34 Pa. Code § 127.153. Medical fee updates on and after January 1, 1995—outpatient providers, services and supplies subject to the Medicare fee schedule.

§ 127.153. Medical fee updates on and after January 1, 1995—outpatient providers, services and supplies subject to the Medicare fee schedule.

(a)  On and after January 1, 1995, outpatient providers whose payments under the act are based on the Medicare fee schedule under § §  127.103—127.108 shall be paid as follows: the amount of payment authorized shall be frozen on December 31, 1994, and updated annually by the percentage change in the Statewide average weekly wage.
(b)  On and after January 1, 1995, adjustments and modifications by HCFA relating to a change in description or renumbering of any HCPCS code will be incorporated into the basis for determining the amount of payment as frozen in subsection (a) for services rendered under the act.
(c)  On and after January 1, 1995, payment rates under the act for new HCPCS codes will be based on the rates allowed in the Medicare fee schedule on the effective date of the new codes. These payment rates shall be frozen immediately, and thereafter updated annually by the percentage change in the Statewide average weekly wage.

Cross References

   This section cited in 34 Pa. Code §  127.101 (relating to medical fee caps—Medicare); and 34 Pa. Code §  127.103 (relating to outpatient providers subject to the Medicare fee schedule—generally).

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