NOTICES
DEPARTMENT OF
HUMAN SERVICES
Medical Assistance Program Fee Schedule: Addition of Procedure Code for Vaccine Administration
[48 Pa.B. 1346]
[Saturday, March 3, 2018]In accordance with 55 Pa. Code § 1150.61(a) (relating to guidelines for fee schedule changes), the Department of Human Services (Department) announces the addition of the following procedure code to the Medical Assistance (MA) Program Fee Schedule for the administration of a quadrivalent influenza virus vaccine derived from cell cultures that contains a preservative, effective for dates of service on and after March 5, 2018.
Procedure Code Description MA Fee 90756 Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use (Flucelvax Quadrivalent®) $10 Flucelvax Quadrivalent® is a suspension for injection that is now available either in a 0.5 mL, single-dose, pre-filled syringe or a 5 mL multidose vial containing ten doses. The United States Food and Drug Administration (FDA) first approved use of Flucelvax Quadrivalent®, a quadrivalent influenza virus vaccine derived from cell cultures, preservative and antibiotic free, in a single-dose, pre-filled syringe, on May 23, 2016. On July 7, 2017, the FDA approved the Flucelvax Quadrivalent® containing a preservative and supplied in a 5 mL multidose vial containing ten doses. The American Medical Association released Common Procedural Terminology (CPT) code 90756 on July 1, 2017, for administration of a quadrivalent influenza virus vaccine derived from cell cultures that contains a preservative, such as Flucelvax Quadrivalent® as supplied in a 5 mL multidose vial containing ten doses. The Centers for Medicare & Medicaid Services made CPT code 90756 available as of January 1, 2018, as part of the annual 2018 Healthcare Common Procedure Coding System update. The Department is adding CPT code 90756 to the MA Program Fee Schedule to identify when a practitioner administers preservative-containing Flucelvax Quadrivalent® from a 5 mL multidose vial containing ten doses.
The Department will issue an MA Bulletin to providers enrolled in the MA Program specifying the procedures for billing of the administration of the influenza virus vaccine.
Fiscal Impact
The Department anticipates no fiscal impact as a result of adding CPT code 90756 to the MA Fee Schedule, as there is an existing procedure code on the fee schedule that is being used for the administration of an unspecified vaccine and the addition of this procedure code will not increase utilization.
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, 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 revision to the MA Program Fee Schedule.
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,
Acting SecretaryFiscal Note: 14-NOT-1211. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 18-337. Filed for public inspection March 2, 2018, 9:00 a.m.]
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