NOTICES
Medical Assistance Program Fee Schedule Revisions
[43 Pa.B. 2109]
[Saturday, April 13, 2013]The Department of Public Welfare (Department) announces changes to the Medical Assistance (MA) Program Fee Schedule. These changes are effective for dates of service on and after April 15, 2013.
Fee Schedule Revisions
The Department is making updates to the MA Program Fee Schedule based upon payment indicators specified by the Centers for Medicare and Medicaid Services, in response to requests received from providers, and clinical reviews conducted by Department staff related to standards of practice, provider type/specialty combinations (PT/Spec), places of service (POS) and procedure code/modifier combinations.
Physician Services
The following surgical procedure codes will have POS 24 (ambulatory surgical center (ASC)/short procedure unit (SPU)) added for PT 31 (physician), with or without modifier 80 (assistant surgeon) as indicated as follows:
Procedure Codes and Modifiers
11981 11982 15221 15937 15953 19324 21243 21243 (80) 21295 21296 22222 22222 (80) 23031 23397 23397 (80) 23532 23532 (80) 24077 24077 (80) 24362 24362 (80) 24802 24802 (80) 25316 25316 (80) 25355 25355 (80) 25370 25370 (80) 25671 26262 26262 (80) 26991 27193 27194 27202 27202 (80) 27391 27392 27392 (80) 27497 27498 27498 (80) 27499 27499 (80) 27501 27503 27509 27604 27892 27893 28039 28039 (80) 28576 29860 29861 Procedure code 27096 will be end-dated in POS 22 (outpatient hospital) for PT 31 because this service is not payable to physicians in a clinic setting per MA regulations at 55 Pa. Code § 1221.51 (relating to general payment policy).
The following surgical procedure codes will have individual provider specialties end-dated and ''All'' specialties added because the Department has determined these procedures are within the scope of practice of all physicians:
Procedure Codes
15936 19307 20982 21047 21049 21160 29827 29899 Podiatrist Services
The following surgical procedure codes will have POS 21 (inpatient hospital) and 24 added for PT 14 (podiatrist), with or without modifier 80 as indicated as follows, because the Department has determined that these settings are appropriate for the performance of these services:
Procedure Code
and/or ModifierPOS Procedure Code
and/or ModifierPOS 15121 21, 24 27604 24 27692 24 27692 (80) 24 27816 24 27825 21, 24 28001 24 28039 24 28039 (80) 24 28106 24 28106 (80) 24 28436 24 28470 24 28496 24 28510 24 28576 24 28665 24 29450 24 ASC/SPU Services
The following surgical procedure codes will have PT/Specs 01/021 (SPU) or 02/020 (ASC), or both, added as indicated as follows in POS 24 with modifier SG (ASC/SPU facility support component) and will be paid the facility support component fee of $776.00:
