Pennsylvania Code
Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

• No statutes or acts will be found at this website.

The Pennsylvania Bulletin website includes the following: Rulemakings by State agencies; Proposed Rulemakings by State agencies; State agency notices; the Governor’s Proclamations and Executive Orders; Actions by the General Assembly; and Statewide and local court rules.

PA Bulletin, Doc. No. 23-899

NOTICES

DEPARTMENT OF
HUMAN SERVICES

Medical Assistance Program Fee Schedule Revisions; End-Dating COVID-19 Pharmacy Specimen Collection and Laboratory Testing Procedure Codes

[53 Pa.B. 3652]
[Saturday, July 8, 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 end-dating of three procedure codes related to the novel coronavirus (COVID-19) specimen collection by pharmacies and testing by laboratories, effective with dates of service on and after May 12, 2023.

Background

 On April 13, 2020, the Department of State issued guidance that granted licensed pharmacists the authority to order, administer tests and communicate results for COVID-19 tests. In response, the Department added the COVID-19 specimen collection procedure code G2023 to the Medical Assistance (MA) Program Fee Schedule to be used for collection of the COVID-19 specimen by a licensed pharmacist. This guidance is no longer in effect as of the end of the COVID-19 public health emergency (PHE) and therefore the procedure code will be end-dated, for dates of service on and after May 12, 2023.

 On April 14, 2020, the Centers for Medicare & Medicaid Services announced the creation of two new laboratory procedure codes to provide a higher payment for use of high-throughput technologies for increased testing capacity for the COVID-19 PHE. In response, the Department added procedure codes U0003 and U0004 to the MA Program Fee Schedule to be used for laboratory testing to detect SARS-CoV-2 virus. At the end of the COVID-19 PHE, these procedure codes will be end-dated, for dates of service on and after May 12, 2023. Outpatient clinics and laboratories can continue to bill for laboratory testing for COVID-19 with procedure codes U0001 or U0002.

Procedure Codes Being End-dated

 The Department is end-dating the following procedure codes from the MA Program Fee Schedule, effective with dates of service on and after May 12, 2023:

Procedure Codes
G2023U0003U0004

Fiscal Impact

 The Department does not anticipate a fiscal impact associated with this change.

Public Comment

 Interested persons are invited to submit written comments regarding the end-dating of the procedure codes indicated in this notice 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 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 (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

VALERIE A. ARKOOSH, 
Secretary

 Fiscal Note: 14-NOT-1585. No fiscal impact; recommends adoption.

[Pa.B. Doc. No. 23-899. Filed for public inspection July 7, 2023, 9:00 a.m.]


No part of the information on this site may be reproduced for profit or sold for profit.

This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.