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PA Bulletin, Doc. No. 10-197

NOTICES

Medical Assistance Program Outpatient Fee Schedule Revisions for Vision Services

[40 Pa.B. 675]
[Saturday, January 30, 2010]

 The purpose of this notice is to announce the Department of Public Welfare's (Department) several changes to the Medical Assistance (MA) Program Outpatient Fee Schedule, effective with dates of service on and after March 1, 2010.

Fee Schedule Revisions

 The Department is end-dating the following local procedure codes for vision services billed by optometrists and physicians. These procedure codes were previously end-dated for other types of providers: Y0012, Y0017, Y0034, Y2021, Y2411 and Y0090.

 There are national procedure codes already on the MA Program Outpatient Fee Schedule that have replaced Y0012, Y0017, Y0034 and Y2021.

 National procedure code V2770, defined as ''occluder lens, per lens,'' is being added to the MA Program Outpatient Fee Schedule. This will replace local procedure code Y2411. Local procedure code Y0090 will not be replaced with a National procedure code, since there were only 6 claims paid from January 1, 2007, through July 30, 2009.

 The following procedure codes for physical therapy services are being end-dated for optometrists: 97112, 97116 and 97530.

 An MA Bulletin will be issued to optometrists and physicians who provide vision services and will include a crosswalk of the local procedure codes that are being end-dated and the National procedure codes and modifiers, as applicable, which are replacing them.

 Services rendered on and after March 1, 2010, must be billed using the National procedure code and modifier, if appropriate.

Fiscal Impact

 The end-dating of the local procedure codes is anticipated to be budget neutral and, 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 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).

HARRIET DICHTER, 
Acting Secretary

 Fiscal Note: 14-NOT-630. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 10-197. Filed for public inspection January 29, 2010, 9:00 a.m.]


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