Update on DHS Vision PPS Implementation

As reported earlier, the Department of Human Services (DHS) has issued a Medical Assistance Bulletin establishing a separate vision PPS rate, effective Oct. 1, 2020, as well as adding vision to allow for up to four FQHC encounters per day (now medical, dental, behavioral and vision). Here are some points on the new vision PPS:

  • Health centers already offering vision services are to individually work with DHS on calculation of a vision PPS rate from the prior cost report.
  • PACHC has shared the updated cost report template as an attachment to the weekly All PA FQHC CEO Call summary, as well as with health center finance leaders.
  • The medical and dental provider productivity benchmarks have not changed in the new cost report template and Opthalmology is 3,599 and Optometry is 2,530.

PACHC is awaiting DHS’ decision on how payments will be made from Oct.1, 2020 until the vision PPS rate is established for health centers currently offering vision. For example, retroactive reconciliation back to Oct.1, 2020 or just start the new rate when it is calculated.