869 Medical Assistance Program fee schedule revisions; 2001 HCPCS updates  

  • DEPARTMENT OF PUBLIC WELFARE

    Medical Assistance Program Fee Schedule Revisions; 2001 HCPCS Updates

    [31 Pa.B. 2638]

       The Department of Public Welfare announces that effective January 1, 2001, changes have been made to the Medical Assistance (MA) Program Fee Schedule as a result of implementing the 2001 updates to the Health Care Financing Administration Common Procedure Coding System. The new procedure codes are compensable beginning January 1, 2001. Fees for the new procedure codes will be published in a MA Bulletin that will be issued to all providers.

    Changes to the MA Program Fee Schedule for Provider Types 01, 03, 04, 05, 07, 10, 11, 12, 15, 16, 17, 19, 20, 23, 30, 43, 49, and 50.

    Additions Effective January 1, 2001

    TOS Procedure Code TOS Procedure Code TOS Procedure Code TOS Procedure Code TOS Procedure Code
    AE A4324 AE A6231 9P, 9R E0148 AM L3923 25, 27, 40 19102
    AE A4325 AE A6232 9P, 9R E0149 9S L8040 25, 27, 40 19103
    AE A4331 AE A6233 9P, 9R E0168 9S L8041 25, 40 19295
    AE A4348 AE A7501 9R E0298 9S L8042 10, 20, 27, 40 21199
    AE A4396 AE A7502 9P, 9R E0571 9S L8043 20, 27, 40 22520
    AE A4561 AE A7503 9P, 9R E0572 9S L8044 20, 27, 40 22521
    AE A4562 AE A7504 9R E0574 9S L8045 20, 40 22522
    AE A4608 AE A7505 9P, 9R K0541 9S L8046 20, 27, 40 30465
    AE A6021 AE A7506 9P, 9R K0542 9S L8047 10, 20, 40 33141
    AE A6022 AE A7507 9P, 9R K0543 10, 20, 27, 40 15342 10, 20, 40 34800
    AE A6023 AE A7508 9P, 9R K0544 10, 20, 40 15343 10, 20, 40 34802
    AE A6024 AE A7509 AM L3760 20, 40 16036 10, 20, 40 34804
    10, 20, 40 34808 25, 27, 40 45387 10, 20, 40 61697 54, 57, RD 73222 86 83664
    10, 20, 40 34812 10, 20, 40 50545 10, 20, 40 61698 54, 57, RD 73223 86 83921
    10, 20, 40 34813 10, 20, 27, 40 50947 20, 27, 40 64614 54, 57, RD 73706 86 84152
    10, 20, 40 34820 10, 20, 27, 40 50948 20, 27, 40 67221 54, 57, RD 73718 86 85307
    10, 20, 40 34825 20, 27, 40 52341 54, 57, RD 70496 54, 57, RD 73719 86 85536
    10, 20, 40 34826 20, 27, 40 52342 54, 57, RD 70498 54, 57, RD 73722 86 86001
    10, 20, 40 34830 20, 27, 40 52343 54, 57, RD 70542 54, 57, RD 73723 86 86146
    10, 20, 40 34831 20, 27, 40 52344 54, 57, RD 70543 54, 57, RD 74175 86 86300
    10, 20, 40 34832 20, 27, 40 52345 54, 57, RD 70544 54, 57, RD 74182 86 86301
    10, 20, 27, 40 36870 20, 27, 40 52346 54, 57, RD 70545 54, 57, RD 74183 86 86304
    25, 27, 40 43231 25, 27, 40 52351 54, 57, RD 70546 54, 57, RD 75635 86 86611
    25, 27, 40 43232 20, 27, 40 52352 54, 57, RD 70547 54, 57, RD 75952 86 86666
    25, 27, 40 43240 20, 27, 40 52353 54, 57, RD 70548 54, 57, RD 75953 86 86683
    25, 27, 40 43242 20, 27, 40 52354 54, 57, RD 70549 54, 57, RD 76012 86 86696
    25, 27, 40 43256 10, 20, 27, 40 52355 54, 57, RD 71275 54, 57, RD 76013 86 86757
    25, 27, 40 44370 10, 20, 27, 40 52400 54, 57, RD 71551 54, 57, RD 76393 86 87046
    10, 25, 27, 40 44379 20, 27, 40 54512 54, 57, RD 71552 54, 57, RD 76819 86 87071
    25, 27, 40 44383 20, 27, 40 54522 54, 57, RD 72191 86 80157 86 87073
    25, 27, 40 44397 20, 27, 40 55873 54, 57, RD 72195 86 80173 86 87077
    25, 27, 40 45327 27, 30, 40 57022 54, 57, RD 72197 86 82373 86 87107
    25, 40 45341 20, 27, 40 57023 54, 57, RD 73206 86 82945 86 87149
    25, 40 45342 10, 20, 27, 40 57287 54, 57, RD 73218 86 83090 86 87152
    25, 40 45345 20, 27, 40 58353 54, 57, RD 73219 86 83663 86 87185
    86 87254 86 87281 86 87337 86 87451 86 88400
    86 87273 86 87283 86 87339 86 87800 80, AY, AZ 92586
    86 87275 86 87300 86 87341 86 87801
    86 87277 86 87327 86 87400 86 87901
    86 87279 86 87336 86 87427 86 87904

    End--Dated May 31, 2001

    Procedure Codes Being Deleted from the Fee Schedule as a Result of Those Updates and Which Will Not Be Compensable for Services Provided After May 31, 2001

    TOS Procedure Code TOS Procedure Code TOS Procedure Code TOS Procedure Code TOS Procedure Code
    AE A4560 86 P9013 20, 27, 40 52340 86 82251 86 87192
    AE A5065 9P Z9802 54, 57, RD 70541 86 87060 86 87208
    AE K0280 20, 27, 40 52335 54, 57, RD 71036 86 87117 86 87211
    9P, 9R K0456 20, 27, 40 52336 54, 57, RD 76365 86 87145
    9P, 9R K0457 20, 27, 40 52337 54, 57, RD 76934 86 87151
    9P K0458 20, 27, 40 52338 54, 57, RD 76938 86 87155
    9P K0459 10, 20, 27, 40 52339 54, 57, RD 76960 86 87175

       The fiscal note was prepared under provision of section 612 of The Administrative Code of 1929 (71 P. S. § 232).

    Price changes made to the MA Fee Schedule are routinely included in carryforward budget estimates.

    Contact Person:

       Interested persons are invited to submit written comments to this notice within 30-days of this publication. Comments should be sent to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Any comments received will be considered for subsequent fee schedule updates.

       Persons with a disability may use the AT&T Relay Services by calling (800) 654-5984 (TDD users) or (800) 654-5988 (voice users). Persons who require another alternative should contact Thomas Vracarich at (717) 783-2800.

    FEATHER O. HOUSTOUN,   
    Secretary

       Fiscal Note:  14-NOT-258.  (1) General Fund; (2) Implementing Year 2000-01 is $260,000; (3) 1st Succeeding Year 2001-02 is $704,000; 2nd Succeeding Year 2002-03 is $574,000; 3rd Succeeding Year 2003-04 is $574,000; 4th Succeeding Year 2004-05 is $574,000; 5th Succeeding Year 2005-06 is $574,000; (4) 1999-00 Program--$622,669,000; 1998-99 Program--$695,935,000; 1997-98 Program--$662,740,000; (7) Medical Assistance--Outpatient; (8) recommends adoption. Funds are included in the budget for this purpose.

    [Pa.B. Doc. No. 01-869. Filed for public inspection May 18, 2001, 9:00 a.m.]

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