Procedure Code PT/Spec Procedure Code PT/Spec 11981 01/021, 02/020 11982 01/021, 02/020 15937 01/021, 02/020 15945 02/020 15953 01/021, 02/020 19324 01/021, 02/020 21150 01/021, 02/020 21243 01/021, 02/020 21295 01/021, 02/020 21296 01/021, 02/020 21805 01/021, 02/020 21935 01/021, 02/020 22222 01/021 23031 01/021, 02/020 23397 01/021, 02/020 23532 01/021, 02/020 23921 01/021, 02/020 24077 01/021, 02/020 24362 01/021, 02/020 24802 01/021, 02/020 25316 01/021, 02/020 25335 01/021, 02/020 25355 01/021, 02/020 25370 01/021, 02/020 25392 01/021, 02/020 25393 01/021, 02/020 25490 01/021, 02/020 25491 01/021, 02/020 25492 01/021, 02/020 25671 01/021, 02/020 25931 01/021, 02/020 26262 01/021, 02/020 26416 01/021, 02/020 26479 01/021, 02/020 26593 01/021, 02/020 26991 01/021, 02/020 27193 01/021, 02/020 27194 01/021, 02/020 27202 01/021, 02/020 27391 01/021, 02/020 27392 01/021, 02/020 27497 01/021, 02/020 27498 01/021, 02/020 27499 01/021, 02/020 27501 01/021, 02/020 27503 01/021, 02/020 27509 01/021, 02/020 27604 01/021, 02/020 27732 01/021, 02/020 27871 01/021, 02/020 27889 01/021, 02/020 27892 01/021, 02/020 27893 01/021, 02/020 28039 01/021, 02/020 28106 02/020 28340 01/021, 02/020 28360 01/021 28436 01/021, 02/020 28576 01/021, 02/020 29860 01/021, 02/020 29861 01/021, 02/020 The following surgical procedure codes will have PT/Specs 01/021 or 02/020, or both, end-dated as explained as follows:
Procedure Code PT/Spec Reason 20101 02/020 Emergent/urgent service performed in inpatient or SPU settings only 20102 02/020 Emergent/urgent service performed in inpatient or SPU settings only 21049 02/020 Surgical service performed in inpatient or SPU settings only 21175 02/020 Surgical service performed in inpatient or SPU settings only 26125 01/021, 02/020 ASC/SPUs are not eligible for support component for add-on codes 26863 01/021, 02/020 ASC/SPUs are not eligible for support component for add-on codes 27216 02/020 Surgical service performed in inpatient or SPU settings only 27235 02/020 Surgical service performed in inpatient or SPU settings only Modifier Updates
Assistant Surgeon Services
The following surgical procedure codes will have modifier 80 added in POS 21 or 24, or both, as indicated with the specified fee, based upon provider requests and the Department's clinical review:
Procedure Code POS Fee Procedure Code POS Fee 20692 21, 24 $22.72 21047 21, 24 $89.60 21049 21, 24 $141.92 21339 21, 24 $48.64 21387 21 $105.59 21406 21, 24 $75.11 21495 21, 24 $52.00 21502 21, 24 $42.00 21600 21, 24 $42.00 21750 21 $61.60 21810 21 $17.92 22212 21 $160.00 22222 21, 24 $160.00 22812 21 $160.00 22855 21 $124.80 22900 21, 24 $18.80 23156 21, 24 $44.40 23332 21 $56.80 23405 21, 24 $56.32 23406 21, 24 $56.32 23515 21, 24 $42.08 23530 21, 24 $54.24 23532 21, 24 $54.24 23550 21, 24 $63.12 23585 21, 24 $64.00 23660 21, 24 $77.84 24101 21, 24 $44.88 24126 21, 24 $62.96 24330 21, 24 $75.76 24362 21, 24 $119.84 24802 21, 24 $95.76 24930 21 $59.92 24940 21 $143.84 25135 21, 24 $56.80 25145 21, 24 $34.72 25251 21, 24 $34.72 