NOTICES
DEPARTMENT OF PUBLIC WELFARE
Medical Assistance Program Fee Schedule Revisions
[44 Pa.B. 412]
[Saturday, January 18, 2014]The Department of Public Welfare (Department) announces changes to the Medical Assistance (MA) Program Fee Schedule. These changes are effective for dates of service on and after December 30, 2013.
Fee Schedule Revisions
The Department is making updates to the MA Program Fee Schedule based upon payment indicators specified by the Centers for Medicare and Medicaid Services, in response to requests received from providers and clinical reviews conducted by Department staff related to standards of practice, provider type/specialty combinations (PT/Spec), places of service (POS) and procedure code/modifier combinations.
Physician Services
The following surgical procedure codes will have POS 24 (ambulatory surgical center (ASC)/short procedure unit (SPU)) added for PT 31 (physician) in both the ASC and SPU unless otherwise indicated as follows:
Procedure Codes
31292(SPU) 31293(SPU) 31294(SPU) 32960(SPU) 33211(SPU) 33217(SPU) 33220(SPU) 33235(SPU) 33282(SPU) 33284(SPU) 35458(SPU) 37208(SPU) 37565(SPU) 37605(SPU) 37606(SPU) 38241 42227 42507 44378 46760 53085 53442 53449 54316 56805 57291 57335(SPU) 58260(SPU) 58290(SPU) 59100 59414(SPU) 61026 61050 61720(SPU) 61770 62000(SPU) 63046(SPU) 63048 64736 64738 64876 65800 66165 67218 67430 67974 68745 69530 69670 69725(SPU) 69820 69840 69915 The following surgical procedure codes will have POS 99 (Special Treatment Room) added for PT 31 as indicated as follows:
Procedure Codes
35471 35472 35475 35476 Surgical procedure code 62291 will be end-dated in POS 22 (outpatient hospital) for PT 31 because this service is not payable to physicians in a clinic setting under MA regulations in 55 Pa. Code § 1221.51 (relating to general payment policy).
The following surgical procedure codes will have individual provider specialties end-dated and ''All'' specialties added because the Department has determined these procedures are within the scope of practice of all physicians:
Procedure Codes
36561 36838 37182 37183 37500 50543 50592 52402 53500 58290 58553 61316 61517 62148 64561 65780 Dental Services
The following surgical procedure codes will be end-dated for all PT 27 (dentist) specialties, except provider specialty 272 (oral/maxillofacial surgeon), because the procedures can only be performed by a dentist with education and training in oral/maxillofacial surgery:
Procedure Codes
31040 42205 42215 42226 42227 42235 42260 42507 64732 64736 64738 The following surgical procedure codes will have PT/Spec 27/All end-dated because the procedures are outside the provider's scope of practice, beyond their scope of education or training, or both:
Procedure Codes
30117 30118 30125 30310 67810 Podiatrist Services
Surgical procedure code 64787 will have POS 21 (inpatient hospital) and 24 added for PT 14 (podiatrist), with or without modifier 80, because the Department has determined that these settings are appropriate for the performance of this service.
Certified Nurse Midwife Services
Surgical procedure code 59414 will have POS 23 (emergency room) end-dated for PT 33 (certified nurse midwife) because the Department has determined that certified nurse midwives do not provide this service in the emergency room.
Clinic Services
The following surgical procedures codes will be revised for clinics as indicated in the key as follows:
Procedure Code
and/or ModifierPT/PS/POS
End-datedPT/PS/POS Added/updated Comments 31231 08/All/49 08/082/49 Specialty Updated 57452 Not applicable 08/082/49 PT/PS/POS added 64612 08/All/49 08/082/49 Specialty Updated 64614 Not applicable 01/183/22 PT/PS/POS added 64614 Not applicable 08/082/49 PT/PS/POS added 65860 Not applicable 01/183/22 PT/PS/POS added Key: 08/082/49 Independent Medical-Surgical Clinic
01/183/22 Hospital Medical Clinic Emergency Room Services
Surgical procedure code 32960 will have ''All'' specialties end-dated for PT 01 (inpatient facility) in POS 23 and specialty 017 (ER Arrangement 2) added because only under ER arrangement 2 does the hospital bill for services provided by the emergency room physician.
