NOTICES
Medical Assistance Program Fee Schedule Revisions
[39 Pa.B. 5670]
[Saturday, September 26, 2009]Purpose of Notice
The Department of Public Welfare (Department) announces that it will revise the fees, or a component of the fee, on the Medical Assistance (MA) Program Fee Schedule for select medical, surgical, laboratory, durable medical equipment and radiological services effective October 5, 2009.
Fee Schedule Revisions
The Pennsylvania Medicaid State Plan (State Plan) specifies that maximum fees for services covered under the MA Program are to be determined on the basis of the following: fees may not exceed the Medicare upper limit when applicable; fees must be consistent with efficiency, economy and quality of care; and fees must be sufficient to assure the availability of services to recipients. The regulations at 55 Pa. Code § 1150.62(a) (relating to payment levels and notice of rate setting changes) also specify that the MA fees may not exceed the Medicare upper limit.
The Department has determined that MA fees for approximately 320 medical, surgical, laboratory, durable medical equipment and radiological procedure codes or combinations of procedure codes and modifiers, are above the Medicare upper limit for the same procedure codes. The Department is adjusting the fees on the MA Program Fee Schedule for these combinations of procedure codes and modifiers to equal the Medicare upper limit. Revision of these fees is necessary to comply with the regulation and State Plan, and to avoid a Federal disallowance. When adjusting the assistant surgeon fee (modifier 80), the Department followed the Medicare guidelines of paying 16% of the maximum allowable payment to a primary surgeon, as MA fees may not exceed the Medicare upper limit.
The Department has revised the total fee (billed with no modifier) and, as applicable, the professional component fee (billed with modifier 26), the technical component fee (billed with modifier TC), the assistant surgeon fee (billed with modifier 80), and the fee when billing for the purchase (NU) or rental (RR) of Durable Medical Equipment; ''N/A'' indicates that the modifier is not on the MA Program Fee Schedule for the procedure code, and ''N/C'' indicates that there is no change in the fee associated with the modifier:
Procedure Code/Modifier NU or RR where indicated Procedure Code Description
Assistant Surgeon fee Revision (Billing with Modifier 80) Professional Component Fee Revision (Billing with Modifier 26) Technical Component Fee Revision (Billing with Modifier TC) Billing with No Modifier or with Pricing Modifiers NU or RR 15600 Delay of flap or sectioning of flap (division and inset); at trunk N/A N/A N/A $174.94 15610 Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs N/A N/A N/A $207.79 17003 Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (e.g., actinic keratoses); second through 14 lesions, each (List separately in addition to code for first lesion) N/A N/A N/A $4.25 20900 Bone graft, any donor area; minor or small (e.g., dowel or button) $39.40 N/A N/A $246.27 23921 Disarticulation of shoulder; secondary closure or scar revision N/A N/A N/A $354.51 26432 Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (e.g., mallet finger) N/A N/A N/A $426.63 26434 Repair of extensor tendon, distal insertion, primary or secondary; with free graft (includes obtaining graft) N/A N/A N/A $553.32 26510 Cross intrinsic transfer, each tendon $82.41 N/A N/A $515.05 26591 Repair, intrinsic muscles of hand, each muscle N/A N/A N/A $372.93 26593 Release, intrinsic muscles of hand, each muscle N/A N/A N/A $513.36 27250 Closed treatment of hip dislocation, traumatic; without anesthesia N/A N/A N/A $219.33 27740 Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula; $97.27 N/A N/A $607.94 28456 Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each N/A N/A N/A $239.78 28530 Closed treatment of sesamoid fracture N/A N/A N/A $89.45 29520 Strapping; hip N/A N/A N/A $32.99 30150 Rhinectomy; partial N/A N/A N/A $694.00 36598 Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report N/A N/A N/A $58.00 41510 Suture of tongue to lip for micrognathia (Douglas type procedure) N/A N/A N/A $351.41 41825 Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair N/A N/A N/A $110.59 42220 Palatoplasty for cleft palate; secondary lengthening procedure $78.13 N/A N/A $488.29 42509 Parotid duct diversion, bilateral (Wilke type procedure); with excision of both submandibular glands N/A N/A N/A $750.02 46614 Anoscopy; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) N/A N/A N/A $64.21 47525 Change of percutaneous biliary drainage catheter N/A N/A N/A $124.12 51102 Aspiration of bladder; with insertion of suprapubic catheter N/A N/A N/A $154.34 52400 Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds $79.25 N/A N/A $495.31 52640 Transurethral resection; of postoperative bladder neck contracture N/A N/A N/A $306.02 62350 Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy $57.48 N/A N/A $359.25 62355 Removal of previously implanted intrathecal or epidural catheter $42.91 N/A N/A $268.17 62362 Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming $60.58 N/A N/A $378.64 62365 Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion $47.60 N/A N/A $297.52 63650 Percutaneous implantation of neurostimulator electrode array, epidural N/A N/A N/A $372.95 64416 Injection, anesthetic agent; brachial plexus, continuous infusion by catheter (including catheter placement) N/A N/A N/A $89.38 64446 Injection, anesthetic agent; sciatic nerve, continuous infusion by catheter (including catheter placement) N/A N/A N/A $87.42 64448 Injection, anesthetic agent; femoral nerve, continuous infusion by catheter (including catheter placement) N/A N/A N/A $77.48 64449 Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) N/A N/A N/A $85.81 64585 Revision or removal of peripheral neurostimulator electrodes N/A N/A N/A $145.54 64590 Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling $25.99 N/A N/A $162.41 64595 Revision or removal of peripheral or gastric neurostimulator pulse generator or receiver N/A N/A N/A $128.57 65150 Reinsertion of ocular implant; with or without conjunctival graft N/A N/A N/A $469.22 66820 Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) N/A N/A N/A $315.96 69120 Excision external ear; complete amputation N/A N/A N/A $348.46 70140 Radiologic examination, facial bones; less than 3 views N/A $9.24 $18.91 $28.15 70350 Cephalogram, orthodontic N/A $8.52 $10.79 $19.31 70355 Orthopantogram N/A $9.94 $11.90 $21.84 70371 Complex dynamic pharyngeal and speech evaluation by cine or video recording N/A $40.86 $52.05 $92.91 72020 Radiologic examination, spine, single view, specify level N/A N/C $14.46 $21.40 72070 Radiologic examination, spine; thoracic, 2 views N/A N/C $20.91 $30.94 73020 Radiologic examination, shoulder; 1 view N/A $7.47 $14.46 $21.93 73542 Radiological examination, sacroiliac joint arthrography, radiological supervision and interpretation N/A $27.79 $47.38 $75.17 74485 Dilation of nephrostomy, ureters, or urethra, radiological supervision and interpretation N/A $27.65 $84.36 $112.01 75962 Transluminal balloon angioplasty, peripheral artery, radiological supervision and interpretation N/A $27.32 $243.87 $271.19 75964 Transluminal balloon angioplasty, each additional peripheral artery, radiological supervision and interpretation (List separately in addition to code for primary procedure) N/A $18.49 $140.87 $159.36 75966 Transluminal balloon angioplasty, renal or other visceral artery, radiological supervision and interpretation N/A $67.94 $250.21 $318.15 75968 Transluminal balloon angioplasty, each additional visceral artery, radiological supervision and interpretation (List separately in addition to code for primary procedure) N/A $18.77 $140.87 $159.64 75978 Transluminal balloon angioplasty, venous (e.g., subclavian stenosis), radiological supervision and interpretation N/A $26.59 $240.20 $266.79 75994 Transluminal atherectomy, renal, radiological supervision and interpretation N/A $61.99 N/C $585.68 76098 Radiological examination, surgical specimen N/A $8.16 $10.79 $18.95 76377 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; requiring image postprocessing on an independent workstation N/A $41.28 $68.47 $109.75 76511 Ophthalmic ultrasound, diagnostic; quantitative A-scan only N/A N/C $44.76 $75.76 76512 Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) N/A N/C $39.60 $77.10 76516 Ophthalmic biometry by ultrasound echography, A-scan; N/A $26.87 $36.76 $63.63 76519 Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation N/A $27.21 $40.76 $67.97 76529 Ophthalmic ultrasonic foreign body localization N/A $28.67 $36.15 $64.82 76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation N/A $92.38 $107.51 $199.89 76820 Doppler velocimetry, fetal; umbilical artery N/A $24.54 $28.37 $52.91 76827 Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete N/A $28.04 $41.04 $69.08 76828 Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study N/A $27.37 $24.14 $51.51 76936 Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging) N/A $101.19 $88.25 $189.44 76946 Ultrasonic guidance for amniocentesis, imaging supervision and interpretation N/A $18.49 $24.92 $43.41 76977 Ultrasound bone density measurement and interpretation, peripheral site(s), any method N/A $2.86 $10.96 $13.82 77003 Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve, or sacroiliac joint), including neurolytic agent destruction N/A N/C $29.08 $50.29 77012 Computed tomography guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), radiological supervision and interpretation N/A $58.46 $132.81 $191.27 77031 Stereotactic localization guidance for breast biopsy or needle placement (e.g., for wire localization or for injection), each lesion, radiological supervision and interpretation N/A $79.87 $107.17 $187.04 77032 Mammographic guidance for needle placement, breast (e.g., for wire localization or for injection), each lesion, radiological supervision and interpretation N/A N/C $29.42 $50.00 77051 Computer-aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation, with or without digitization of film radiographic images; diagnostic mammography (List separately in addition to code for primary procedure) N/A $3.22 $8.40 $11.62 77052 Computer-aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation, with or without digitization of film radiographic images; screening mammography (List separately in addition to code for primary procedure) N/A $3.22 $8.40 $11.62 77053 Mammary ductogram or galactogram, single duct, radiological supervision and interpretation N/A $18.10 $54.83 $72.93 77077 Joint survey, single view, 2 or more joints (specify) N/A N/C $25.03 $36.74 77079 Computed tomography, bone mineral density study, 1 or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) N/A $10.33 $43.65 $53.98 77081 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) N/A $10.66 $18.30 $28.96 77083 Radiographic absorptiometry (e.g., photodensitometry, radiogrammetry), 1 or more sites N/A $9.60 $15.96 $25.56 77295 Therapeutic radiology simulation-aided field setting; 3-dimensional N/A $225.14 $436.36 $661.50 77331 Special dosimetry (e.g., TLD, microdosimetry) (specify), only when prescribed by the treating physician N/A N/C $17.46 $57.81 77333 Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus) N/A $41.53 $25.97 $67.50 77417 Therapeutic radiology port film(s) N/A N/A N/A $15.24 77418 Intensity modulated treatment delivery, single or multiple fields/arcs, by means of narrow spatially and temporally modulated beams, binary, dynamic MLC, per treatment session N/A N/A N/A $478.80 78320 Bone and/or joint imaging; tomographic (SPECT) N/A $52.08 $185.90 $237.98 78461 Myocardial perfusion imaging; multiple studies (planar), at rest and/or stress (exercise and/or pharmacologic), and redistribution and/or rest injection, with or without quantification N/A $62.32 $137.52 $199.84 78464 Myocardial perfusion imaging; tomographic (SPECT), single study (including attenuation correction when performed), at rest or stress (exercise and/or pharmacologic), with or without quantification N/A $57.22 $201.92 $259.14 78478 Myocardial perfusion study with wall motion, qualitative or quantitative study (List separately in addition to code for primary procedure) N/A $26.82 $30.25 $57.07 78480 Myocardial perfusion study with ejection fraction (List separately in addition to code for primary procedure) N/A $17.27 $30.25 $47.52 78710 Kidney imaging morphology; tomographic (SPECT) N/A $33.31 $186.57 $219.88 79005 Radiopharmaceutical therapy, by oral administration N/A N/C $58.84 $132.03 79101 Radiopharmaceutical therapy, by intravenous administration N/A N/C $63.84 $143.82 79200 Radiopharmaceutical therapy, by intracavitary administration N/A N/C $68.51 $133.51 79403 Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion N/A $114.07 $95.87 $209.94 80047 Basic metabolic panel (Calcium, ionized) N/A N/A N/A $12.36 88182 Flow cytometry, cell cycle or DNA analysis N/A $34.95 N/C $41.31 89230 Sweat collection by iontophoresis N/A N/A N/A $3.78 91022 Duodenal motility (manometric) study N/A N/C $98.75 $158.07 91034 Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation N/A N/C $131.78 $172.10 91040 Esophageal balloon distension provocation study N/A N/C $291.58 $331.90 92270 Electro-oculography with interpretation and report N/A $39.39 $38.48 $77.87 92284 