25301 21, 24 $48.16 25316 21, 24 $57.36 25335 21, 24 $130.56 25355 21, 24 $71.68 25370 21, 24 $71.68 25392 21, 24 $93.60 25393 21, 24 $104.00 25444 21, 24 $83.20 25449 21, 24 $46.88 25490 21, 24 $50.88 25491 21, 24 $67.36 25492 21, 24 $89.12 25628 21, 24 $48.00 25645 21, 24 $37.92 25905 21 $56.80 25907 21, 24 $17.92 25922 21, 24 $17.92 25924 21 $53.76 25929 21, 24 $31.20 26260 21, 24 $62.96 26357 21, 24 $47.36 26434 21, 24 $88.53 26497 21, 24 $57.36 26550 21, 24 $89.60 26555 21, 24 $89.60 26562 21, 24 $84.00 27030 21 $71.68 27033 21, 24 $71.68 27035 21, 24 $132.08 27036 21 $141.67 27048 21, 24 $19.20 27054 21 $95.70 27065 21, 24 $56.80 27080 21, 24 $41.28 27158 21 $108.00 27202 21, 24 $7.44 27259 21 $101.92 27331 21, 24 $60.96 27332 21, 24 $72.96 27333 21, 24 $72.96 27335 21, 24 $108.39 27381 21, 24 $78.08 27397 21, 24 $95.76 27626 21, 24 $71.68 27715 21 $143.84 28039 21, 24 $42.06 28107 21, 24 $33.28 28130 21, 24 $53.28 28238 21, 24 $70.08 28260 21, 24 $35.36 28261 21, 24 $81.76 28262 21, 24 $91.12 28264 21, 24 $61.92 28296 21, 24 $66.40 28297 21, 24 $66.56 28298 21, 24 $46.16 28299 21, 24 $66.40 28300 21, 24 $51.84 28302 21, 24 $14.88 28320 21, 24 $44.56 28340 21, 24 $65.55 28740 21, 24 $35.36 28760 21, 24 $65.28 28800 21 $61.92 29827 21, 24 $128.83 29847 21, 24 $75.04 29899 21, 24 $118.16 The following surgical procedure codes will have modifier 80 end-dated because an assistant surgeon is not appropriate for these procedures, based upon the Department's clinical review:
Procedure Codes
10081 12037 13102 13122 13133 13153 14350 15101 15120 15121 15221 15570 15572 15574 15576 15650 15736 15936 15937 15945 15946 15953 19125 19126 19325 19340 19342 19371 19380 20101 20102 20103 20920 20982 21029 21050 21210 21215 21235 21295 21296 21336 21356 21935 23130 23180 23415 24110 24130 24136 24145 24147 24310 24566 24582 25024 25025 25118 25120 25150 25210 25230 25240 25272 25274 25275 25280 25295 25337 25520 25652 25900 26121 26123 26125 26135 26140 26215 26412 26426 26480 26490 26496 26508 26510 26516 26520 26525 26536 26540 26542 26545 26567 26608 26685 27185 27187 27193 27194 27215 27235 27391 27425 27437 27475 27477 27485 27496 27497 27501 27503 27509 27596 27600 27601 27640 27641 27652 27664 27680 27681 27686 27695 27696 27707 27730 27766 27792 27824 27825 27882 27886 27889 27892 27893 28046 28344 28576 29819 29838 29848 29850 29870 29874 29875 29876 29877 29879 29880 29902 Right/Left/50 Modifiers
The following surgical procedure codes will have modifiers right (Rt), left (Lt) and bilateral (50) added because the procedures may be performed laterally or bilaterally:
Procedure Codes