ASC/SPU Services
The following surgical procedure codes will have PT/Specs 01/021 (SPU) or 02/020 (ASC), or both, added as follows in POS 24 with modifier SG (ASC/SPU facility support component) and will be paid the facility support component fee of $776.00:
Procedure
CodePT/Spec Procedure
CodePT/Spec 31292 01/021 31293 01/021 31294 01/021 32960 01/021 33211 01/021 33217 01/021 33220 01/021 33235 01/021 33282 01/021 33284 01/021 35458 01/021 37565 01/021 37605 01/021 37606 01/021 38241 01/021, 02/020 42227 01/021, 02/020 42507 01/021, 02/020 43831 01/021 44378 01/021, 02/020 46760 01/021, 02/020 53085 01/021, 02/020 53442 01/021, 02/020 53449 01/021, 02/020 54316 01/021, 02/020 56805 01/021, 02/020 57291 01/021, 02/020 57335 01/021 58260 01/021 59100 01/021, 02/020 59414 01/021 60502 01/021 61026 01/021, 02/020 61050 01/021, 02/020 61720 01/021 61770 01/021, 02/020 62000 01/021 62291 01/021, 02/020 62361 01/021, 02/020 63046 01/021 64736 01/021, 02/020 64738 01/021, 02/020 65800 01/021, 02/020 66165 01/021, 02/020 67218 01/021, 02/020 67430 01/021, 02/020 67974 01/021, 02/020 68745 01/021, 02/020 69530 01/021, 02/020 69670 01/021, 02/020 69725 01/021 69820 01/021, 02/020 69840 01/021, 02/020 69915 01/021, 02/020 The following surgical procedure codes will have PT/Specs 01/021 or 02/020, or both, end-dated as explained as follows:
Procedure
CodePT/Spec Reason 31290 01/021, 02/020 Service performed in inpatient setting only 31291 01/021, 02/020 Service performed in inpatient setting only 31800 01/021, 02/020 Service performed in inpatient setting only 33206 02/020 Service performed in acute care facility only 33213 02/020 Service performed in acute care facility only 33214 02/020 Service performed in acute care facility only 33233 02/020 Service performed in acute care facility only 33234 02/020 Service performed in acute care facility only 33240 02/020 Service performed in acute care facility only 33241 02/020 Service performed in acute care facility only 33244 02/020 Service performed in acute care facility only 33967 01/021, 02/020 Service performed in inpatient setting only 35450 01/021, 02/020 Service performed in inpatient setting only 35471 02/020 Service performed in acute care facility only 35472 02/020 Service performed in acute care facility only 35475 02/020 Service performed in acute care facility only 35476 02/020 Service performed in acute care facility only 36440 01/021, 02/020 Support component payment is made only for the primary service 36460 02/020 Service performed in acute care facility only 36511 01/021, 02/020 Service does not require anesthesia 36512 01/021, 02/020 Service does not require anesthesia 36513 01/021, 02/020 Service does not require anesthesia 36514 01/021, 02/020 Service does not require anesthesia 36515 01/021, 02/020 Service does not require anesthesia 36516 01/021, 02/020 Service does not require anesthesia 36821 02/020 Service performed in acute care facility only 36822 01/021, 02/020 Service performed in inpatient setting only 36825 02/020 Service performed in acute care facility only 36838 