Medical Assistance Fee Schedule Revisions in the Act 150 Program
[49 Pa.B. 7136]
[Saturday, November 30, 2019]
The Department of Human Services (Department) is announcing a change in the fee schedule rates for Personal Assistance Services (PAS) procedure codes W1793, W1792 and W1792 TU for the Act 150 Program under 55 Pa. Code § 52.45 (relating to fee schedule rates).
The changes in the fee schedule rates for these services will be effective January 1, 2020.
The Department's rate methodology for the fee schedule rates was published in a public notice at 42 Pa.B. 3343 (June 9, 2012). Fee schedule rates were developed using a standardized market-based rate setting methodology. Relevant market-based information used to determine the fee schedule rates included Commonwealth-specific wage information from the Center for Workforce Information and Analysis, Occupational Wages by County, Bureau of Labor Statistics Employer Costs, cost surveys from providers, Medicare rate information and MA State Plan Fee Schedules.
The existing fee schedule rates for PAS (Agency), procedure code W1793, are increased by 2%. The intent of the increase is to provide for a wage increase for direct care workers providing agency-directed personal assistance services. The Department increased the rate under section 1729-J (72 P.S. § 1729-J), also known as the Fiscal Code, as amended by the act of June 28, 2019 (P.L. 173, No. 20). The Department is also increasing the PAS (Consumer) and PAS (Consumer Overtime) rates, procedure codes W1792 and W1792 TU, to maintain equity in all the PAS rates in the Act 150 Program.
Fee Schedule Rates
The following tables provide the rates for PAS procedure codes W1793, W1792 and W1792 TU:
Region Act 150 Procedure Code Rate Unit 1 X W1793 $4.47 15 minutes 2 X W1793 $4.97 15 minutes 3 X W1793 $4.68 15 minutes 4 X W1793 $4.98 15 minutes
Region Act 150 Procedure Code Rate Unit 1 X W1792 $3.48 15 minutes 2 X W1792 $3.33 15 minutes 3 X W1792 $3.64 15 minutes 4 X W1792 $4.08 15 minutes
PAS (Consumer Overtime)
Region Act 150 Procedure Code Rate Unit 1 X W1792 TU $5.22 15 minutes 2 X W1792 TU $5.00 15 minutes 3 X W1792 TU $5.46 15 minutes 4 X W1792 TU $6.12 15 minutes
The fiscal impact of this change is estimated at $0.429 million in State funds for Fiscal Year (FY) 2019-2020 and $1.031 million in State funds for FY 2020-2021.
Interested persons are invited to submit written comments regarding these fee schedule rates to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Marilyn Yocum, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments can also be sent to RAemail@example.com. Comments received within 30 days 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).
TERESA D. MILLER,
Fiscal Note: 14-NOT-1374. (1) General Fund and Lottery Fund;
(7) PENNCARE; (2) Implementing Year 2019-20 is $219,000; (3) 1st Succeeding Year 2020-21 through 5th Succeeding Year 2024-25 are $526,000; (4) 2018-19 Program—$333,778,000; 2017-18 Program—$336,062,000; 2016-17 Program—$331,246,000;
(7) Attendant Care; (2) Implementing Year 2019-20 is $210,000; (3) 1st Succeeding Year 2020-21 through 5th Succeeding Year 2024-25 are $505,000; (4) 2018-19 Program—$221,599,000; 2017-18 Program—$259,815,000; 2016-17 Program—$226,899,000;
(8) recommends adoption. The appropriations will absorb this increase.
[Pa.B. Doc. No. 19-1789. Filed for public inspection November 27, 2019, 9:00 a.m.]
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