15736 15945 15946 15953 19324 19325 19340 19342 19371 19380 20103 21050 21243 21295 21296 21356 21387 21406 23031 23130 23156 23180 23332 23405 23406 23415 23515 23530 23532 23550 23585 23660 23921 24077 24101 24110 24126 24130 24136 24145 24147 24330 24362 24566 24582 24802 24925 24930 24940 25024 25025 25118 25120 25135 25145 25150 25230 25240 25275 25300 25301 25316 25335 25337 25355 25370 25392 25393 25444 25449 25490 25491 25492 25520 25628 25630 25645 25652 25671 25900 25905 25907 25922 25924 25929 25931 26121 26496 26497 26508 26550 26555 26665 26991 27030 27033 27035 27036 27048 27054 27065 27096 27185 27187 27235 27259 27331 27332 27333 27334 27335 27381 27397 27425 27437 27475 27477 27485 27495 27496 27497 27498 27499 27501 27503 27506 27509 27596 27600 27601 27604 27626 27637 27640 27641 27652 27675 27695 27696 27707 27715 27730 27732 27766 27784 27792 27816 27824 27825 27871 27882 27886 27889 27892 27893 28130 28238 28260 28261 28262 28264 28296 28297 28298 28299 28300 28302 28360 28436 28496 28576 28760 28800 28805 29345 29450 29804 29819 29827 29838 29846 29847 29848 29850 29860 29861 29870 29874 29875 29876 29877 29879 29880 29894 29895 29898 29899 29902 Other Modifiers
The following surgical procedure codes will have modifiers added as indicated:
Codes Modifier Codes Modifiers 26123 F1,F2,F3,F4,F5,F6,F7,F8,F9,FA 26125 F1,F2,F3,F4,F5,F6,F7,F8,F9,FA 26135 F1,F2,F3,F4,F5,F6,F7,F8,F9,FA 26215 F1,F2,F3,F4,F5,F6,F7,F8,F9,FA 26260 F1,F2,F3,F4,F5,F6,F7,F8,F9,FA 26262 F1,F2,F3,F4,F5,F6,F7,F8,F9,FA 26426 F1,F2,F3,F4,F5,F6,F7,F8,F9,FA 26434 F1,F2,F3,F4,F5,F6,F7,F8,F9,FA 26520 F1,F2,F3,F4,F5,F6,F7,F8,F9,FA 26567 F1,F2,F3,F4,F5,F6,F7,F8,F9,FA 26685 F1,F2,F3,F4,F6,F7,F8,F9 28175 T1,T2,T3,T4,T5,T6,T7,T8,T9,TA 28510 T1,T2,T3,T4,T6,T7,T8,T9 28665 T1,T2,T3,T4,T5,T6,T7,T8,T9,TA Key: TA = left foot, great toe FA = left hand, thumb T1 = left foot, second digit F1 = left hand, second digit T2 = left foot, third digit F2 = left hand, third digit T3 = left foot, fourth digit F3 = left hand, fourth digit T4 = left foot, fifth digit F4 = left hand, fifth digit T5 = right foot, great toe F5 = right hand, thumb T6 = right foot, second digit F6 = right hand, second digit T7 = right foot, third digit F7 = right hand, third digit T8 = right foot, fourth digit F8 = right hand, fourth digit T9 = right foot, fifth digit F9 = right hand, fifth digit Limit Updates
The following surgical procedure codes will have changes to the limits as indicated as follows:
Code Present Limit Revised Limit Reason 14350 20 2 Used only for hands or feet—not digits. Only 2 surgical services are payable per 55 Pa. Code § 1150.54 (relating to surgical services) 15945 1 2 Adding Rt-Lt-50 modifiers 15946 1 2 Adding Rt-Lt-50 modifiers 15953 1 2 Adding Rt-Lt-50 modifiers 19324 1 2 Adding Rt-Lt-50 modifiers 19325 1 2 Adding Rt-Lt-50 modifiers 19371 1 2 Adding Rt-Lt-50 modifiers 19380 1 2 Adding Rt-Lt-50 modifiers 20103 1 2 Adding Rt-Lt-50 modifiers 21050 1 2 Adding Rt-Lt-50 modifiers 21243 1 2 Adding Rt-Lt-50 modifiers 21295 1 2 Adding Rt-Lt-50 modifiers 21296 1 2 Adding Rt-Lt-50 modifiers 21356 1 2 Adding Rt-Lt-50 modifiers 21387 1 2 Adding Rt-Lt-50 modifiers 21406 1 2 Adding