02/020 Service performed in acute care facility only 36870 02/020 Service performed in acute care facility only 37183 02/020 Service performed in acute care facility only 37207 02/020 Service performed in acute care facility only 37500 02/020 Service performed in acute care facility only 37607 02/020 Service performed in acute care facility only 37700 02/020 Service performed in acute care facility only 37735 02/020 Service performed in acute care facility only 37760 02/020 Service performed in acute care facility only 37780 02/020 Service performed in acute care facility only 38120 02/020 Service performed in acute care facility only 43830 02/020 Service performed in acute care facility only 44820 01/021, 02/020 Service performed in inpatient setting only 44950 01/021, 02/020 Service performed in inpatient setting only 46600 01/021, 02/020 Service performed in acute care facility only 46715 01/021, 02/020 Service performed in inpatient setting only 49020 01/021, 02/020 Service performed in inpatient setting only 49040 01/021, 02/020 Service performed in inpatient setting only 49425 01/021, 02/020 Service performed in inpatient setting only 50543 01/021, 02/020 Service performed in inpatient setting only 50605 01/021, 02/020 Service performed in inpatient setting only 51845 01/021, 02/020 Service performed in inpatient setting only 53448 01/021, 02/020 Service performed in inpatient setting only 53500 02/020 Service performed in acute care facility only 54535 01/021, 02/020 Service performed in inpatient setting only 57110 01/021, 02/020 Service performed in inpatient setting only 57555 02/020 Service performed in acute care facility only 58290 02/020 Service performed in acute care facility only 58553 02/020 Service performed in acute care facility only 59120 01/021, 02/020 Service performed in inpatient setting only 59121 01/021, 02/020 Service performed in inpatient setting only 59140 01/021, 02/020 Service performed in inpatient setting only 59830 01/021, 02/020 Service performed in inpatient setting only 59850 01/021, 02/020 Service performed in inpatient setting only 59851 01/021, 02/020 Service performed in inpatient setting only 59855 01/021, 02/020 Service performed in inpatient setting only 59856 01/021, 02/020 Service performed in inpatient setting only 60240 02/020 Service performed in acute care facility only 60271 02/020 Service performed in acute care facility only 61140 01/021, 02/020 Service performed in inpatient setting only 61575 01/021, 02/020 Service performed in inpatient setting only 61750 01/021, 02/020 Service performed in inpatient setting only 61751 01/021, 02/020 Service performed in inpatient setting only The following ASC/SPU fees were reviewed and adjusted as follows:
Procedure
CodePT/Spec MA Fee
(SG modifier)New Fee
(SG modifier)Reason 30310(SG) 01/021, 02/020 $1,090.00 $776.00 Error was made with original pricing 64561 01/021, 02/020 No fee assigned $776.00 SG modifier was previously omitted in error Modifier Updates
Assistant Surgeon Services
