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  • Pennsylvania medicaid fee schedule

    3901] [Saturday, June 30, 2018]. The 2018 Medicare Fee Schedule contains the rates that were installed January 1, 2018, unless otherwise noted. The MA fee schedule is a list of all services and items covered under the MA program. Removal of foreign body, external. Sep 19, 2017. All documents include 4 pages, 4 indexed names  7 Jan 2015 Clinical Policies on the DMA Web Site. The Table of Contents contains active bookmark links to each section of the fee schedule. SCDHHS has published the fee schedule for telehealth codes that have been created during the COVID-19 public health emergency on the agency’s COVID-19 website. The revised professional fee schedule is published on this website every Tuesday after 4 p. Initial 90 minute visit (CPT code 99205 + 90838 + 99354): $450*. 1, 2021. Pennsylvania Medicaid Provider Manual. References: 1. 153(c), which states on or after Jan. g. Please use the monthly. Please note that the downloadable fee schedule is updated quarterly, with the most recent update having occurred on ​Publications for Providers. 70546. com, you can limit the fee schedules that appear to those that apply to your provider identifier. Nov 30, 2019 · The changes in the fee schedule rates for these services will be effective January 1, 2020. 70544. To obtain Table I, please contact the Bureau of Workers' Compensation by e-mail or telephone, 717-787-3486. 3. Access this page by clicking on the following link: The PROMISe™ Outpatient Fee Schedule can be found on the Fee Schedules page of the DHS Web site at the following link: http://dhs. To read more about the MPFS search tool, go to the MLN® booklet, How to Use The Searchable Medicare Physician Fee Schedule Booklet (September 2017) (PDF). the minimum fee schedule, the percentage discount for Modifier 26 from the Medicare fee schedule shall instead be applied to the minimum fee schedule. Current Fee Schedules; 2020: 2020 Fee Schedule - Covered Procedures Report with SA Requirements as of 10-01-2020 : 2020: 2020 Fee Schedule - Manually Priced Items with SA Requirements as of 10-01-2020 : 2020: 2020 SUD Services - Service Types,Codes and Rates : 2020 Fee Schedules File Type File Type Effective Date; Ambulance: PDF: Excel: July 1, 2020: Ambulatory Surgical Center Fee Schedule for DOS: PDF: Excel: July 1, 2020 Medicare replacement (PDF download) medicare benefits (PDF download) medicare part b (PDF download) Dental Fee Schedule 070116 – Pennsylvania Department of Medicare Physician Fee Schedule Part B January - 2021 Rev 2. The Centers for Medicare and Medicaid Services’ (CMS) 2020 Medicare Physician Fee Schedule (MPFS), includes changes to both Medicare physician payment and quality reporting program policies. Department of State Issues Telemedicine Guidance to Address COVID-19 Emergency Feb 16, 2021 · Medicaid Provider Updates: Feb 2021 Authorization Requirements Medicaid -Feb 15: Feb 2021 Notice of Medicaid Policy Updates For Mar 15: Feb 2021 Welcome to the Department of Medical Assistance Services’ (DMAS) homepage. 28. 888. If you notice inconsistencies or Pennsylvania Department of Human Services Logo. Please note-Recorded document base fees are listed on the fee schedule. This fee schedule includes reimbursement information for providers that bill services using professional claims and dental claims reimbursed under the fee-for-service (FFS) delivery system. C. 40. Pennsylvania (PA) Medicaid. As of July 2011, over 80 percent of all Medicaid beneficiaries were enrolled in some form of managed care. This site contains links to other  Therefore, an access to care issue is not a relevant or fair determination to revisit a fee schedule. Participants are not eligible for Community HealthChoices if they are a(n): • Act 150 program Participant; The Outpatient Fee Schedules are several Appendices of Ohio Administrative Code Rule 5160-2-21, effective through 7/31/17. Addendum ( PDF ) - ( XLS ) CPT Code Changes Effective 1/1/2017. Pennsylvania began experimenting with various managed carearrangements in the 1970’s, beginning with the introduction of its. 61. Nov 04, 2020 · Find telehealth information related to Medicare, HIPAA, Pennsylvania insurers, and more. 153. If you are a Texas Medicaid provider and you have an active account on TMHP. CPT procedure code. [49 Pa. Fee Schedules Medicaid Programs & Initiatives Dental Program ICD 10 Medical Equipment and Supplies Medicaid Customer Service: 1. Showing 1-10 of 26 entries 2019 Medicare Part A Fee Schedules . 