2006 proposed fee schedule - American Society of Clinical Oncology

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for a new code may change because we did not initially have
Medicare utilization data to determine the specialty mix for the
service. In these cases, we either assigned the code to a
particular specialty’s practice expense pool based on the
specialty most likely to provide the service, or we used the “all
physician” practice expense pool to determine the code’s practice
expense RVUs. While we try to minimize instability in the
practice expense RVUs for new services by assigning the specialty
that is most likely to perform the service until such time as we
have actual utilization data, the addition of actual utilization
data may still result in some change to the practice expense RVUs
during the first few years a code is in existence.
The estimated payment impacts reflect the averages for each
specialty based on Medicare utilization. To the extent that
there are year-to-year changes in the volume and mix of services
provided by a specialty, the actual impact on total Medicare
revenues may be different than those shown here. Also, the
payment impact for an individual physician may be different from
the specialty average impact, based on the mix of services the
physician provides. Because physicians, practitioners and
suppliers, furnish services to both Medicare and non-Medicare
patients and they may receive substantial Medicare revenues for
services that are not paid under the PFS, the average change in
total revenues for any specialty, practitioner or supplier, would
be less than the impacts displayed here. For instance,