Rt-Lt-50 modifiers 23130 1 2 Adding Rt-Lt-50 modifiers 23156 1 2 Adding Rt-Lt-50 modifiers 23180 1 2 Adding Rt-Lt-50 modifiers 23332 1 2 Adding Rt-Lt-50 modifiers 23405 1 2 Adding Rt-Lt-50 modifiers 23406 1 2 Adding Rt-Lt-50 modifiers 23415 1 2 Adding Rt-Lt-50 modifiers 23921 1 2 Adding Rt-Lt-50 modifiers 24077 1 2 Adding Rt-Lt-50 modifiers 24101 1 2 Adding Rt-Lt-50 modifiers 24110 1 2 Adding Rt-Lt-50 modifiers 24126 1 2 Adding Rt-Lt-50 modifiers 24130 1 2 Adding Rt-Lt-50 modifiers 24136 1 2 Adding Rt-Lt-50 modifiers 24145 1 2 Adding Rt-Lt-50 modifiers 24147 1 2 Adding Rt-Lt-50 modifiers 24330 1 2 Adding Rt-Lt-50 modifiers 24362 1 2 Adding Rt-Lt-50 modifiers 24802 1 2 Adding Rt-Lt-50 modifiers 24940 1 2 Adding Rt-Lt-50 modifiers 25024 1 2 Adding Rt-Lt-50 modifiers 25025 1 2 Adding Rt-Lt-50 modifiers 25118 1 2 Adding Rt-Lt-50 modifiers 25120 1 2 Adding Rt-Lt-50 modifiers 25135 1 2 Adding Rt-Lt-50 modifiers 25145 1 2 Adding Rt-Lt-50 modifiers 25150 1 2 Adding Rt-Lt-50 modifiers 25230 1 2 Adding Rt-Lt-50 modifiers 25240 1 2 Adding Rt-Lt-50 modifiers 25275 1 2 Adding Rt-Lt-50 modifiers 25316 1 2 Adding Rt-Lt-50 modifiers 25335 1 2 Adding Rt-Lt-50 modifiers 25337 1 2 Adding Rt-Lt-50 modifiers 25355 1 2 Adding Rt-Lt-50 modifiers 25370 1 2 Adding Rt-Lt-50 modifiers 25392 1 2 Adding Rt-Lt-50 modifiers 25393 1 2 Adding Rt-Lt-50 modifiers 25444 1 2 Adding Rt-Lt-50 modifiers 25449 1 2 Adding Rt-Lt-50 modifiers 25490 1 2 Adding Rt-Lt-50 modifiers 25491 1 2 Adding Rt-Lt-50 modifiers 25492 1 2 Adding Rt-Lt-50 modifiers 25628 1 2 Adding Rt-Lt-50 modifiers 25652 1 2 Adding Rt-Lt-50 modifiers 25671 1 2 Adding Rt-Lt-50 modifiers 25929 1 2 Adding Rt-Lt-50 modifiers 25931 1 2 Adding Rt-Lt-50 modifiers 26123 2 1 Code is for single digit
Code 26125 used for additional digits26125 2 1 Only 2 surgical services are payable per 55 Pa. Code § 1150.54 26516 2 1 Code is for single digit 27035 1 2 Adding Rt-Lt-50 modifiers 27048 1 2 Adding Rt-Lt-50 modifiers 27096 1 2 Adding Rt-Lt-50 modifiers 27187 1 2 Adding Rt-Lt-50 modifiers 27381 1 2 Adding Rt-Lt-50 modifiers 27425 1 2 Adding Rt-Lt-50 modifiers 27495 1 2 Adding Rt-Lt-50 modifiers 27601 1 2 Adding Rt-Lt-50 modifiers 27675 1 2 Adding Rt-Lt-50 modifiers 27690 2 1 Code is for single tendon
Code 27692 used for additional tendons27691 2 1 Code is for single tendon
Code 27692 used for additional tendons27692 2 1 Only 2 surgical services are payable per 55 Pa. Code § 1150.54 27715 1 2 Adding Rt-Lt-50 modifiers 27732 1 2 Adding Rt-Lt-50 modifiers 27871 1 2 Adding Rt-Lt-50 modifiers 28046 1 2 Code used for foot or toes 28238 1 2 Adding Rt-Lt-50 modifiers 28261 1 2 Adding Rt-Lt-50 modifiers 28297 1 2 Adding Rt-Lt-50 modifiers 28340 1 2 2 units allowed per National Correct Coding Initiative's (NCCI) medically unlikely events (MUE) 28344 10 2 Only 2 surgical services are payable per 55 Pa. Code § 1150.54 28436 1 2 Adding Rt-Lt-50 modifiers 28496 1 2 Adding Rt-Lt-50 modifiers 29847 1 2 Adding Rt-Lt-50 modifiers 29860 1 2 Adding Rt-Lt-50 modifiers 29861 1 1 Adding Rt-Lt-50 modifiers 29902 1 2 Adding Rt-Lt-50 modifiers Outside the scope