58. UPMC for You …. The fee schedules and rates are provided as a courtesy to providers. The CY 2021 Medicare Physician Fee Schedule Final Rule was placed on display at the Federal Register on December 2, 2020. Contact Us: Join E-Mail List: Policy Search: Novitasphere : Providers in DC, DE, MD, NJ & PA A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. The Department  Durable Medical Equipment Providers: Medicaid Provider Information: Medicaid: Medical Services: Services: Department of Human Services: State of North Dakota. Closed on State holidays. 342. 11. Code Section 127. An item that does not normally need advanced The Centers for Medicare and Medicaid Services' (CMS) 2020 Medicare Physician Fee Schedule (MPFS), includes changes to both Medicare physician payment and quality reporting program policies. The fee schedules below describe services covered by South Dakota Medicaid. 4605] [Saturday, August 17, 2019]. 70545. Because this list is no longer used by Medicare, as they Fee Schedule for COVID-19 related codes. Varies by fee schedule type: Indian Tribal (I/T/U) NC Medicaid Contact Center Phone: 888-245-0179. The pricing formula will otherwise remain the same. Medicaid, a joint state and 11 Feb 2019 Aetna Better Health®of Pennsylvania. 56. 2020 Workers' Compensation Part B Fee Schedule Medicare Location Global Surgery Indicator Multiple Surgery For Pennsylvania Medicaid Providers PA Health & Wellness gives all Pennsylvania Medicaid providers the tools needed to provide comprehensive care to their patients. com Therapy Comply Home Page . 222. This fee was accessed on using the Palmetto GBA Medicare Fee Schedule Part B Lookup Tool. The Medicaid program of Pennsylvania follows certain requirements that enrollees must meet. Rate Year. Pennsylvania’s Requirements for Medicaid Qualification. If you are not enrolled in an MCO, call the Bureau of Fee for Service for help. A. Important Notes and Instructions. This is for Miscellaneous documents that require the payment of Pennsylvania Realty Transfer Taxes&nb Pennsylvania's Medicaid Program: Eligibility, Benefits, and How to Apply. The Department of  Medical Assistance Program Fee Schedule Revisions; 2018 Healthcare Common Procedure Coding System Updates; Prior Authorization Requirements. To start your search, go to the Medicare Physician Fee Schedule Look-up Tool. When revisions are made to the fee schedules, the appropriate providers will receive This system provides functionality for the Outpatient Fee Schedule. Assistance  Highmark's annual updates to the Skilled Nursing Facility Outpatient Fee Schedule for Medicare Advantage members. EP II 11350 McCormick Road, Suite 904 Hunt Valley, MD. 2000 Market certain ambulance transportation services on the Medical Assistance (MA) Program Fee. ND Medicaid BASIC Fee Schedule as of 7-1-2009 (1. Medicare JL. 3343 (June 9, 2012). These Medicare Fee Schedule amounts are for Delaware, District of Columbia (DC), Maryland (MD), New Jersey (NJ), and Pennsylvania (PA), and they are subject to change. Below is the link to the Medicaid Fee Schedule. www. The following chart is a quick reference that lists many Health Partners Medicaid benefits and services. Yes Services not on the Medical Assistance fee schedule, or that exceed the fee schedule in 1 May 2008 represents the fee schedule in effect for dates of service on and after the effective date. 34 Pa. Each additional UPI, $15. Dec 31, 2020 · The Fee Schedule is provided below in HTML and PDF formats. * Site of Service (SOS) Indicator should be interpreted in this way: A single procedure code/  Keystone First, coverage by Vista Health Plan, an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania. The links below contain all of Pennsylvania's zip codes and provides the correct region for each. The Pennsylvania Medical Society's&nbs Add $2. Outpatient Fee Schedule can be found on the Fee Schedules page of the DHS Web site. Becoming a contracted Pennsylvania Medicaid provider means you will also receive newsletters and alerts on upcoming education opportunities so that you are always providing superior Fee Schedule 2020. This link will take you to the PROMISe™ website where you will be required to log in using your Provider ID and Password. 86. 46. Medicare and Medicaid Services (CMS) to provide medical and behavioral health services to dual-eligible members. A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. Description. 0 - 999. Several updates have been made to the Adult Dental Fee Schedule. A4424. 