Medical Assistance Program Fee Schedule Update
[52 Pa.B. 7567]
[Saturday, December 10, 2022]
The purpose of this notice is to announce, in accordance with 55 Pa. Code § 1150.61(a) (relating to guidelines for fee schedule changes), that the Department of Human Services (Department) is making the following updates to the Medical Assistance (MA) Program Fee Schedule for disposable breast milk collection and storage bags and breast pump replacement supplies.
Stakeholders contacted the Department to request that disposable breast milk collection and storage bags be a covered supply, as well as for fees to be reevaluated for a possible price adjustment to certain breast pump replacement parts. After evaluating these requests, the Department is making changes to the MA Program Fee Schedule as noted as follows.
New Procedure Code
The Department added the following procedure code, with a limit of 120 bags per month, to the MA Program Fee Schedule for the coverage of disposable collection and storage bags for human milk, effective with dates of service on and after December 25, 2022.
Procedure Code Code Description Fee K1005 Disposable Collection and Storage Bag for Breast Milk, Any Size, Any Type, Each $0.21 per bag
MA Program Fee Update
The Department updated the fee for the following procedure codes on the MA Program Fee Schedule for the coverage of breast pump supplies, effective with dates of service on and after July 12, 2022.
Procedure Code Code Description Fee A4281 Tubing For Breast Pump, Replacement $15.91 per unit A4282 Adapter for Breast Pump, Replacement $22.70 per unit A4284 Breast Shield and Splash Protector for Use with Breast Pump, Replacement $16.89 per unit
There is no fiscal impact for the addition and updates of these procedure codes.
Interested persons are invited to submit written comments to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, P.O. Box 2675, Harrisburg, PA 17120 or RA-PWMAProgComments@pa.gov. Comments received within 30 days will be reviewed and considered for any subsequent revision of the MA Program Fee Schedule.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania Hamilton Relay Service (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
Fiscal Note: 14-NOT-1554. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 22-1904. Filed for public inspection December 9, 2022, 9:00 a.m.]
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