Dental Services
The following surgical procedure codes will be end-dated for all PT 27 (dentist) specialties, except provider specialty 272 (oral/maxillofacial surgeon), because the procedures can only be performed by a dentist with education and training in oral/maxillofacial surgery:
Procedure Codes
12037 13132 13133 13152 13153 15120 15121 15572 15574 15576 20920 21029 21047 21049 21050 21141 21142 21143 21145 21146 21147 21150 21151 21154 21155 21159 21160 21172 21210 21215 21235 21243 21295 21296 21336 21339 21356 21387 21406 21502 29804 Certified Registered Nurse Practitioner Services
The following surgical procedure codes will have PT 09 (certified registered nurse practitioner) end-dated for all specialties because the procedures are outside the provider's scope of practice, beyond their scope of education or training, or both:
Procedure Codes
29345 29450 Other
The following surgical procedure codes will have PT/Specs 14/140 or 27/All, or both, end-dated as indicated as follows because the procedures are outside the provider's scope of practice, beyond their scope of education or training, or both:
Procedure Code PT/Specialty Procedure Code PT/Specialty Procedure Code PT/Specialty 12037 14/140 13102 14/140 13121 14/140 27/All 27/All 13122 14/140 15100 14/140 15101 14/140 27/All 15572 14/140 20920 14/140 22900 14/140 27600 14/140 27601 14/140 27637 14/140 27640 14/140 27641 14/140 27658 14/140 27659 14/140 27664 14/140 27665 14/140 27675 14/140 27707 14/140 27892 14/140 27893 14/140 29345 14/140 End-Date POS
The following surgical procedure codes will have POS 11, 12 (home), 22, 23, 24, 31, 32, 49 (independent clinic), 54 (intermediate care facility) and/or 99 (special treatment room) end-dated, as indicated as follows, because the Department has determined that these settings are not appropriate for the performance of these services:
Procedure Codes POS Procedure Codes POS 13101 11,22,23,49,99 13102 11,12,22,23,31,32,49,99 13121 11,12,22,23,31,32,49,99 13122 11,12,22,23,31,32,49,99 13132 11,12,22,23,31,32,49,99 13133 11,12,22,23,31,32,49,99 13152 11,22,23,31,32,49,99 13153 11,22,23,31,32,49,99 14350 11,22,23,49,99 15100 11,22,23,49,99 15101 11,22,23,49,99 15120 11,22,23,49,99 15121 11,22,23,49,99 15220 22,23,49,99 15221 11,22,23,49,99 15570 22,23,49,99 15572 11,12,22,23,31,32,49,99 15574 11,22,23,49,99 15576 11,22,23,49,99 15650 11,22,23,49,99 15945 11,22,23,49,99 15953 11,22,23,49,99 19125 11,22,23,49,99 19126 11,22,23,49,99 20101 11,23,99 20102 23,99 20103 11,23,99 20692 22,23,49,99 20920 11,12,22,23,31,32,49,99 20962 24 21029 11,22,23,49,99 21047 11,22,23,49,99 21049 11,22,23,49,99 21141 24 21142 24 21143 24 21145 24 21146 24 21147 24 21151 24 21154 