NOTICES
DEPARTMENT OF HUMAN SERVICES
Fee Increases for Certain Ambulance Transportation Services
[48 Pa.B. 7834]
[Saturday, December 22, 2018]The Department of Human Services (Department) announces that it will increase fees in the Medical Assistance (MA) Program for certain ambulance transportation services in both the fee-for-service and managed care delivery systems for dates of service on and after January 1, 2019.
Discussion
Act 2018-42 (P.L. 281, No. 42) (Act 42), enacted on June 22, 2018, authorizes increased MA fees for ambulance transportation services in both the fee-for-service and managed care delivery systems. Specifically, Act 42 authorizes the following fees: not less than $180 per loaded trip for basic life support ambulance transportation services; not less than $300 per loaded trip for advanced life support ambulance transportation services; and not less than $3,325.53 per loaded trip for air ambulance transportation services. Act 42 also authorizes a fee of not less than $2 per loaded mile for each loaded mile beyond 20 loaded miles for ground mileage and a fee of not less than $22.45 per loaded mile for each loaded mile beyond 20 loaded miles for air mileage.
As a result, the Department is revising the fees on the MA Fee Schedule for the following procedure codes effective with dates of service on and after January 1, 2019:
Procedure Code Procedure Code Definition Pricing Modifier Current MA Fee New MA Fee A0426 Ambulance service, advanced life support, nonemergency transport, level 1 (ALS1) $200 $300 A0427 Ambulance service, advanced life support, emergency transport, level 1 (ALS1—emergency) $200 $300 A0428 Ambulance service, basic life support, nonemergency transport (BLS) $120 $180 A0429 Ambulance service, basic life support, emergency transport (BLS, emergency) $120 $180 A0430 Ambulance service, conventional air services, transport, one way (fixed wing) U8 $200 $3,325.53 A0431 Ambulance service, conventional air services, transport, one way (rotary wing) $200 $3,325.53 A0433 Advanced life support, level 2 (ALS 2) $200 $300 A0434 Specialty care transport (SCT) $200 $300 A0435 Fixed wing air mileage, per statute mile $2 per mile beyond the first 20 loaded miles of a trip $22.45 per mile for each loaded mile beyond 20 loaded miles of a trip A0436 Rotary wing air mileage, per statute mile $2 per mile beyond the first 20 loaded miles of a trip $22.45 per mile for each loaded mile beyond 20 loaded miles of a trip Fiscal Impact
The Fiscal Year (FY) 2018-2019 fiscal impact is $3.672 million ($1.351 million in State general funds and $2.321 million in Federal funds).
The FY 2019-2020 fiscal impact is an annualized amount of $5.753 million ($1.940 million in State general funds and $3.813 million in Federal funds).
Public Comment
Interested persons are invited to submit written comments regarding the revised ambulance transportation fees to the Department of Human Services, 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 ambulance transportation fees.
Persons with a disability who require an 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).
TERESA D. MILLER,
SecretaryFiscal Note: 14-NOT-1296. (1) General Fund; (2) Implementing Year 2018-19 is $1,351,000; (3) 1st Succeeding Year 2019-20 through 5th Succeeding Year 2023-24 are $1,940,000; (4) 2017-18 Program—$477,690,000; 2016-17 Program—$450,970,000; 2015-16 Program—$392,918,000; (7) MA—Fee-for-Service; (8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 18-1982. Filed for public inspection December 21, 2018, 9:00 a.m.]
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