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PA Bulletin, Doc. No. 21-2156

NOTICES

DEPARTMENT OF
HUMAN SERVICES

Medical Assistance Program Fee Increases for Private Duty/Shift Nursing Services to MA Beneficiaries Under 21 Years of Age

[51 Pa.B. 8027]
[Saturday, December 25, 2021]

 The Department of Human Services (Department) is announcing that it will increase the Medical Assistance (MA) Program fees for the following private duty/shift nursing services provided to MA beneficiaries under 21 years of age effective January 1, 2022.

Fee Update

 In accordance with section 1729-B of the Fiscal Code (72 P.S. § 1729-B), as amended by the act of June 30, 2021 (P.L. 62, No. 24), the Department is increasing the MA Program Fee Schedule rate for private duty/shift nursing services as follows:

Procedure Code  DescriptionCurrent MA Fee MA Fee Effective January 1, 2022 
S9123 Nursing care, in the home; by Registered Nurse, per hour$45.00$50.00
S9124Nursing care, in the home; by Licensed Practical Nurse, per hour $45.00$50.00

 The Department has updated the MA Program's Fee Schedule to reflect the increase in payment for identified nursing services. An MA Bulletin will be issued to providers with instructions for billing.

Fiscal Impact

 The estimated impact to fee-for-service is $0.538 million in total funds for Fiscal Year 2021-2022 and $1.080 million in total funds for Fiscal Year 2022-2023. The estimated impact to managed care is $12.510 million in total funds for Fiscal Year 2021-2022 and $50.026 million in total funds in Fiscal Year 2022-2023.

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 Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

MEG SNEAD, 
Acting Secretary

 Fiscal Note: 14-NOT-1473. (1) General Fund;

 (7) MA—Fee-for-Service; (2) Implementing Year 2021-22 is $221,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2026-27 are $517,000; (4) 2020-21 Program—$808,350,000; 2019-20 Program—$344,107,000; 2018-19 Program—$342,544,000;

 (7) MA—Caption; (2) Implementing Year 2021-22 is $5,144,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2021-22 are $23,927,000; (4) 2020-21 Program—$3,080,000,000; 2019-20 Program—$2,507,000,000; 2018-19 Program—$3,303,000,000;

 (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 21-2156. Filed for public inspection December 23, 2021, 9:00 a.m.]


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