1. Clicking the bookmark will bring the user directly to that section. Follow-up visit with 50 minutes of psychotherapy/medical management (CPT codes 99215 + 90838): $350*. With members throughout Berks, Bucks, Carbon, Chester, Dauphin, Delaware, Lancaster, Lebano Wyoming Medicaid Dental providers should refer to the Dental Fee Schedule when researching codes. Other claim form types will be rejected and returned to the provider. com. Each additional Name, $0. A4423. 6207 | Healthy Louisiana: Medicaid covered claims adjudicated through OPPS will be paid according to the applicable Medicare fee schedule, IHS providers are generally paid using the All-Inclusive Rate (please refer to the Indian Health provider manual for more specifics) and 1915(c) HCBS waiver providers should refer to the appropriate waiver-specific fee schedule. Therapy Comply is an education and compliance firm dedicated to assisting physical and occupational therapists with their compliance and reimbursement needs. These are large and complex documents. Great care has been taken to make sure that the prepared documents and the claims payment system are the same. S. Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) To use a general fee schedule, Medicaid providers can click Static Fee Schedules. NC Medicaid (Division of Health Benefits) is dedicated to providing access to physical and behavioral health care and services to improve the health and well-being of over 2. 1, 1995, payment rates under the act for new HCPCS codes will be based on the rates allowed in the Medicare fee schedule on the effective date of Clinical Laboratory Fee Schedule Files Note: Including a code and/or payment amount for a particular clinical diagnostic laboratory test does not imply Medicare will cover the test. 160. B. c. Fee schedules are subject to review and amendment under the provisions of Administrative Rule of South Dakota. Out-of-Office Administrative Time: $75 per 15 minute increment**. 1 PA PROMIS Therefore, providers should not use the fee schedule to set their rates. 04. Y. pa. DMAS is the agency that administers Medicaid and the State Children’s Health Insurance Program (CHIP) in Virginia. Recipients PA. Certain codes, including not not limited to 99381-5 and Jun 30, 2020 · Medicaid Adult Dental Benefit. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis. Medicaid Maximum&nb 16 Feb 2018 Nor is it covered by government programs such as Medicare and Medicaid. Optometric Services, Health Partners, Inc. 33. 2018 Medicare Part A Fee Schedules . Prothonotary Automation Fee as indicated in Act Number 98-164 is included in all new filing fees PA. Searching the Fee Schedule No fee schedules, basic unit, relative values or related listings are included in CPT. An Official Pennsylvania Government Compensation > Health Care Services Review > Medical Fee Review > Fee Schedule > Fee Schedule E0665 Medicare Location CY 2021 Physician Fee Schedule Final Rule. BY REPORT. The fee schedules do not address the various coverage limitations routinely applied by Oklahoma Medicaid before final payment is determined (e. Fee schedule rates were developed using a standardized market-based rate setting methodology. 00 notation fee for additional notations, Each additional Page, $2. 21031 P: 410-527-0780 E: info@pennsylvaniamgma. https://www . 50. m. County Detailed Rates 2019-2020 View 2019-2020 County Detailed Rates 2018-2019. No No The following fee schedules will now be effective April 1st through March 31st starting in calendar year (CY) 2019: Physician's (RBRVS) Fee Schedule Clinical Lab Fee Schedule billing guidance, fee schedules, and preauthorization information Nursing Services Program Rates – Fiscal Year 2020 Effective 7/1/19 COVID-19 Reimbursable Vaccine and Infusion Codes Fee Schedule Pennsylvania Medicaid services also cover complete health checks. Providers should always bill their usual and customary charges. 65205. This fee  Core Based Statistical Areas · Delaware / Washington DC · Maryland · New Jersey · Pennsylvania  30 Mar 2020 Services (CMS) and the Pennsylvania Department of Human Services (PA DHS) to healthcare providers regarding coding and The MA (Medicaid) fee schedule provides appropriate coding instructions and is the source for. Health Partners Plans is proud to work with you and the thousands of PCPs, specialists, dentists and vision care and other providers who make up our network. Fee schedules are listed by provider type. 66. 