Based upon provider requests and the Department's clinical review, the following surgical procedure codes will have modifier 80 added in POS 21 or 24, or both, as follows, with the specified fee:
Procedure
CodePOS Fee Procedure
CodePOS Fee 30125 21,24 $83.20 32810 21 $93.60 33970 21 $53.57 36261 21,24 $40.00 36460 21,24 $51.11 36821 21,24 $80.10 36825 21,24 $87.25 36838 21,24 $151.30 37207 21,24 $66.48 37208 21,24 $32.12 37606 21,24 $48.16 38542 21,24 $21.76 42205 21,24 $119.84 42215 21,24 $95.76 42226 21,24 $93.28 42227 21,24 $93.28 42235 21,24 $95.76 42260 21,24 $58.40 42507 21,24 $70.98 42810 21,24 $38.64 43401 21 $100.80 43830 21,24 $47.68 43831 21,24 $39.52 44820 21 $59.92 44850 21 $77.84 44900 21 $48.08 46715 21 $65.32 46750 21,24 $59.92 46760 21,24 $87.04 47010 21 $108.64 47801 21 $85.60 47802 21 $61.44 48000 21 $81.44 48020 21 $119.84 49020 21 $41.52 49425 21 $73.60 49495 21,24 $50.96 50081 21,24 $155.36 50290 21 $87.04 50605 21 $108.80 51045 21,24 $43.04 51845 21 $86.36 53085 21,24 $20.00 53442 21,24 $52.00 53444 21,24 $98.39 53446 21,24 $75.54 53447 21,24 $72.80 53448 21 $146.64 53449 21,24 $52.00 53500 21,24 $89.10 54115 21,24 $58.26 54120 21,24 $49.68 54125 21 $99.36 54130 21 $124.40 54135 21 $148.96 54522 21,24 $82.15 54530 21,24 $51.52 54535 21 $61.92 55150 21,24 $31.20 56805 21,24 $112.16 56810 21,24 $27.84 57130 21,24 $23.06 57291 21,24 $77.24 57335 21,24 $160.00 57720 21,24 $31.20 58820 21,24 $26.64 59140 21 $42.40 59150 21,24 $65.52 59151 21,24 $81.76 61140 21 $48.16 61575 21 $160.00 61850 21 $86.16 64732 21,24 $42.00 64736 21,24 $42.00 64738 21,24 $59.92 64761 21,24 $60.28 64786 21,24 $71.68 64836 21,24 $73.84 64837 21,24 $48.16 64840 21,24 $66.48 64857 21,24 $66.48 64892 21,24 $88.40 65105 21,24 $71.68 65260 21,24 $88.56 65265 21,24 $100.88 65710 21,24 $138.54 65730 21,24 $153.80 65750 21,24 $156.21 65770 21,24 $160.00 65900 21,24 $122.26 66165 21,24 $71.68 66180 21,24 $71.68 66185 21,24 $71.68 66220 21,24 $87.95 67039 21,24 $50.40 67040 21,24 $160.00 67121 21,24 $63.20 67255 21,24 $107.04 67340 21,24 $43.14 67413 21,24 $93.76 67414 21,24 $93.76 67430 21,24 $132.08 67570 21,24 $91.22 67973 21,24 $89.60 67974 21,24 $108.00 68745 21,24 $89.60 68750 21,24 $89.60 69320 21,24 $160.00 69530 21,24 $125.92 69550 21,24 $143.64 69670 21,24 $108.00 69725 21,24 $143.84 69820 21,24 $119.84 69840 21,24 $68.64 69915 21,24 $160.00 69950 21 $160.00 Based upon the Department's clinical review, the following surgical procedure codes will have modifier 80 end-dated because an assistant surgeon is not appropriate for these procedures:
Procedure Codes 30118 31040 31231 31235 31237 31238 31239 31240 31255 31256 31267 31276 31287 31288 31290 31291 31292 31293 31294 31582 31800 33206 33211 33213 33214 33217 33220 33223 33233 33234 33235 33240 33241 33244 33282 33284 33961 33967 34490 35458 35471 35472 35475 35476 36822 36870 37182 37183 37500 37565 37607 37700 37735 37760 37780 38241 38550 43205 43215 43216 43244 43246 43248 43249 43250 43259 43261 43420 44312 44340 44378 44379 44394 45190 46288 47561 50575 50592 51030 52355 52400 52402 53240 54640 54840 55040 55041 55500 55530 55540 58559 58561 58562 58670 58800 59320 59414 59610 59612 59614 59618 59622 61316 61517 61720 61735 61750 61751 61760 61770 62000 62148 62201 62350 62287 62355 62360 62361 62362 62365 64590 64702 64718 64719 64744 64782 64784 64787 64788 64790 64820 65780 65782 65860 66825 69150 The following surgical procedure codes will have modifiers end-dated, because the modifier pricing equals the default pricing:
Procedure Code
and/or ModifierModifier pricing No modifier
(default) pricing57452 (U7) $39.50 $39.50 58600 (U7) $306.50 $306.50 58611 (TH) $71.89 $71.89 58900 (U7) $338.50 $338.50 The following assistant surgeon fee will be adjusted as indicated below because MA regulations at 55 Pa. Code § 1150.62(a) (related to payment levels and notice of rate setting changes) specifies that MA fees may not exceed the Medicare upper limit:
Procedure Code
and/or ModifierCurrent Fee
80 modifierNew Fee
80 modifier63046 (80) $200.00 $193.27 Right/Left/50 Modifiers
The following surgical procedure codes will have modifiers right (Rt), left (Lt) and bilateral (50) added because the procedures may be performed bilaterally unless otherwise indicated by Rt or Lt for unilateral services only:
Procedure Codes
31040 31235 31237 31238 31239 31240 31255 31256 31267 31276 31287 31288 31290 31291 31292 31293 31294 34490 35450 36838 37500 37565 37700 37735 37760 37780 38542 42810 49495 50081 50543 50575 50605 52355 54522 54530 54535 54640 54840 55500 55530 55540 58820 59120(Rt) 59120(Lt) 59151(Rt) 59151(Lt) 64561 64612 64718 64719 64732 64736 64738 64744 64761 64786 64836 64840 65105 65260 65265 65710 65730 65750 65770 65780 65782 65800 65860 65900 66165 66180 66185 66220 66825 67039 67040 67121 67218 67255 67413 67414 67430 67570 67810 67973 67974 68745 68750 69150 69320 69530 69550 69670 69725 69820 69840 69915 69950 Other Modifiers
The following surgical procedure codes will have modifiers added as follows:
Codes Modifier Codes Modifiers 64702 T1,T2,T3,T4,T5,T6,T7,T8,T9,TA 64702 F1.F2,F3,F4,F5,F6,F7,F8,F9,FA 64820 T1,T2,T3,T4,T5,T6,T7,T8,T9,TA 64820 F1.F2,F3,F4,F5,F6,F7,F8,F9,FA
Key: TA = left foot, great toe FA = left hand, thumb T1 = left foot, second digit F1 = left hand, second digit T2 = left foot, third digit F2 = left hand, third digit T3 = left foot, fourth digit F3 = left hand, fourth digit T4 = left foot, fifth digit F4 = left hand, fifth digit T5 = right foot, great toe F5 = right hand, thumb T6 = right foot, second digit F6 = right hand, second digit T7 = right foot, third digit F7 = right hand, third digit T8 = right foot, fourth digit F8 = right hand, fourth digit T9 = right foot, fifth digit F9 = right hand, fifth digit Surgical procedure code 58900 will have modifier FP end-dated because the service is not a family planning service.
Limit Updates
The following surgical procedure codes will have changes to the limits as follows. Based on payment limitations set forth at 55 Pa. Code § 1150.54(5) (related to surgical services) no procedure has a limit greater than two.
