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PA Bulletin, Doc. No. 23-231

NOTICES

DEPARTMENT OF HUMAN SERVICES

Medical Assistance Program Ambulance Transportation Fee Schedule Update

[53 Pa.B. 1022]
[Saturday, February 18, 2023]

 In accordance with 55 Pa. Code § 1150.61(a) (relating to guidelines for fee schedule changes), the Department of Human Services (Department) announces that it will increase fees in the Medical Assistance (MA) Program for certain ambulance transportation services in both the fee-for-service (FFS) and managed care delivery systems, effective with dates of service on and after January 1, 2023.

Discussion

 Act 54 of 2022 (P.L. 540, No. 54) (Act 54), enacted July 11, 2022, authorizes increased MA fees for ambulance transportation services in both the FFS and managed care delivery systems. Specifically, Act 54 authorizes the following fees: not less than $325 for basic life support ambulance transportation services; not less than $400 for advanced life support ambulance transportation services; and a fee of not less than $4 per loaded mile for each loaded mile beyond 20 loaded miles for ground ambulance transportation.

 The Department announced at 52 Pa.B. 7217 (November 19, 2022) increases to certain ambulance-related codes effective January 1, 2023. The Department is announcing that it will increase the MA fee for two additional ambulance transportation procedure codes effective January 1, 2023.

 The Department is revising the fees on the MA Program Fee Schedule for the following procedure codes, effective with dates of service on and after January 1, 2023.

Procedure
Code		Procedure Code DefinitionPricing Modifier  Current
MA Fee		 MA Fee Effective 
January 1, 2023
A0433Advanced life support, level 2 (ALS 2)  $300$400
A0434Specialty care transport (SCT)$300$400

Fiscal Impact

 There is no additional fiscal impact.

Public Comment

 Interested persons are invited to submit written comments regarding these fee increases to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, P.O. Box 2675, Harrisburg, PA 17120 or RA-PWMAProgComments@pa.gov. Comments received within 30 days will be reviewed and considered for any subsequent revision of 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, 
Acting Secretary

 Fiscal Note: 14-NOT-1565. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 23-231. Filed for public inspection February 17, 2023, 9:00 a.m.]


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