24 21155 24 21159 24 21172 24 21243 11,22,49 21336 11,22,23,49,99 21339 11,22,23,49,99 21356 11,22,49,99 21387 11,22,23,24,49,99 21406 11,22,23,49,99 21495 11,22,23,49,99 21502 11,22,23,49,99 21600 22,23,49,99 21705 24 21805 22,23,49,99 21810 22,23,24,49,99 21935 22,23,49,99 22855 11,22,23,24,49,99 22900 11,12,22,23,31,32,49,99 23031 11,12,22,23,31,32,49,99 23130 22,23,49,99 23156 22,23,49,99 23180 22,23,49,99 23332 22,23,24,49,99 23397 22,23,49,99 23405 22,23,49,99 23406 22,23,49,99 23415 11,22,23,49,99 23515 22,23,49,99 23530 22,23,49,99 23532 22,23,49,99 23550 22,23,49,99 23585 22,23,49,99 23660 22,23,49,99 23921 11,22,23,49,99 24101 22,23,49,99 24110 22,23,49,99 24126 11,22,23,31,32,49,99 24130 22,23,49,99 24136 11,22,23,31,32,49,99 24145 22,23,49,99 24147 22,23,49,99 24310 22,23,49,99 24330 22,23,49,99 24566 11,22,23,49,99 24582 22,23 24802 22,23,49,99 24930 24 25024 22,23,49 25025 22,23,49 25118 22,23,49 25120 22,23,49,99 25135 22,23,49,99 25145 11,22,23,31,32,49,99 25150 22,23,49,99 25210 22,23,49,99 25215 22,23,49,99 25230 22,23,49,99 25240 22,23,49,99 25251 11,22,23,49,99 25270 11,22,23,49,99 25272 11,22,23,49,99 25274 11,22,23,49,99 25275 22,23,49 25280 11,22,23,49,99 25290 11,22,23,49,99 25295 11,22,23,49,99 25300 11,22,23,49,99 25301 11,22,23,24,49 25316 22,23,49,99 25335 11,22,23,49,99 25355 22,23,49,99 25370 22,23,49,99 25392 11,22,23,49,99 25393 11,22,23,49,99 25444 11,22,23,49,99 25449 11,22,23,49,99 25490 11,22,23,49,99 25491 11,22,23,49,99 25492 11,22,23,49,99 25520 11,99 25628 11,22,23,49,99 25630 12,99 25645 22,23,49,99 25652 22,23,49 25671 22,23,49 25900 22,23,24,49,99 25905 22,23,49,99 25907 22,23,49,99 25922 22,23,49,99 25924 22,23,49,99 25929 11,22,23,49,99 25931 11,22,23,49,99 26121 22,23,49,99 26123 22,23,49,99 26125 22,23,49,99 26135 22,23,49,99 26140 11,22,23,49,99 26215 22,23,49,99 26260 22,23,49,99 26262 22,23,49,99 26412 22,23,49,99 26415 22,23,49,99 26416 22,23,49,99 26426 11,22,23,49,99 26434 22,23,49,99 26479 11,22,23,49,99 26480 22,23,49,99 26490 22,23,49,99 26496 22,23,49,99 26497 22,23,49 26508 22,23,49,99 26510 11,22,49,99 26516 22,23,49,99 26520 22,23,49,99 26525 11,22,23,49,99 26536 22,23,49,99 26540 22,23,49,99 26542 11,22,23,49,99 26545 22,23,49,99 26550 22,23,49,99 26555 22,23,49,99 26556 24 26562 22,23,49,99 26567 22,23 26593 99 26608 11,22,23,49,99 26665 11,22,23,31,32,49,54,99 26685 22,23,49,99 26775 22,23,49,99 26863 11,22,23,49,99 26991 11,12,22,23,31,32,49,99 27030 22,23,24,49,99 27033 22,23,49,99 27035 22,23,49,99 27036 24 27048 11,22,23,31,32,49,54,99 27054 22,23,24,49,99 27065 22,23,49,99 27080 22,23,49,99 27096 12,23,24,31,32,99 27185 22,23,24,49,99 27187 24 27193 11,22,23,49,99 27194 11,22,23,49,99 27202 11,12,22,23,31,32,49,99 27235 11,22,23,49,99 27259 22,23,24,49,99 27331 11,12,22,23,31,32,49,54,99 27332 22,23,49,99 27333 22,23,49 27334 22,23,49,99 27335 22,23,49,99 27381 11,22,23,49,99 27391 