2006 proposed fee schedule - American Society of Clinical Oncology

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● At least 50 percent of its patients are individuals
under 18 years of age;
● Its nursing personnel costs are allocated properly
between each mode of care;
● The additional nursing hours per treatment are not
the result of an excess number of employees;
● Its pediatric patients require a significantly
higher staff-to-patient ratio than typical adult patients;
and
● These services, procedures, or supplies and its per
treatment costs are clearly prudent and reasonable when
compared to those of pediatric facilities with a similar
patient mix.
The “Atypical service intensity” criterion is the one
under which exceptions for facilities that treated a high
proportion of pediatric patients were granted in the past.
In order to receive approval for an exception rate,
pediatric facilities would still need to meet many of the
same criteria previously required under §413.184 for
“Atypical service intensity.”
To better match the patient listing documentation
requirements to the characteristics of pediatric ESRD
facilities, we are proposing to eliminate five categories
currently required in §413.184(b) (Documentation) and
replace those items with a revised list. Under the proposed