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PA Bulletin, Doc. No. 23-1558

NOTICES

DEPARTMENT OF
HUMAN SERVICES

Fee Schedule Rates for Select Services Funded Through the Office of Developmental Programs' Consolidated, Community Living, Person/Family Directed Support and Adult Autism Waivers

[53 Pa.B. 7099]
[Saturday, November 11, 2023]

 The Department of Human Services (Department) is providing final notice of the Fee Schedule Rates for Community Participation Support, Needs Group 5 Residential Habilitation and group Music Therapy, Art Therapy and Equine Assisted Therapy services funded through the Consolidated, Community Living and Person/Family Directed Support (P/FDS) Waivers and Transportation Trip services funded through the Consolidated, Community Living, P/FDS and Adult Autism Waivers.

 The Fee Schedule Rates for Community Participation Support and Transportation Trip services that are currently in effect will remain effective on November 11, 2023, which is 6 months after the expiration of the Federal novel coronavirus (COVID-19) public health emergency. The Fee Schedule Rates for Needs Group 5 Residential Habilitation and group Music Therapy, Art Therapy and Equine Assisted Therapy services will be effective on January 1, 2024.

Background

 Proposed Fee Schedule Rates for Community Participation Support, Transportation Trip, Needs Group 5 Residential Habilitation, Life Sharing Without Day, and group Music Therapy, Art Therapy and Equine Assisted Therapy services were published at 53 Pa.B. 2902 (May 27, 2023). The Department received comments from 16 stakeholders regarding the proposed Fee Schedule Rates. A summary of the comments received and the Department's responses is available at https://www.dhs.pa.gov/providers/Providers/Documents/ODP/Public%20Notices%20Related%20to%20 %20Rates/Summary%20of%20Rate%20Comments%20for %20Services%20Impacted%20By%202023%20Amendments. pdf. After reviewing the comments on the proposed rates, the Department determined that no changes were necessary to the proposed Fee Schedule Rates for Community Participation Support, Transportation Trip, Needs Group 5 Residential Habilitation and group Music Therapy, Art Therapy and Equine Assisted Therapy services. The Department will not be implementing the proposed rates for Life Sharing Without Day services because funding for these services was not included in the General Appropriations Act for Fiscal Year 2023-2024.

 The Fee Schedule Rates also serve as the Department-established fees under 55 Pa. Code § 4300.115(a) (relating to Department established fees) for base-funded services managed through county programs for individuals with an intellectual disability under the Mental Health and Intellectual Disability Act of 1966 (50 P.S. §§ 4101—4704); 55 Pa. Code Chapter 4300 (relating to county mental health and intellectual disability fiscal manual); and 55 Pa. Code Chapter 6100 (relating to services for individuals with an intellectual disability or autism).

 The final Fee Schedule Rates represent the maximum rates the Department will pay for each service. The final Fee Schedule Rates are included in the following tables and can also be found online at https://www.dhs.pa.gov/providers/Providers/Pages/ODP-Rates.aspx.


FEE SCHEDULE RATES FOR COMMUNITY PARTICIPATION SUPPORT SERVICES
EFFECTIVE NOVEMBER 11, 2023

Rates in the table are per 15-minute unit.

ServiceProcedure
Code		Staff to
Individual
Ratio		Fee Schedule
Rate		Fee Schedule
Rate for
Enhanced
Communication
Community Participation Support—FacilityW72221:11 to 1:15$2.96$3.27
W72231:7 to 1:10$3.18$3.61
W72261:4 to 1:6$5.23$6.01
W72241:2 to 1:3$6.84$7.90
W72441:1$12.40$14.50
W93531:1 Enhanced$17.27$20.66
W72692:1$23.77$27.96
W93562:1 Enhanced$28.65$34.12
Community Participation Support—CommunityW93511:2 to 1:3$6.98$8.02
W93522:3$10.43$13.60
W59961:1$12.81$14.97
W59971:1 Enhanced$17.83$21.38
W59932:1$24.62$29.07
W59942:1 Enhanced$29.70$35.43

FEE SCHEDULE RATES FOR TRANSPORTATION TRIP SERVICES EFFECTIVE NOVEMBER 11, 2023

ServiceUnit of ServiceProcedure
Code		Fee Schedule Rate
Transportation TripZone 1
(greater than 0 and up to 10 miles)		W7274$33.83
Zone 2
(greater than 10 miles and up to 30 miles)		W7275$60.91
Zone 3
(over 30 miles)		W7276$69.19

FEE SCHEDULE RATES FOR RESIDENTIAL HABILITATION NEEDS GROUP 5 AND GROUP MUSIC THERAPY, ART THERAPY, AND EQUINE ASSISTED THERAPY SERVICES EFFECTIVE JANUARY 1, 2024

Service NameNeeds
Group		Program
Capacity
or Staffing
Level		Procedure
Code/
Modifier		Fee
Schedule
Rate		Enhanced
Communication
Statewide
Fee
Licensed Residential Habilitation With Day Needs Group 51 person W9000/
U9		$1,265.90
(per day unit)		$1,519.08
(per day unit)
2 personW9029/
U9		$1,146.38
(per day unit)		$1,375.66
(per day unit)
3 personW9045/
U9		$788.17
(per day unit)		$945.80
(per day unit)
4 personW9047/
U9		$606.45
(per day unit)		$727.74
(per day unit)
5—8 personW9064/
U9		$546.93
(per day unit)		$656.32
(per day unit)
Licensed Residential Habilitation Without DayNeeds Group 51 personW9000/
U9/HI		$1,655.20
(per day unit)		$1,986.24
(per day unit)
2 personW9029/
U9/HI		$1,238.27
(per day unit)		$1,485.92
(per day unit)
3 personW9045/
U9/HI		$947.47
(per day unit)		$1,136.96
(per day unit)
4 personW9047/
U9/HI		$722.91
(per day unit)		$867.49
(per day unit)
5—8 personW9064/
U9/HI		$644.85
(per day unit)		$773.82
(per day unit)
Music TherapyN/A1:2 to 1:4G0176/
SE/
HQ		$9.58
(per 15-minute unit)		$12.11
(per 15-minute unit)
Art TherapyN/A1:2 to 1:4G0176/
HQ		$9.58
(per 15-minute unit)		$12.11
(per 15-minute unit)
Equine Assisted TherapyN/A1:2 to 1:4S8940/
HQ		$6.67
(per 15-minute unit)		$8.13
(per 15-minute unit)

 Copies of this notice may be obtained by contacting the Department of Human Services, Office of Developmental Programs, Division of Provider Assistance and Rate Setting, 4th Floor, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120, ra-ratesetting@pa.gov.

Fiscal Impact

 It is anticipated that there will be no fiscal impact.

VALERIE A. ARKOOSH, 
Secretary

 Fiscal Note: 14-NOT-1597. No fiscal impact; recommends adoption.

[Pa.B. Doc. No. 23-1558. Filed for public inspection November 10, 2023, 9:00 a.m.]


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