Dark adaptation examination with interpretation and report N/A $11.38 $40.76 $52.14 92565 Stenger test, pure tone N/A N/A N/A $11.90 92577 Stenger test, speech N/A N/A N/A $16.41 92586 Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; limited N/A $23.14 $34.70 $57.84 92587 Evoked otoacoustic emissions; limited (single stimulus level, either transient or distortion products) N/A $6.74 $29.98 $36.72 92588 Evoked otoacoustic emissions; comprehensive or diagnostic evaluation (comparison of transient and/or distortion product otoacoustic emissions at multiple levels and frequencies) N/A $17.71 $42.10 $59.81 92977 Thrombolysis, coronary; by intravenous infusion N/A N/A N/A $126.69 93000 Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report N/A N/A N/A $19.98 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report N/A N/A N/A $11.12 93015 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report N/A N/A N/A $95.56 93041 Rhythm ECG, 1-3 leads; tracing only without interpretation and report N/A N/A N/A $5.06 93224 Wearable electrocardiographic rhythm derived monitoring for 24 hours by continuous original waveform recording and storage, with visual superimposition scanning; includes recording, scanning analysis with report, physician review and interpretation N/A N/A N/A $113.18 93226 Wearable electrocardiographic rhythm derived monitoring for 24 hours by continuous original waveform recording and storage, with visual superimposition scanning; scanning analysis with report N/A N/A N/A $51.83 93270 Wearable patient activated electrocardiographic rhythm derived event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time; recording (includes connection, recording, and disconnection) N/A N/A N/A $20.47 93278 Signal-averaged electrocardiography (SAECG), with or without ECG N/A $12.74 $26.31 $39.05 93321 Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); follow-up or limited study (List separately in addition to codes for echocardiographic imaging) N/A $8.13 $25.14 $33.27 93555 Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; ventricular and/or atrial angiography N/A $43.73 $69.64 $113.37 93556 Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits (whether native or used in bypass) N/A $44.78 $112.96 $157.74 93724 Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings) N/A $261.25 $63.74 $324.99 95027 Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report by a physician, specify number of tests N/A N/A N/A $4.42 95834 Muscle testing, manual (separate procedure) with report; total evaluation of body, including hands N/A N/A N/A $29.15 97597 Removal of devitalized tissue from wound(s), selective debridement, without anesthesia (e.g., high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), with or without topical application(s), wound assessment, and instruction(s) for ongoing care, may include use of a whirlpool, per session; total wound(s) surface area less than or equal to 20 square centimeters N/A N/A N/A $31.54 97598 Removal of devitalized tissue from wound(s), selective debridement, without anesthesia (e.g., high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), with or without topical application(s), wound assessment, and instruction(s) for ongoing care, may include use of a whirlpool, per session; total wound(s) surface area greater than 20 square centimeters N/A N/A N/A $41.81 A4615 Cannula, nasal N/A N/A N/A $0.75 A4620 Variable concentration mask N/A N/A N/A $0.62 E0143-RR Walker, folding, wheeled, adjustable or fixed height N/A N/A N/A $19.54 E0158-NU Leg extensions for walker, per set of 4 N/A N/A N/A $29.12 E0250-RR Hospital bed, fixed height, with any type side rails, with mattress N/A N/A N/A $88.47 E0251-RR Hospital bed, fixed height, with any type side rails, without mattress N/A N/A N/A $67.04 E0255-RR Hospital bed, variable height, hi-lo, with any type side rails, with mattress N/A N/A N/A $103.50 E0256-RR Hospital bed, variable height, hi-lo, with any type side rails, without mattress N/A N/A N/A $70.67 E0260-RR Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress N/A N/A N/A $127.12 E0261-RR Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress N/A N/A N/A $116.43 E0271-RR Mattress, innerspring N/A N/A N/A $20.87 E0272-RR Mattress, foam rubber N/A N/A N/A $19.12 E0280-NU Bed cradle, any type N/A N/A N/A $33.49 E0290-RR Hospital bed, fixed height, without side rails, with mattress N/A N/A N/A $67.64 E0291-RR Hospital bed, fixed height, without side rails, without