DEPARTMENT OF
PUBLIC WELFAREAddition of Psychiatric Rehabilitation Services to the Medical Assistance Program Fee Schedule [40 Pa.B. 2062]
[Saturday, April 17, 2010]Purpose of Notice
The Department of Public Welfare (Department) announces the addition of psychiatric rehabilitation services to the Medical Assistance (MA) Program fee schedule, beginning on May 1, 2010.
Description of Services
Psychiatric rehabilitation is a therapeutic rehabilitative service for individuals with mental illness that may decrease the need for or shorten lengths of stay in inpatient, partial hospitalization and day treatment settings. It is designed to assist individuals to increase competence in normal life activities and gain the skills necessary to pursue life goals with the greatest amount of independence. Psychiatric rehabilitation helps individuals to achieve valued roles in the community in living, learning, working and social environments. Services include identifying strategies and treatment options to minimize negative effects of mental illness; developing and implementing individual skills to restore stability; supporting functional gains; and adapting to community living. Services must be recommended by a physician or other licensed practitioner of the healing arts acting within the scope of practice under State law. Medically necessary services may be delivered on an individual or group basis.
Fee Schedule
The procedure codes, modifiers, places of service and fees for psychiatric rehabilitation services are as follows:
Services Procedure Code Pricing Modifier Informational Modifier Place of
ServiceMA Rate Psych Rehab Site Based—Individual H0036 U7 99 $12.80 Psych Rehab Site Based—Group (more than 1 individual) H0036 U8 HQ (group setting) 99 $2.56 Psych Rehab Mobile—Individual H0036 U9 15 $14.75 Psych Rehab Mobile—
Group (no more than 2 individuals)H0036 UB HQ (group setting) 15 $7.38 Clubhouse Site Based—Individual H2030 U7 99 $12.80 Clubhouse Site Based—
Group (more than 1 individual)H2030 U8 HQ (group setting) 99 $2.56
Fiscal Impact
It is anticipated that adding psychiatric rehabilitation services to the MA Program fee schedule will have no fiscal impact because the reduction in more costly traditional mental health treatment and improved clinical and social outcomes will offset the cost of psychiatric rehabilitation services.
Public Comment
Interested persons are invited to submit written comments regarding the addition of psychiatric rehabilitation services to the MA Program fee schedule within 30 days of its publication to the Department at the following address: Department of Public Welfare, Office of Mental Health and Substance Abuse Services, c/o Deputy Secretary's Office, Attention: Regulations Coordinator, P. O. Box 2675, Harrisburg, PA 17105. Comments will be considered in subsequent revisions to the fee schedule.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service by calling (800) 654-5984 (TDD users) or (800) 654-5988 (Voice users).
HARRIET DICHTER,
Acting SecretaryFiscal Note: 14-NOT-635. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 10-695. Filed for public inspection April 16, 2010, 9:00 a.m.]
