2006 proposed fee schedule - American Society of Clinical Oncology

codes be added to the existing list of codes under the
exception: 92975; 92980 to 92998; and 93617 to 93641.
4. Dominant Specialty for Low-Volume Codes
102
The final recommendation from the PLI Workgroup is to
use the dominant specialty approach for services or
procedures with fewer than 100 occurrences. The Workgroup
supplied a list of 1,844 services for our review and
recommends that we utilize only the dominant specialty in
calculating the final malpractice RVUs for these services.
The PLI Workgroup worked in conjunction with various
specialty organizations to identify the dominant specialty
that performs each service.
We recognize and appreciate the efforts of the
Workgroup to review these codes. We have considered the
data that was presented to us and the argument for using the
dominant specialty to establish the malpractice RVUs for
these 1,844 codes.
We have previously registered our concerns with the
dominant specialty approach. We believe that basing payment
on all specialties that perform a particular service ensures
that the actual PLI costs of all specialties are included in
the calculation of the malpractice RVUs. Therefore, we do
not believe it would appropriate, even for these low-volume
services, to include only the dominant specialty if other
specialties regularly provide the service.