177. Voluntary Managed Care Program, a comprehensive risk-based MCO program availableto most Medicaid upmc for you fee schedule. Mar 19, 2020, 09:17 AM Pa. PDF download: PROMISe Quick Tip #201 Medical Assistance (MA) Fee Schedule … attachment to MA Bulletin 01-16-33 et al; titled MA Program Fee Schedule As of December 2019, has enrolled 985,201 individuals in Medicaid and CHIP — a net increase of 57. 31 PER MONTH. In addition to payment updates, it adds new services to the telehealth list, updates the scope … Jan 25, 2021 · For our Pennsylvania providers, we've developed a set of guidelines for a variety of conditions, as well as clinical indicators and reference materials. Update 10/12/2020. 46. 42 Section Et Seq. The Pennsylvania Workers’ Compensation Part B Fee Schedule reimbursement for all new HCPCS codes have been calculated in compliance with 34 Pa. Pennsylvania General Dentist Fee Schedule Pennsylvania General Dentist Fee Schedule ** Any treatment provided by a participating specialist, if available, in Oral Surgery, Orthodontics, Periodontics, Pedodontics, Prosthodontics or Endodontics, will be charged at a 25% reduction of participating specialist’s fees for that particular case. Accessed February 19, 2020. Medicaid Fee Schedule * Last Update (February 2021) Medicaid Provider Rates and Fee Schedules 2 Medicaid Related Assistance Medicaid & Long-Term Care https://service. Once approval is received, the fee schedule will be updated with only the revised rates and the corresponding effective date. govdelivery. NC Medicaid Bulletins for additions, changes, and deletion to this schedule. Medical management only for 30 minutes (CPT code 99214 + 90833): $200*. This fee schedule offers a list of codes, the reimbursement rate, any age limitations, and a column specfic to whether the code requires an LOA for reimbursement. When revisions are made to the fee schedules, the appropriate providers will receive notice of such changes in writing at least 30 days in advance of the revisions being Drug Fee Schedules MA Fee Schedules Personal Care Home Reports Pharmacy Service Fax Forms PROMISe Companion Guides PROMISe Desk References PROMISe Provider Handbooks and Billing Guides PA Provider Quick Tips RA Mailing Dates Regulations, Handbooks, Guides, and Manuals Remittance Advice Alerts/PROMISe Banner Pages ODP Fee Schedule Rate Tables Effective Starting July 1, 2019 The Department of Human Services (department) establishes the fee schedule rates for targeted support management and select services funded through the Consolidated, Person/Family Directed Support (P/FDS), and Community Living waivers, as well as the Department-Established Fees for Generally, since January 1, 1995, medical fees for outpatient services rendered under the Act are capped at 113% of the Medicare reimbursement rate. 195. These reductions have been submitted to CMS for review and are pending approval. Medical. CMS updates and corrects fees often, which may mean the information below is out of date. 61. These updates include coverage of D1206 (Topical Application of Fluoride Varnish) and D1208 (Topical Application of Fluoride-Excluding Fluoride Varnish). 00 service charge&nb. Payment rates are then frozen and thereafter updated annually by the percentage change in the Statewide average weekly wage. Dec 18, 2019 · MA Fee Schedules. gov/providers/Providers/Pages/Health%20Care%20for%20Providers/MA -Fee-Schedule. 45. "Usual and customary charge" means the provider's charge for providing the same service to persons not eligible for Medicaid benefits. Provides verification of MA eligibility & plan information …. Medicare Physician Fee Schedule. View 2018-2019 County Detailed Rates: 2017-2018: View 2017-2018 County Detailed Rates Mar 13, 2017 · Pennsylvania Medicaid Fee Schedule. This fee schedule divides fees into four geographic regions. HPI Fee. 43. 29. 31. Act 21 Forms · Behavioral Health Services · Bureau of Hearings and Appeals Non-Formal Provider Appeals · Child Care Forms · Child Care Works Regulations, Policies, and Documents &mi These are the current fees the Pennsylvania Department of Health pays participating providers for services for the conditions or programs listed below. Mar Pennsylvania - 2015 AAP Medicaid Reimbursement Survey Medicare rates in this report are (a) based on non-facility Medicare payment published by the Centers for Medicare and Medicaid Services for 2011, and (b) adjusted with Geographic Practice Cost Index (GPCIs) published by CMS. The 2019 Medicare Fee Schedule contains the rates that were installed January 1, 2019, unless otherwise noted. Code §§ 127. , recipient and provider eligibility, billing instructions, frequency of services, third party liability, copayment, age restrictions, prior authorization, etc. COVID-19. Outpatient fee schedule. 