Medical Assistance Program Fee Schedule Revision [44 Pa.B. 2589]
[Saturday, April 26, 2014]The Department of Public Welfare (Department) is announcing an addition to the Medical Assistance (MA) Program Fee Schedule. This addition is effective for dates of service on and after April 28, 2014.
Fee Schedule Revision
As a result of significant Program Exception requests, the Department is adding Healthcare Common Procedure Coding System procedure code S3854 defined as ''Gene expression profiling panel for use in the management of breast cancer treatment'' to the MA Program Fee Schedule. The Department will require prior authorization for this service as authorized under section 443.6(b)(7) of the Public Welfare Code (62 P. S. § 443.6(b)(7)).
The MA fee for this service is $2,865. The Department will issue an MA Bulletin to providers enrolled in the MA Program specifying the procedures for billing for this service.
Fiscal Impact
Because these services are being paid through program exceptions currently, there is no fiscal impact of adding this procedure code.
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Deputy Secretary's Office, Attention: Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received will be reviewed and considered for any subsequent revisions to the MA Program Fee Schedule.
Persons with a disability who require auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
BEVERLY D. MACKERETH,
SecretaryFiscal Note: 14-NOT-859. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 14-896. Filed for public inspection April 25, 2014, 9:00 a.m.]
