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PA Bulletin, Doc. No. 08-1072

NOTICES

Medical Assistance Program Fee Schedule Increase for a Select Colposcopy Procedure Code

[38 Pa.B. 2743]
[Saturday, June 7, 2008]

Purpose of Notice

   The Department of Public Welfare (Department) announces that the fee paid by the Medical Assistance (MA) Program for Common Procedural Terminology (CPT) procedure code 57454 has increased effective with dates of service on or after May 15, 2008. As set forth, CPT procedure code 57454 includes a colposcopy of the cervix with one or more biopsies of the cervix and endocervical curettage. CPT procedure codes 57455 and 57456, which include colposcopy of the cervix and related procedures have significantly higher fees than the current MA Program fee for CPT procedure code 57454. Therefore, after consultation with medical providers, the Department is increasing the MA Program Outpatient Fee Schedule rate for CPT procedure code 57454 to be consistent with the MA Outpatient Program Fee Schedule rates for CPT procedure codes 57455 and 57456 as follows:

CPT Code Procedure Code Definition Current Fee Fee Effective May 15, 2008
57454 Colposcopy of the cervix including upper/adjacentvagina; with biopsy(s) of the cervix and endocervical curettage $69.00 $105.94

Fiscal Impact

   The increase is anticipated to have no fiscal impact in Fiscal Year 2007-2008. The increased fee will result in increased costs of $0.101 million ($0.046 million in State funds) in the MA Outpatient Program in Fiscal Year 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 in any subsequent revisions 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,   
Secretary

   Fiscal Note:  14-NOT-551. (1) General Fund; (2) Implementing Year 2007-08 is $46,000; (3) 1st Succeeding Year 2008-09 is $50,000; 2nd Succeeding Year 2009-10 is $50,000; 3rd Succeeding Year 2010-11 is $50,000; 4th Succeeding Year 2011-12 is $50,000; 5th Succeeding Year 2012-13 is $50,000; (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.

[Pa.B. Doc. No. 08-1072. Filed for public inspection June 6, 2008, 9:00 a.m.]


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