Medicaid Physician Reimbursement

The Division of Medicaid and Health Financing (DMHF) is submitting changes to the Medicaid State Plan through Attachment 4.19-B, SPA 12-002-UT Reimbursement for Physician and Anesthesia Services. The changes proposed would require that the physician fee schedule be updated annually using then current relative value units and a budget neutral conversion factor to establish rates. It proposes annual updates to the anesthesia fee schedule. It also makes other technical changes (e.g., removal of the "Rate Adjustment -- Access" program which is no longer in practice).

DMHF does not anticipate any impact to the budget as a result of this amendment.

The proposed effective date for these changes is July 1, 2012. The amendment is pending Centers for Medicare and Medicaid Services approval.

A copy of the changes 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 changes are also available at local county health department offices.

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