Medical Supplies: Maximum Allowable mc sup mapc

Product Cost (MAPC) List 1

The Maximum Allowable Product Cost (MAPC) List for medical supplies contains maximum cost limits for certain medical supplies. Each cost limit is based on a reference product.

All medical supply types will be reviewed at least annually in priority of dollar volume purchased, or by changes in market conditions that affect supply and/or cost, as identified by the Department of Health

Care Services (DHCS). After a medical supply type is selected for review, all related medical supplies within that particular medical supply type will be reviewed by DHCS. Companies producing the medical

supplies within the reviewed medical supply type will have their products arrayed by Estimated Acquisition Cost in ascending order.

Proceedings before DHCS for establishing MAPC will be undertaken at public hearing. All interested

parties will receive prior notification of the hearing at least 45 days before the hearing date. Upon

request, DHCS will furnish any interested party a copy of the proposed MAPC regulations and the name

or names of the manufacturers of the reference product used to establish the MAPC. The price for the reference product upon which an established MAPC is based will be automatically updated and will not be subject to the public hearing regulation change process.

Other medical supplies are listed in the medical supplies list section of this manual.

Codes and Rates Medical supplies are reimbursed as listed below:

Medical Supply

Medical Supply Size MAPC Type Code Billing Unit

Catheters 5cc

2-Way Latex

Foley Catheters $ 10.7500 9914F ea

2-Way Latex-

combination

Foley Catheters 10.7500 9914H ea

2-Way 100%

Silicone Foley

Catheters 10.7500 9914J ea

3-Way of any

material Foley

Catheters 10.7500 9914L ea

Other Foley

Catheters

(not listed) 10.7500 9914N ea

2 – Medical Supplies: Maximum Allowable

Product Cost (MAPC) List October 2007


mc sup mapc

3

Medical Supply

Medical Supply Size MAPC Type Code Billing Unit

Catheters 30cc

2-Way Latex

Foley Catheters $ 12.4500 9914G ea

2-Way Latex-

combination

Foley Catheters 12.4500 9914I ea

2-Way 100%

Silicone Foley

Catheters 12.4500 9914K ea

3-Way of any

material Foley

Catheters 12.4500 9914M ea

Other Foley

Catheters

(not listed) 12.4500 9914O ea

Condoms

Male 0.2802 9914A ea †

Male 0.2802 UPN ea †

Female 2.5000 UPN ea †

Diaphragms

Limit one 35.0000 UPN ea †

Fountain Syringe

Limit one 4.7000 9931A ea

Hot Water Bottle

Limit one 5.0000 9931B ea

Thermometer 2.0500 9957A ea

Vaporizer 7.1200 9960A ea

† Effective March 1, 2009

** Effective March 1, 1998

2 – Medical Supplies: Maximum Allowable Allied Health

Product Cost (MAPC) ________ 2001