Skip to Page Content  |  Text OnlyGovernor | General Assembly | Courts | Elected Officials | State Agencies
 Photo: Featured Delaware Photo
 Phone Numbers Mobile Help Size Print Email

Delaware General AssemblyDelaware RegulationsMonthly Register of RegulationsMarch 2013

Table of Contents Previous Next

Authenticated PDF Version

In compliance with the State's Administrative Procedures Act (APA - Title 29, Chapter 101 of the Delaware Code), 42 CFR §447.205, and under the authority of Title 31 of the Delaware Code, Chapter 5, Section 512, Delaware Health and Social Services (DHSS) / Division of Medicaid and Medical Assistance (DMMA) is proposing to amend the Delaware Title XIX Medicaid State Plan regarding increased Medicaid payments for designated primary care services.
In 42 CFR §447.410, States are required to submit a State Plan Amendment (SPA) to reflect the fee schedule rate increases for eligible primary care physicians under section 1902(a)(13)(A) of the Social Security Act. The purpose of this requirement is to assure that when States make the increased reimbursement to providers, they have State Plan authority to do so and they have notified providers of the change in reimbursement as required by Federal regulations.
The rates do not reflect site of service adjustments, but reimburse at the Medicare rate applicable to the office setting.
The state has adjusted its fee schedule to make payment at the higher rate for each E&M and vaccine administration code.
This payment applies to all Evaluation and Management (E&M) billing codes 99201 through 99499.
The state will make payment under this SPA for the following codes which have been added to the fee schedule since July 1, 2009 (specify code and date added). (To Be Determined)
A single rate was in effect on 7/1/09 for all vaccine administration services, regardless of billing code. This 2009 rate is: $8.00 (eight dollars).
Last Updated: December 31 1969 19:00:00.
site map   |   about this site   |    contact us   |    translate   |