedure codes, there are various models of speech generating devices that are included in the code description, and the prices vary depending on screen size. The Department has received 1150 Administrative Waiver (Program Exception) requests seeking increased payment rates for certain models of speech generating devices. For these reasons, the Department is increasing the fee for procedure codes E2504 and E2508, and adding pricing modifiers to the MA Program Outpatient Fee Schedule to be billed with procedure codes E2506 and E2510.
Fee Schedule Revisions
MA Fee and Pricing Modifier Procedure
CodeDescription Current Effective
December 1, 2007E2504 Speech generating device, digitized speech, using prerecorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time $1,261.94
NU$1,419.68
NUE2506 Speech generating device, digitized speech, using prerecorded messages, greater than 40 minutes
recording time$1,850.37
NU$2,081.66
NUE2506 Speech generating device, digitized speech, using prerecorded messages, greater than 40 minutes
recording time$1,850.37
NU$2,312.96
N6E2508 Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device $2,861.29
NU$3,218.95
NUE2510 Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access $5,414.60
NU$2,500.00
N6E2510 Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access $5,414.60
NU$6,091.43
NUE2510 Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access $5,414.60
NU$6,768.25
U7
An MA Bulletin will be issued to affected providers that contains specific instructions for the use of these pricing modifiers.
Fiscal Impact
It is estimated that these revisions will result in costs of $0.019 million ($0.009 million in State funds) in the Medical Assistance Outpatient Program in Fiscal Year (FY) 2007-2008 and annualized costs of $0.046 million ($0.021 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 Deputy Secretary's Office, Attention: 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) 654-5988 (voice users).
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-534. (1) General Fund; (2) Implementing Year 2007-08 is $9,000; (3) 1st Succeeding Year 2008-09 is $21,000; 2nd Succeeding Year 2009-10 is $21,000; 3rd Succeeding Year 2010-11 is $21,000; 4th Succeeding Year 2011-12 is $21,000; 5th Succeeding Year 2012-13 is $21,000; (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. 07-2126. Filed for public inspection November 21, 2007, 9:00 a.m.]
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