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PA Bulletin, Doc. No. 02-2076



Medical Assistance Fee Schedule; Addition of Procedure Codes

[32 Pa.B. 5713]

   The Department of Public Welfare (Department) announces under 55 Pa. Code § 1150.61(a) (relating to guidelines for fee schedule changes) that effective November 16, 2002, the following procedure codes will be added to the Medical Assistance (MA) Fee Schedule.

Procedure Code Description MA Fee
81002 Urinalysis, nonautomated, without microscopy $3.65
86580 Immunology, tuberculosis, intradermal 5.50
90732 Immunization, pneumococcal polysaccharide vaccine 23-valent, adult or immunosuppressed patient dosage, for use in individuals 2 years of age or older, for subcutaneous or intramuscular use 10.00
99173 Screening test of visual acuity, quantitative, bilateral 6.00
99435History and examination of the normal newborn infant, including the preparation of medical records. (This code should only be used for newborns assessed and discharged from the hospital or birthing room on the same day.) 42.00

Fiscal Impact

   The estimated cost for Fiscal Year 2002-2003 is $429,000 ($200,000 in State funds). Of this amount, $343,000 ($161,000 in State funds) relates to the Capitation program while $87,000 ($39,000 in State funds) is for MA-Outpatient services.

   The estimated cost for Fiscal Year 2003-2004 is $756,000 ($348,000 in State funds). Of this amount, $548,000 ($254,000 in State funds) relates to the Capitation program while $208,000 ($94,000 in State funds) is for MA-Outpatient services.


   Interested persons are invited to submit written comments regarding this notice to the Department within 30 days of publication of this notice in the Pennsylvania Bulletin. Comments should be addressed to Department of Public Welfare, Office of Medical Assistance Programs, Attention: Suzanne Love, P. O. Box 2675, Harrisburg, PA 17105. Persons with a disability may use the AT&T Relay Services, (800) 654-5984 (TTD users) or (800) 654-5988 (voice users).


   Fiscal Note:  14-NOT-340. (1) General Fund;

Outpatient Capitation
(2) Implementing year 2002-03 is $39,000 $161,000
(3) 1st Succeeding year 2003-04 is $94,000 $254,000
2nd Succeeding Year 2004-05 is $94,000 $254,000
3rd Succeeding Year 2005-06 is $94,000 $254,000
4th Succeeding Year 2006-07 is $94,000 $254,000
5th Succeeding Year 2007-08 is $94,000 $254,000
Outpatient Capitation
(4) 2001-02 Program-- $649,055,000 $2,037,376,000
2000-01 Program-- $668,586,000 $1,487,944,000
1999-00 Program-- $622,669,000 $1,384,763,000
(7) MA--Outpatient and MA--Capitation; (8) recommends adoption. The additional costs outlined have been included in the 2002-03 Executive Budget.
[Pa.B. Doc. No. 02-2076. Filed for public inspection November 15, 2002, 9:00 a.m.]

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