2006 proposed fee schedule - American Society of Clinical Oncology

II. Provisions of the Proposed Rule
This proposed rule would affect the regulations set
forth at Part 405, Federal Health Insurance for the Aged and
Disabled; Part 410, Supplementary Medical Insurance (SMI)
Benefits; Part 411, Exclusions from Medicare and Limitations
on Medicare Payment; Part 413, Principles of Reasonable Cost
Reimbursement, Payment for End-Stage Renal Disease Services,
Prospectively Determined Payment Rates for Skilled Nursing
Facilities; 414, Payment for Part B Medical and Other Health
Services; Part 426, Review of National Coverage
Determinations and Local Coverage Determinations.
A. Resource-Based Practice Expense (PE) RVUs
[If you choose to comment on issues in this section, please
include the caption “PRACTICE EXPENSE” at the beginning of
your comments.]
Based on section 1848(c)(1)(B) of the Act practice
expenses are the portion of the resources used in furnishing
the service that reflects the general categories of
physician and practitioner expenses (such as office rent and
wages of personnel, but excluding malpractice expenses).
Section 121 of the Social Security Amendments of 1994
(Pub. L. 103-432), enacted on October 31, 1994, required us
to develop a methodology for a resource-based system for
determining PE RVUs for each physician‘s service. Up until
this point, physicians’ practice expenses were based on
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