RCPA - Rehabilitation and Community Providers Association


OMAP Clarifications
November 1, 2004

The Department of Public Welfare, Office of Medical Assistance Programs (OMAP), has issued several bulletins and clarifications that are of interest to PCPA members.

Medical Assistance (MA) Bulletin 99-04-13, Postponed Implementation of National Procedure Codes was issued on October 29 and is effective on November 1. This bulletin notifies all MA providers in the fee-for-service delivery system that implementation of additional national billing codes through the PROMISe system is postponed, except for those affecting ambulance services. Providers are instructed to continue using local procedure codes and modifiers as described in MA Bulletin #99-04-04: Billing of Local Codes through PROMISe, which was issued February 25. Providers in the managed care delivery system should contact their managed care organization (MCO) for specific guidance, as implementation may vary among MCOs. The bulletin encourages providers with questions about billing procedures to contact the appropriate Provider Services Inquiry Line.

DPW has updated the PROMISe web site.

  • Additional responses have been added to the Professional Provider Issues Log.
  • Teleconference training sessions have been scheduled for November 16 at 10:00 a.m. on Internet Training for Physicians and on November 18 at 1:30 p.m. for Mental Health Intensive Case Management, Mental Health Resource Coordination, Family Based Mental Health Service, and Mental Health Crisis Intervention Service. Interested providers should access www.dpw.state.pa.us/omap/promise/provconfcalltrng_process.asp to register for the training program.
  • A link to download Provider Electronic Solutions Software, Version 3.53 was added on October 21.
  • Information regarding duplicate claims was added on October 19.
  • Changes were made to the State Maximum Allowable Cost List, Effective October 28

For further information, please contact Betty Simmonds at PCPA.

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