Pennsylvania Code
Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

• No statutes or acts will be found at this website.

The Pennsylvania Bulletin website includes the following: Rulemakings by State agencies; Proposed Rulemakings by State agencies; State agency notices; the Governor’s Proclamations and Executive Orders; Actions by the General Assembly; and Statewide and local court rules.

PA Bulletin, Doc. No. 21-1131

NOTICES

DEPARTMENT OF HUMAN SERVICES

Medical Assistance Program Fee Schedule Revisions

[51 Pa.B. 3926]
[Saturday, July 17, 2021]

 The Department of Human Services (Department) announces revisions to the Medical Assistance (MA) Program Fee Schedule. These changes were effective for dates of services on and after December 21, 2020.

 The Department made updates to the MA Program Fee Schedule based upon payment indicators specified by the Centers for Medicare & Medicaid Services, in response to requests received from providers, and based on clinical reviews conducted by Department staff related to standards of practice, prior authorization, provider type (PT)/ specialty (Spec) combinations, places of service (POS) and procedure code/modifier combinations.

Procedure Codes Being Added or End-dated

 The Department added the following procedure code and modifier combinations to the MA Program Fee Schedule based upon provider requests and/or clinical review. These procedure codes may include the modifiers SG (ASC/SPU facility support component), RT (right), LT (left), 50 (bilateral), 80 (assistant surgeon) and/or GT (telemedicine).

Procedure Codes and Modifiers
29893 (SG)  29893 (RT)  29893 (LT)  29893 (50)  60650 (RT)
60650 (LT) 60650 (50)  60650 (RT) (80)  60650 (LT) (80)  60650 (50) (80)
81221 81222 81223 90662 96136
96136 (GT) 96137 96137 (GT)

 The Department end-dated the following vaccine procedure codes as they are obsolete, or the vaccine is no longer available.

Procedure Codes
90634  90649  90650  90654  90655  
90657 90658 90660 90661 90673
90676 90682 90690 90733 90748

Fiscal Impact

 These changes are estimated to result in no fiscal impact for the MA Fee-for-Service Program.

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 Deputy Secretary's Office, Attention: Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received will be reviewed and considered for any subsequent revisions to the MA Program Fee Schedule.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania Hamilton Relay Service (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

MEG SNEAD, 
Acting Secretary

 Fiscal Note: 14-NOT-1453. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 21-1131. Filed for public inspection July 16, 2021, 9:00 a.m.]


No part of the information on this site may be reproduced for profit or sold for profit.

This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.