NOTICES

DEPARTMENT OF HUMAN SERVICES

Medical Assistance Program Fee Schedule: Addition of Procedure Codes for Vaccine Administration

[53 Pa.B. 6118]
[Saturday, September 30, 2023]

 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 vaccine administration. The effective dates and MA Fee for the codes are indicated as follows:

Procedure Code	National Code Description	Effective Date	MA Fee
90380	Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use	10/1/23	$10
90381	Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use	10/1/23	$10
90581	Anthrax vaccine, for subcutaneous or intramuscular use	10/1/23	$10
90589	Chikungunya virus vaccine, live attenuated, for intramuscular use	1/1/24	$10
90623	Meningococcal pentavalent vaccine, conjugated Men A, C, W, Y—tetanus toxoid carrier and Men B-FHbp, for intramuscular use	1/1/24	$10
90678	Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use	10/1/23	$10
90679	Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use	10/1/23	$10
90683	Respiratory syncytial virus vaccine, mRNA lipid nanoparticles, for intramuscular use	1/1/24	$10
90738	Japanese encephalitis virus vaccine, inactivated, for intramuscular use	10/1/23	$10
90758	Zaire ebolavirus vaccine, live, for intramuscular use	10/1/23	$10

 The Department will issue an MA bulletin to providers enrolled in the MA Program advising of the addition of the new Current Procedural Terminology codes to the MA Program Fee Schedule for vaccine administration.

Fiscal Impact

 The estimated annualized cost beginning in Fiscal Year 2023-2024 is $0.029 million in total funds.

Public Comment

 Interested persons are invited to submit written comments regarding the vaccine administration procedure code additions to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, P.O. Box 2675, Harrisburg, PA 17120 or to RA-PWMAProgComments@pa.gov. 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).

VALERIE A. ARKOOSH, 
Secretary

 Fiscal Note: 14-NOT-1592. Under section 612 of The Administrative Code of 1929 (71 P.S. § 232), (1) General Fund; (2) Implementing Year 2023-24 is $13,000; (3) 1st Succeeding Year 2024-25 through 5th Succeeding Year 2028-29 are $13,000; (4) 2022-23 Program—$589,137,000; 2021-22 Program—$644,059,000; 2020-21 Program—$808,350,000; (7) MA—Fee-for-Service; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 23-1339. Filed for public inspection September 29, 2023, 9:00 a.m.]

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