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PA Bulletin, Doc. No. 22-438

NOTICES

DEPARTMENT OF HUMAN SERVICES

Medical Assistance Program Fee Schedule; Addition of Procedure Codes for MenQuadfi® and Vaxelis® Vaccine Administration

[52 Pa.B. 1696]
[Saturday, March 19, 2022]

 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 codes to the Medical Assistance (MA) Program Fee Schedule for the administration of the MenQuadfi® and Vaxelis® vaccines effective for dates of service on and after June 1, 2021.

CPT CodeVaccineDescriptionMA Fee
90619MenQuadfi®Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWY-TT),
for intramuscular use		$10
90697Vaxelis®Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine and hepatitis B vaccine (DTaP-IPV-Hib-HepB),
for intramuscular use		$10

 The Department updated the MA Program Fee Schedule to include Common Procedural Terminology (CPT) codes 90619 and 90697 for the administration of the vaccines. MA providers are to bill the Department for the administration of the vaccines for MA beneficiaries using the previously listed CPT codes.

 The Department will issue an MA Bulletin to providers enrolled in the MA Program advising of the addition of the new CPT codes to the MA Fee Schedule.

Fiscal Impact

 No fiscal impact will result from the addition of these procedure codes.

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-1502. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 22-438. Filed for public inspection March 18, 2022, 9:00 a.m.]


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