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Tags Posts tagged with "Final Rates"

Final Rates

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Photo by Markus Winkler on Unsplash

Due to delays in Individual Support Plan revisions and other factors impacting provider billing, ODP has extended the time period for providers to submit claims for services.

As indicated in ODP Announcement 24-084: Publication of Final Rates Effective Starting Fiscal Year 2024-2025 and Operational Guidance, page 8 noted, “In November, ODP will process a gross adjustment for any fee schedule services billed during the 1st quarter of the fiscal year. This gross adjustment will compensate providers for the rate differential effective July 1, 2024.”

This is a reminder to all providers to bill for any services rendered from July 1, 2024, through September 30, 2024. ODP will be compensating providers, via gross adjustments, for the difference between the rate billed and the updated fee schedule rate for dates of service rendered during the period July 1, 2024, through September 30, 2024. ODP anticipates processing gross adjustments on Remittance Advices dated Monday, December 23, 2024, to ensure all billing for dates of service July 1, 2024, through September 30, 2024, has been completed. Paid claims data in Remittance Advices between July 1, 2024, and November 18, 2024, will be used as the basis for the gross adjustment.

For questions on how to resolve billing errors for services, contact ODP Claims Resolution.

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As indicated in ODP Announcement 24-084: Publication of Final Rates Effective Starting Fiscal Year 2024-2025 and Operational Guidance, page 8 noted, “In November, ODP will process a gross adjustment for any fee schedule services billed during the 1st quarter of the fiscal year. This gross adjustment will compensate providers for the rate differential effective July 1, 2024.”

This is a reminder to all providers to bill for any services rendered from July 1, 2024, through September 30, 2024. ODP will be compensating providers, via gross adjustments, for the difference between the rate billed and the updated fee schedule rate for dates of service rendered during the period July 1, 2024, through September 30, 2024. ODP anticipates processing gross adjustments at the end of November 2024 to ensure all billing for dates of service July 1, 2024, through September 30, 2024, has been completed. Paid claims data in Remittance Advices between July 1, 2024, and November 4, 2024, will be used as the basis for the gross adjustment.

For questions on how to resolve billing errors for services, contact ODP Claims Resolution.

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The Office of Developmental Programs (ODP) has shared ODPANN 24-087, which informs stakeholders of corrections to rates for select services provided through the ODP Consolidated, Community Living, Person/Family Directed Support, and Adult Autism Waivers and base-funding that were published as final in the Pennsylvania Bulletin. Corrections were made to the following rates:

  • Community Participation Support Rates, Effective July 1, 2024; and
  • Life Sharing Without Day 1-Person Needs Group 3 and 4 Rates, Effective October 1, 2024.

The corrected final Fee Schedule Rates and Department-Established Fees for each service can also be found on DHS’s website. Please view the announcement for details.

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