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PA Bulletin, Doc. No. 13-579

NOTICES

Medical Assistance Program Fee Schedule Updates

[43 Pa.B. 1812]
[Saturday, March 30, 2013]

 The Department of Public Welfare (Department) announces changes to the Medical Assistance (MA) Program Fee Schedule.

Fee Schedule Revisions

 In implementing the 2012 Healthcare Common Procedural Coding System updates to the MA Program Fee Schedule, the Department added incorrect purchase (NU) and rental (RR) fees for procedure code K0606. This procedure code was added to the MA Program Fee Schedule as a result of numerous Program Exception requests. The Department has revised the MA Program Fee Schedule fees for procedure code K0606 as follows:

Procedure
Code 		Procedure Description Pricing
Modifier 		Current MA Fee Revised MA Fee
K0606 Automatic external defibrillator, with integrated electrocardiogram analysis, garment type NU $2,449.26 $21,639.50
K0606 Automatic external defibrillator, with integrated electrocardiogram analysis, garment type RR $244.93 $2,163.95

 The Department will reprocess provider claims submitted for dates of service on and after June 25, 2012, to pay the revised MA fees. The Department will issue an MA Bulletin to providers notifying them of these fee revisions and the reprocessing of claims.

Fiscal Impact

 For Fiscal Year (FY) 2012-2013 these changes are expected to result in increased costs of $0.291 million ($0.158 million in State funds). The estimated cost for FY 2013-2014 is $0.218 million ($0.117 million in State funds).

Public Comment

 Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, 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 revisions of the MA Program Fee Schedule.

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

GARY D. ALEXANDER, 
Secretary

 Fiscal Note: 14-NOT-809. (1) General Fund; (2) Implementing Year 2012-13 is $158,000; (3) 1st Succeeding Year 2013-14 is $117,000; 2nd Succeeding Year 2014-15 is $117,000; 3rd Succeeding Year 2015-16 is $117,000; 4th Succeeding Year 2016-17 is $117,000; 5th Succeeding Year 2017-18 is $117,000; (4) 2011-12 Program—$645,095,000; 2010-11 Program—$467,929,000; 2009-10 Program—$435,939,000; (7) MA—Outpatient; (8) recommends adoption. The MA—Outpatient appropriation is able to absorb the increased cost.

[Pa.B. Doc. No. 13-579. Filed for public inspection March 29, 2013, 9:00 a.m.]


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