22,23,49,99 27392 22,23,49,99 27397 22,23,49,99 27425 11,22,23,49,99 27437 22,23,49,99 27475 22,23,49,99 27477 22,23,24,49,99 27485 22,23,24,49,99 27495 11,22,23,24,49,99 27496 99 27497 99 27498 99 27499 99 27501 11,22,23,49,99 27503 22,23,49,99 27506 22,23,24,49,99 27509 11,22,23,49,99 27596 22,23,24,49,99 27600 11,22,23,49,99 27601 11,22,23,49,99 27604 11,12,22,23,31,32,49,99 27626 11,22,23,49,99 27637 22,23,49,99 27640 22,23,49 27641 22,23,49,99 27652 22,23,49,99 27658 22,23,49,99 27659 22,23,49,99 27664 11,22,23,49,99 27665 11,22,23,49,99 27675 11,22,23,49,99 27680 22,23,49,99 27681 22,23,49,99 27686 22,23,49,99 27690 22,23,49,99 27691 22,23,49,99 27692 11,22,23,49,99 27695 11,22,23,49,99 27696 11,22,23,31,32,49,99 27707 22,23,49,99 27715 22,23,49,99 27730 11,12,22,23,31,32,49,99 27732 22,23,31,32,49,99 27766 11,23,31,32,49,54,99 27784 22,23,49,99 27792 11,22,23,31,32,49,54,99 27816 31,32,54,99 27824 31,32,54,99 27825 23,99 27871 11,12,22,23,31,32,49,99 27882 22,23,49,99 27886 22,23,24,49,99 27889 22,23,49,99 27892 11,22,23,49,99 27893 11,22,23,49,99 28001 12,31,32,54,99 28002 11,12,22,23,31,32,49,54,99 28039 11,22,49,99 28104 11,22,23,49,54,99 28106 11,22,23,49,99 28107 11,22,23,49,99 28130 11,22,23,49,99 28173 11,22,23,49,99 28175 11,22,23,49,99 28238 11,22,23,49,99 28260 22,23,49,99 28261 11,22,23,49,99 28262 22,23,49,99 28264 11,22,23,31,32,49,99 28298 11,22,23,49,99 28299 11,22,23,49 28300 11,22,23,49,99 28302 11,22,23,49,99 28320 11,22,23,49,99 28340 11,22,49,99 28344 11,22,49,99 28360 22,49,99 28436 11,22,23,49,99 28470 31,32,99 28496 11,22,23,49,99 28510 12,31,32,54,99 28576 11,22,23,31,32,49,99 28665 11,22,23,49,99 28740 11,22,23,49,99 28760 11,22,23,31,32,49,99 28800 22,23,24,49,99 28805 11,22,23,24,49,99 29345 12,31,32,99 29450 31,32,99 29804 11,22,23,49,99 29819 11,22,23,31,32,49,99 29827 22,49 29838 11,22,23,31,32,49,99 29846 11,22,49,99 29847 11,22,49,99 29848 11,22,49,99 29850 99 29860 22,23,49 29861 22,23,49 29870 11,22,23,31,32,49,99 29874 11,22,23,31,32,49,99 29875 11,22,23,31,32,49 29876 11,22,23,31,32,49,99 29877 11,22,23,31,32,49 29879 11,22,23,31,32,49,99 29880 99 29894 11,12,22,23,31,32,49,99 29895 11,12,22,23,31,32,49,99 29898 11,12,22,23,31,32,49,99 29899 11,22,23,49,99 29902 22,23,49 Fiscal Impact
It is anticipated that these revisions will result in minimal savings; therefore, there will be no fiscal impact.
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 Deputy Secretary's Office, Attention: Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received will be reviewed and considered for any subsequent revisions to the MA Program Fee Schedule.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
BEVERLY D. MACKERETH,
Acting SecretaryFiscal Note: 14-NOT-812. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 13-676. Filed for public inspection April 12, 2013, 9:00 a.m.]
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