2006 proposed fee schedule - American Society of Clinical Oncology

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takes good faith efforts to restore opt-out conditions, for
example, by refunding the amounts in excess of the charge
limits to beneficiaries with whom he or she did not sign a
private contract). These good faith efforts must be made
within 45 days of any notice by the carrier that the
physician or practitioner has failed to maintain opt-out
(where the carrier discovers the failure after the two-year
opt-out period has expired), or within 45 days after the
physician or practitioner has discovered the failure to
maintain opt-out, whichever is earlier.
J. Multiple Procedure Reduction for Diagnostic Imaging
[If you choose to comment on issues in this section, please
include the caption “MULTIPE PROCEDURE REDUCTION” at the
beginning of your comments.]
Medicare has a longstanding policy of reducing payment
for multiple surgical procedures performed on the same
patient, by the same physician, on the same day. In those
cases, full payment is made for the highest priced procedure
and each subsequent procedure is paid at 50 percent.
Effective January 1, 1995, the multiple procedure policy,
with the same reductions, was extended to nuclear medicine
diagnostic procedures (CPT codes 78306, 78320, 78802, 78803,
78806 and 78807). In the Medicare Program Physician Fee
Schedule for Calendar Year 1995 final rule, published on
December 8, 1994 (59 FR 63410), we indicated that we would