Reimbursement for Physician and Anesthesia Services

The Division of Medicaid and Health Financing (DMHF) will submit a State Plan Amendment (SPA) to update Attachment 4.19-B of the Medicaid State Plan.

Based on the existing State Plan requirement to annually rebase pricing of physician codes and an increase to the appropriations for these services from the Utah State Legislature,SPA 15-0007-UT Reimbursement for Physician and Anesthesia Servicesis being submitted. In addition to the rebasing, targeted Evaluation and Management and vaccine procedure codes will be increased effective July 1, 2015.

DMHF anticipates this rate change to result in an increase of approximately $4,032,100 in total annual expenditures.

The proposed change is pending Centers for Medicare and Medicaid Services approval.

A copy of the change may be obtained from Craig Devashrayee (801-538-6641), or by writing the Technical Writing Unit, Utah Department of Health, P.O. Box 143102, Salt Lake City, UT 84114-3102. Comments are welcome at the same address. Copies of the change are also available at local county health department offices.