mattress N/A N/A N/A $49.14 E0292-RR Hospital bed, variable height, hi-lo, without side rails, with mattress N/A N/A N/A $73.37 E0293-RR Hospital bed, variable height, hi-lo, without side rails, without mattress N/A N/A N/A $64.72 E0296-RR Hospital bed, total electric (head, foot, and height adjustments), without side rails, with mattress N/A N/A N/A $148.60 E0297-RR Hospital bed, total electric (head, foot, and height adjustments), without side rails, without mattress N/A N/A N/A $127.31 E0424-RR Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing N/A N/A N/A $175.79 E0431-RR Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing N/A N/A N/A $28.77 E0434-RR Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing N/A N/A N/A $28.77 E0439-RR Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask and tubing N/A N/A N/A $175.79 E0560-RR Humidifier, durable for supplemental humidification during IPPB treatment or oxygen delivery N/A N/A N/A $18.19 E0776-NU IV pole N/A N/A N/A $98.86 E0910-RR Trapeze bars, also known as Patient Helper, attached to bed, with grab bar N/A N/A N/A $18.10 E1390-RR Oxygen concentrator, single delivery port, capable of delivering 85% or greater oxygen concentration at the prescribed flow rate N/A N/A N/A $175.79 E1391-RR Oxygen concentrator, dual delivery port, capable of delivering 85% or greater oxygen concentration at the prescribed flow rate, each N/A N/A N/A $175.79 E1405-RR Oxygen and water vapor enriching system with heated delivery N/A N/A N/A $212.61 E1406-RR Oxygen and water vapor enriching system without heated delivery N/A N/A N/A $192.70 E2209-NU Accessory, arm trough, with or without hand support, each N/A N/A N/A $96.98 E2209-RR Accessory, arm trough, with or without hand support, each N/A N/A N/A $9.72 E2210-NU Wheelchair accessory, bearings, any type, replacement only, each N/A N/A N/A $5.93 E2601-NU General use wheelchair seat cushion, width less than 22 inch, any depth N/A N/A N/A $55.35 E2601-RR General use wheelchair seat cushion, width less than 22 inch, any depth N/A N/A N/A $5.55 E2602-NU General use wheelchair seat cushion, width 22 inch or greater, any depth N/A N/A N/A $108.06 E2602-RR General use wheelchair seat cushion, width 22 inch or greater, any depth N/A N/A N/A $10.81 E2603-NU Skin protection wheelchair seat cushion, width less than 22 inch, any depth N/A N/A N/A $137.19 E2603-RR Skin protection wheelchair seat cushion, width less than 22 inch, any depth N/A N/A N/A $13.73 E2604-NU Skin protection wheelchair seat cushion, width 22 inch or greater, any depth N/A N/A N/A $170.51 E2604-RR Skin protection wheelchair seat cushion, width 22 inch or greater, any depth N/A N/A N/A $17.04 E2605-NU Positioning wheelchair seat cushion, width less than 22 inch, any depth N/A N/A N/A $243.60 E2605-RR Positioning wheelchair seat cushion, width less than 22 inch, any depth N/A N/A N/A $24.37 E2611-NU General use wheelchair back cushion, width less than 22 inch, any height, including any type mounting hardware N/A N/A N/A $282.68 E2611-RR General use wheelchair back cushion, width less than 22 inch, any height, including any type mounting hardware N/A N/A N/A $28.26 E2612-NU General use wheelchair back cushion, width 22 inch or greater, any height, including any type mounting hardware N/A N/A N/A $382.40 E2612-RR General use wheelchair back cushion, width 22 inch or greater, any height, including any type mounting hardware N/A N/A N/A $38.24 G0108 Diabetes outpatient self-management training services, individual, per 30 minutes N/A N/A N/A $21.41 G0109 Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes N/A N/A N/A $12.07 Q0035 Cardiokymography N/A $8.19 $10.12 $18.31 Fiscal Impact
It is anticipated that these revisions will result in savings of $0.979 million ($0.351 million in State funds) in the MA Outpatient Program in Fiscal Year (FY) 2009-2010 and annualized savings of $1.679 million ($0.694 million in State funds) in FY 2010-2011. These State fund estimates are based on the increased Federal Medical Assistance Percentages as determined under the American Recovery and Reinvestment Act (ARRA) of 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 revisions of the MA Program Fee Schedule.
Persons with a disability who require auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-622. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 09-1813. Filed for public inspection September 25, 2009, 9:00 a.m.]
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