Code Present Limit Revised Limit Reason 31040 1 2 Adding Rt-Lt-50 modifiers 31235 1 2 Adding Rt-Lt-50 modifiers 31237 1 2 Adding Rt-Lt-50 modifiers 31238 1 2 Adding Rt-Lt-50 modifiers 31239 1 2 Adding Rt-Lt-50 modifiers 31240 1 2 Adding Rt-Lt-50 modifiers 31255 1 2 Adding Rt-Lt-50 modifiers 31256 1 2 Adding Rt-Lt-50 modifiers 31267 1 2 Adding Rt-Lt-50 modifiers 31276 1 2 Adding Rt-Lt-50 modifiers 31287 1 2 Adding Rt-Lt-50 modifiers 31288 1 2 Adding Rt-Lt-50 modifiers 31290 1 2 Adding Rt-Lt-50 modifiers 31291 1 2 Adding Rt-Lt-50 modifiers 31292 1 2 Adding Rt-Lt-50 modifiers 31293 1 2 Adding Rt-Lt-50 modifiers 31294 1 2 Adding Rt-Lt-50 modifiers 35450 1 2 Adding Rt-Lt-50 modifiers 35458 1 2 2 units allowed per National Correct
Coding Initiative's (NCCI) medically unlikely events (MUE)
35471 1 2 2 units allowed per NCCI MUE 37500 1 2 Adding Rt-Lt-50 modifiers 37565 1 2 Adding Rt-Lt-50 modifiers 37760 1 2 Adding Rt-Lt-50 modifiers 38550 2 1 Only 1 unit allowed per NCCI MUE 42810 1 2 Adding Rt-Lt-50 modifiers 50081 1 2 Adding Rt-Lt-50 modifiers 50543 1 2 Adding Rt-Lt-50 modifiers 50575 1 2 Adding Rt-Lt-50 modifiers 50605 1 2 Adding Rt-Lt-50 modifiers 52355 1 2 Adding Rt-Lt-50 modifiers 54522 1 2 Adding Rt-Lt-50 modifiers 54530 1 2 Adding Rt-Lt-50 modifiers 54535 1 2 Adding Rt-Lt-50 modifiers 54840 1 2 Adding Rt-Lt-50 modifiers 55500 1 2 Adding Rt-Lt-50 modifiers 55530 1 2 Adding Rt-Lt-50 modifiers 55540 1 2 Adding Rt-Lt-50 modifiers 58820 1 2 Adding Rt-Lt-50 modifiers 64561 1 2 Adding Rt-Lt-50 modifiers 64726 1 2 Multiple digital plantar nerves 64732 1 2 Adding Rt-Lt-50 modifiers 64736 1 2 Adding Rt-Lt-50 modifiers 64738 1 2 Adding Rt-Lt-50 modifiers 64744 1 2 Adding Rt-Lt-50 modifiers 64786 1 2 Adding Rt-Lt-50 modifiers 64836 1 2 Adding Rt-Lt-50 modifiers 64840 1 2 Adding Rt-Lt-50 modifiers 64857 1 2 Multiple major peripheral nerves 64892 1 2 Single strand repair in multiple nerves 65710 1 2 Adding Rt-Lt-50 modifiers 65730 1 2 Adding Rt-Lt-50 modifiers 65750 1 2 Adding Rt-Lt-50 modifiers 65770 1 2 Adding Rt-Lt-50 modifiers 65780 1 2 Adding Rt-Lt-50 modifiers 65782 1 2 Adding Rt-Lt-50 modifiers 65800 1 2 Adding Rt-Lt-50 modifiers 66180 1 2 Adding Rt-Lt-50 modifiers 66185 1 2 Adding Rt-Lt-50 modifiers 67039 1 2 Adding Rt-Lt-50 modifiers 67121 1 2 Adding Rt-Lt-50 modifiers 67218 1 2 Adding Rt-Lt-50 modifiers 67414 1 2 Adding Rt-Lt-50 modifiers 67570 1 2 Adding Rt-Lt-50 modifiers 67973 1 2 Adding Rt-Lt-50 modifiers 67974 1 2 Adding Rt-Lt-50 modifiers 68745 1 2 Adding Rt-Lt-50 modifiers 68750 1 2 Adding Rt-Lt-50 modifiers 69320 1 2 Adding Rt-Lt-50 modifiers 69530 1 2 Adding Rt-Lt-50 modifiers 69550 1 2 Adding Rt-Lt-50 modifiers 69670 1 2 Adding Rt-Lt-50 modifiers 69725 1 2 Adding Rt-Lt-50 modifiers 69820 1 2 Adding Rt-Lt-50 modifiers 69915 1 2 Adding Rt-Lt-50 modifiers 69950 1 2 Adding Rt-Lt-50 modifiers End-Dated Places of Service
The following surgical procedure codes will have POS 11 (office), 12 (home), 22-24, 31 (skilled nursing facility), 32 (nursing facility), 49 (independent clinic) and/or 99 end-dated, as follows, because the Department has determined that these settings are not appropriate for the performance of these services:
