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PA Bulletin, Doc. No. 21-1132

NOTICES

DEPARTMENT OF HUMAN SERVICES

Medical Assistance Program Fee Schedule Updates

[51 Pa.B. 3927]
[Saturday, July 17, 2021]

 The Department of Human Services (Department) announces changes to the Medical Assistance (MA) Program Fee Schedule.

Fee Schedule Revisions

 On March 13, 2020, the novel coronavirus (COVID-19) was declared a Nationwide emergency under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C.A. §§ 5121—5207) retroactive to March 1, 2020. Due to the COVID-19 pandemic, providers are dispensing a higher than normal amount of personal protective equipment. The Department is increasing the fee for disposable gloves.

 Effective with dates of services on and after July 1, 2021, the Department increased the fee for disposable gloves provided to MA beneficiaries as follows:

Procedure Code Procedure Description
Current MA Fee Revised MA Fee
A4927 Disposable gloves, non-sterile, per 100 $8.00 $14.00

 The MA Program Outpatient Fee Schedule has been updated to reflect this fee revision effective with dates of service on and after July 1, 2021. The Department will reprocess provider claims submitted for dates of service on and after July 1, 2021, to pay the revised MA fees. The Department will issue an MA Bulletin to providers notifying them of these fee revisions and the reprocessing of claims.

Fiscal Impact

 These changes are expected to result in annualized increased costs of $0.582 million in total funds.

Public Comment

 Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered for any subsequent revisions of the MA Program Fee Schedule.

 Persons with a disability who require auxiliary aid or service may submit comments using the Pennsylvania Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

MEG SNEAD, 
Acting Secretary

Fiscal Note: 14-NOT-1455. (1) General Fund; (2) Implementing Year 2020-2021 is $0; (3) 1st Succeeding Year 2021-22 through 5th Succeeding Year 2025-26 are $256,000; (4) 2019-20 Program—$344,107,000; 2018-19 Program—$342,544,000; 2017-18 Program—$477,690,000; (7) MA—Fee-for-Service; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 21-1132. Filed for public inspection July 16, 2021, 9:00 a.m.]



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