43 MB pdf) Updated March 2010 Aug 23, 2019 · Included in the August 24, 2019 Pennsylvania Bulletin was a notice from the Department of Human Services (DHS) about a change in the fee schedule rates for Personal Assistance Services (PAS) procedure codes (W1793, W1793TT, W1792, and W1792TU), and for Residential Habilitation procedure codes W0100 and W0102 in the Medical Assistance OBRA Waiver. The code "PA" next to a maximum fee means that the service or item must be approved in advance. Table I is not available online. gov. docx …. Providers are to charge their reasonable and customary charge regardless of the anticipated reimbursement from the department. This change& Fee Schedule Increase (FSI): indicates the base Florida Medicaid rate with a 4% increase PA. North Dakota Medicaid DME Rental Fee Schedule as of 07/01/2010 (256 kb pdf) Added and Deleted codes to the DME Fee Schedules Effective 4-1-2011 Revision to the Added and Deleted codes to the DME Fee Schedules Effective 4-1-2011; Previous Fee Schedules - 2009 . CMS also contracts Allwell to provide Part D Prescription medications to members enrolled in certain health plans which include a Part D benefit. as amended; All checks returned for insufficient funds will be assessed a $20. If you find a code not listed, contact DXC Technology at 1-866-686-4272, for more information. This final rule updates payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after Jan. Allwell is designed to achieve four main objectives: An Official Pennsylvania Government Website. The services include treatment of health problems diagnosed during checkup for members under 21 years. The fee displayed is the allowable rate for this service. PDF download: 837 Institutional/UB-04 Claim Form – Pennsylvania Department of … Jan 27, 2017 … institutional ub-04 provider handbook_master_01-27-17. 2020. 149. 70543. The state’s independent actuaries determine the dollar value to be included in the MCO capitation Per Member Per Month (PMPM) rates to permit the MCOs to pay enhanced this on-line statement comparing the pennsylvania workers compensation fee schedule with medicare rates evidence from 160 important as well as review them wherever you are now. The Department will apply this 2007 Medicare conversion factor to claims for services rendered on and after May 21, 2007. Q: Where does the medical marijuana come from it? A: All of the medical marijuana sold in Pennsylvania is produced in the state by state-licensed  Fee Schedule. A4425. 29% since the first Marketplace Open Enrollment Period and related Medicaid program changes in October 2013. Removal of foreign body,&nbs Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid. " The Adjusted Fee column displays the fee with all of the percentage reductions applied. The AMA does not directly or indirectly practice medicine or dispense medical services. ) The Pennsylvania Workers' Compensation Fee Schedule for Part B providers uses as its base fees the 1994 Medicare Fee Schedule. gov/publications/forproviders/schedules/mafeeschedules/index. htm . BR: FEE: Maximum reimbursable Medicaid fee. Paper Claim Submissions PA Health & Wellness only accepts the CMS 1500 (2/12) and CMS 1450 (UB-04) paper claim forms. • Are dually eligible for Medicare and Medicaid; OR • Qualify for Medicaid long-term services and supports (LTSS) because need the level of care provided by a nursing facility. The last increase in Medical Assistance reimbursement for 5 Dec 2020 (b) The Medical Assistance program fee schedule and Chapter 1150 (relating to Medical Assistance program payment policies), identify psychiatric services and fees reimbursed by the medical assistance program. View EDP Dental's Pennsylvania general dentist fee schedule. with information current as of the previous Sunday. 65220. Millions of Pennsylvanians need financial help in order to be able to afford their health care and/or long-term care. 1 million North Carolinians on behalf of the North Carolina Department of Health and Human Services. It also extends several recently expired Medicare legislative provisions affecting health care providers and beneficiaries, including the Medicare physician fee schedule work geographic adjustment floor, add-on payments for ambulance services and home health rural services, changes to the payment adjustment for low volume hospitals, and the Cannon Health Building 288 North 1460 West Salt Lake City, UT 84116 Dec 12, 2017 · Pennsylvania has its own rules regarding requirements for citizens to meet and eligibility for residents of the state. Since September 1, 2011, the Online Fee Lookup (OFL) and static fee schedules include a column titled "Adjusted Fee. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. Medical Services Reimbursement Schedule for Pennsylvania Medicaid. Please see the attached Pennsylvania Bulletin Notice from January 18, 2014. PCP visits (including CRNP, PA). $33. Dec 10, 2020 · This week the Centers for Medicare & Medicaid Services (CMS) released the final policy, payment, and quality updates for the Medicare Physician Fee Schedule, the Medicare Shared Savings Program, the Quality Payment Program, and the Diabetes Prevention Program for calendar year 2021. to 5 p. 00. dhs. aspx. 133. Search the Outpatient and Dental Fee Schedule Database; Downloadable MA Program Outpatient Fee schedule - The PROMISe™ Outpatient Fee Schedule is available for download in the following formats: Excel, PDF, and Comma Delimited. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. 101 (a) and 127. Fiscal Impact These fee schedules provide a view of the fees that were in effect during the first seven days of the selected quarter for the Medicaid program. Jan 01, 2020 · Durable Medical Equipment and Medical Supply Services Provider Fee Schedule for All Medicaid Recipients: Promulgated Fee Schedule 1/1/2020 Promulgated XLS 1/1/2020 Updated Fee Schedule 2021 Updated XLS 2021: Early Intervention Services Fee Schedule: Promulgated Fee Schedule 1/1/2020 Updated Fee Schedule 2021: Hearing Services Fee Schedule Jan 01, 2014 · Primary Care Rate Increase (PCRI) Fee Schedule : Last updated on 1/1/2014: Fee Schedules: Medicine : Last updated on 1/8/2021: Fee Schedules: Drugs : Last updated on 1/4/2021: Procedure Codes: Medicine and Drugs : Last updated on 9/4/2020: Fee Schedules: Radiology : Last updated on 1/4/2021: Procedure Codes: Radiology : Last updated on 8/17 AHCCCS 801 E Jefferson St Phoenix, Az 85034 Find Us On Google Maps. Provider Fee Schedules These are the current fees the Pennsylvania Department of Health pays participating providers for services for the conditions or programs listed below. gender, min /max units, PA requirements and PA min/max age are now available for procedures as a reference on this fee schedule. The Medicaid checkup services include vision and hearing screening, physical examination, health and developmental history, dental screening and a referral to a dentist from age Provider Fee Schedules . CHC Provider Update 3/24/2017 – Pennsylvania Department of … www. FEE Fee Schedule. 2. Look into all stipulations set forth before applying. The Workers' Compensation Fee Schedule is best viewed at 800 x 600 pixels. Radiology Fee Schedule. . Monday-Friday 8 a. Before searching and/or viewing the outpatient fee schedule information on this site, you must read and register your compliance with CPT only as contained in the following authoriz Medical Assistance Program Fee Schedule Revisions; 2019 Healthcare Common Procedure Coding System Updates and Fee Adjustments; Prior Authorization Requirements. Feedbooks is a massive collection of downloadable ebooks: fiction and non-fiction, public domain and copyrighted, free and paid. The Center for Medicare and Medicaid Services adjusted the Pennsylvania-specific Medicare conversion factor for 2007, to $15. Anesthesia Fee Schedule- effective 7/1/2018 * The rate schedules with an "*" include the 6% FFS rate reductions as approved in AB3 of the 2020 Special Legislative Session. 02. See Procedure Code section for further explanation by provider type. If you are seeking a general dentist in Pennsylvania, know the current fees. Pennsylvania Medical Group Management Association, Inc. Schedule, effective with dates of service on or after January 1, 2019. [48 Pa. 12 PER YEAR. Users can print individual sections by indicating the pages numbers to be printed. This Addendum should be used in tandem with the 10/1/2016 appendices to determine coverage of procedure codes for dates of service on or after 1/1/2017. Rate-Setting Methodology The Department's rate methodology for the fee schedule rates was published in a public notice at 42 Pa. • The Medicaid Number provided by the found on the member ID card or the provider portal. PDF download: PROMISe Quick Tip 41 Revised – PA.