Procedure
CodesPOS Procedure
CodesPOS 30117 11,12,23,31,32,99 30118 11,12,22,23,31,32,49,99 30125 11,22,23,49,99 30310 22,23,49,99 31040 11,22,23,49,99 31231 99 31235 11,22,23,49,99 31237 11,22,23,49,99 31238 11,22,23,31,32,49,99 31239 11,99, 31255 11,23,99 31256 11,23,99 31267 99 31276 11,22,99 31290 24 31291 24 31582 99 31800 24,99 32810 11,22,23,49,99 32960 11,22,31,32,49,99 33206 22,23,49,99 33211 22,23,99 33213 22,23,99 33214 99 33217 99 33220 99 33223 99 33233 99 33234 99 33235 99 33240 99 33241 99 33282 99 33284 99 33967 22,23,24,49 35450 24 35471 22 36261 22,23,49,99 36440 23 36460 22,23,49,99 36511 21,23,24,49,99 36512 21,23,24,49,99 36513 21,23,24,49,99 36514 21,23,24,49,99 36515 21,23,24,49,99 36516 21,23,24,49,99 36822 11,22,23,24,49,99 36838 11 37207 99 37208 99 37565 23 37607 99 37700 11 38542 11,22,23,49,99 38550 11,22,23,49,99 42205 11,22,49 42215 11,22,49 42226 11,22,49 42227 11,22,49 42235 11,22,49 42260 11,22,49, 42507 11,22,49 42810 11,22,23,31,32,49,99 43205 11,22,23,49 43215 11,22,23,31,32,49 43216 11,22,23 43244 11,22,23 43246 11,22,23,49 43248 11,22,23 43249 11,22,23 43250 11,22,23 43259 11,22,23 43261 11,22 43830 11,22,23,99 44378 11,22,23 44379 23 44394 11,22,23 44820 24 44950 24 44955 24 45190 22,23,49,99 46288 11,22,23,99 46600 12,24,31,32,99 46715 23,24 47802 24,99 49020 23,24,99 49040 23,24,99 49425 24 49495 22,23,49 50081 11,22,23,49,99 50543 24 50575 11,22,99 50605 24 51030 22,23,49,99 51045 22,23,49,99 51845 11,22,23,24,49,99 52355 99 53085 11,22,23,49,99 53240 22,23,49,99 53442 11,22,23,49,99 53444 22,23,49 53446 22,23,49 53448 22,23,24,49 54530 99 54535 24 55040 11,22,23,49,99 55530 11,22,23,49,99 56810 11,22,23,49,99 57110 22,23,24,49,99 57130 22,23,49,99 57452 23,99 58562 99 58600 22,99 58950 24 59120 24 59121 24 59140 24 59320 11,22,23,49,99 59414 22,49,99 59830 11,22,23,24,49 59850 11,22,23,24,49 59851 11,22,23,24,49 59855 24 59856 24 61026 22,49,99 61050 22,23,49 61140 24 61575 24 61750 24 61751 24 62148 24 62287 22 62291 23,49 62350 11,99 62355 11,99 62360 11,23,99 62361 11,23,99 62362 11,99 62365 11,99 64590 22,23,49,99 64612 23,99 64614 99 64702 11,23,99 64719 11,22,23,49,99 64782 11,23,99 64786 23,99 64787 22 64788 22,23,49,99 64836 22,23,49,99 64837 11,22,23,49,99 64840 22,23,49,99 64857 22,23,49,99 65800 11,22,23,49,99 66165 22,23,49,99 66220 22,23,49,99 66825 11,99 67039 11,22,23,49,99 67040 99 67121 11,22,23,49,99 67218 11,22,23,49,99 67255 22,23,49,99 67340 22,23,49,99 67413 22,23,49,99 67430 22,23,49,99 67570 11,22,23,49,99 67810 12,23,31,32,99 67973 22,23,49,99 67974 11,22,23,49,99 Fiscal Impact
No significant fiscal impact is anticipated as a result of this notice.
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 an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service, (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
BEVERLY D. MACKERETH,
SecretaryFiscal Note: 14-NOT-855. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 14-145. Filed for public inspection January 17, 2014, 9:00 a.m.]
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