2006 proposed fee schedule - American Society of Clinical Oncology

153
applying revised composite payment rates. Each Metropolitan
Division would have its own wage index and its own urban
composite payment rate. This proposed methodology is
consistent with the new CBSA-based labor market definitions
under the IPPS. (See the August 11, 2004 Federal Register,
69 FR 49029.)
(3) Micropolitan Statistical Areas
In its June 6, 2003 bulletin, OMB also designated
another classification of metropolitan area, Micropolitan
Statistical Areas, which we will refer to as Micropolitan
Areas. That bulletin listed 565 Micropolitan Areas. Of the
3142 counties in the United States, 1090 are in MSAs and 674
are in Micropolitan Areas, with the remaining 1378 outside
of either classification. As discussed in greater detail in
the August 11, 2004 IPPS final rule (69 FR 49029-49032), the
way that Micropolitan Area counties are classified in
connection with developing revised wage indexes has a
substantial impact on the wage index adjustment.
Specifically, whether or not Micropolitan Areas are included
in computing the statewide rural wage indexes has a
significant effect on the rural wage index in any State that
contains these locales. Consistent with the IPPS final
rule, we are proposing that each Micropolitan Area county
continue to be considered part of each State’s rural labor