2006 proposed fee schedule - American Society of Clinical Oncology
2006 proposed fee schedule - American Society of Clinical Oncology 2006 proposed fee schedule - American Society of Clinical Oncology
following the consideration of public comments, these figures may change. 338 TABLE 34--Impact of Proposed Rule on Payment For Selected Procedures Non-Facility Facility % % HCPCS MOD DESCRIPTION Debride nail, 6 Old New Change Old New Change 11721 or more Destroy benign/premlg $39.79 $38.77 -3% $31.08 $29.60 -5% 17000 lesion Total hip $60.64 $62.54 3% $44.34 $44.39 0% 27130 arthroplasty Treat thigh N/A N/A N/A $1,396.14 $1,321.88 -5% 27244 fracture Total knee N/A N/A N/A $1,134.65 $1,073.62 -5% 27447 arthroplasty CABG, arterial, N/A N/A N/A $1,507.94 $1,427.92 -5% 33533 single Rechanneling of N/A N/A N/A $1,923.30 $1,813.54 -6% 35301 artery Upper GI endoscopy, N/A N/A N/A $1,128.59 $1,072.23 -5% 43239 biopsy After cataract $333.50 $336.27 1% $162.20 $159.18 -2% 66821 laser surgery Cataract surg $248.23 $233.25 -6% $230.42 $216.83 -6% 66984 w/iol, 1 stage Treatment of N/A N/A N/A $684.05 $649.50 -5% 67210 retinal lesion $599.54 $568.15 -5% $573.39 $544.48 -5% 71010 Chest x-ray $28.04 $25.68 -8% N/A N/A N/A 71010 26 Chest x-ray Mammogram, $9.47 $9.17 -3% $9.47 $9.17 -3% 76091 both breasts Mammogram, $97.40 $101.39 4% N/A N/A N/A 76091 26 both breasts Mammogram, $45.10 $43.77 -3% $45.10 $43.77 -3% 76092 screening Mammogram, $85.65 $83.77 -2% N/A N/A N/A 76092 26 screening Radiation tx $36.38 $35.33 -3% $36.38 $35.33 -3% 77427 management, x5 Heart image $172.05 $168.64 -2% $172.05 $166.10 -3% 78465 26 (3d), multiple Tissue exam by $77.31 $74.92 -3% $77.31 $74.92 -3% 88305 26 pathologist $42.07 $40.14 -5% $42.07 $40.14 -5% 90801 Psy dx interview Medication $153.11 $147.29 -4% $144.01 $137.12 -5% 90862 management $51.92 $50.31 -3% $48.89 $46.77 -4%
339 Non-Facility Facility % % HCPCS MOD DESCRIPTION Hemodialysis, Old New Change Old New Change 90935 one evaluation Eye exam N/A N/A N/A $73.14 $69.37 -5% 92012 established pat Eye exam & $65.18 $61.63 -5% $37.14 $35.32 -5% 92014 treatment Insert intracoronary $96.26 $91.31 -5% $60.64 $57.66 -5% 92980 stent Electrocardiogra N/A N/A N/A $809.11 $786.38 -3% 93000 m, complete Electrocardiogra $26.91 $24.23 -10% N/A N/A N/A 93010 m report Cardiovascular $9.10 $8.81 -3% $9.10 $8.81 -3% 93015 stress test Echo exam of $108.01 $107.55 0% N/A N/A N/A 93307 26 heart Left heart $49.27 $47.67 -3% $49.27 $47.67 -3% 93510 26 catheterization Chiropractic $257.32 $252.61 -2% $257.32 $252.61 -2% 98941 manipulation Office/outpatient $36.76 $34.78 -5% $31.83 $30.42 -4% 99203 visit, new Office/outpatient $97.02 $93.33 -4% $72.38 $69.11 -5% 99213 visit, est Office/outpatient $52.68 $50.65 -4% $35.62 $33.96 -5% 99214 visit, est Initial hospital $82.62 $79.62 -4% $59.12 $56.30 -5% 99222 care Initial hospital N/A N/A N/A $112.93 $107.79 -5% 99223 care Subsequent N/A N/A N/A $157.27 $150.29 -4% 99231 hospital care Subsequent N/A N/A N/A $34.11 $32.60 -4% 99232 hospital care Subsequent N/A N/A N/A $55.71 $53.31 -4% 99233 hospital care Observ/hosp N/A N/A N/A $79.21 $75.74 -4% 99236 same date Hospital N/A N/A N/A $223.22 $213.40 -4% 99239 discharge day Office N/A N/A N/A $96.64 $92.53 -4% 99243 consultation Office $122.79 $118.66 -3% $93.99 $90.08 -4% 99244 consultation Initial inpatient $172.81 $166.69 -4% $138.70 $133.04 -4% 99253 consult Initial inpatient N/A N/A N/A $98.91 $94.99 -4% 99254 consult Follow-up N/A N/A N/A $142.12 $136.30 -4% 99261 inpatient consult N/A N/A N/A $22.36 $21.43 -4%
- Page 287 and 288: FQHC claim form to effectuate the b
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- Page 291 and 292: 291 conclude that Hispanic persons
- Page 293 and 294: 293 nuclear medicine services in ei
- Page 295 and 296: adiopharmaceuticals. In the final r
- Page 297 and 298: 297 (including Nuclear Medicine and
- Page 299 and 300: we would resolve any doubt on the m
- Page 301 and 302: facility payment rather than a TC c
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- Page 305 and 306: 305 Underlying the projected rate r
- Page 307 and 308: decisions are central to the health
- Page 309 and 310: however. We are particularly intere
- Page 311 and 312: The collection requirement in this
- Page 313 and 314: eporting requirements are discussed
- Page 315 and 316: IV. Response to Comments Because of
- Page 317 and 318: achieve the objectives with less si
- Page 319 and 320: 319 The analysis and discussion pro
- Page 321 and 322: 321 for a new code may change becau
- Page 323 and 324: 323 TABLE 30--Impact of Practice Ex
- Page 325 and 326: hour for these specialties. As note
- Page 327 and 328: Both physical/occupational therapy
- Page 329 and 330: 329 proposing to add cardiology cat
- Page 331 and 332: Speciality Impact of Removing Aberr
- Page 333 and 334: Family TABLE 32--Impact of Multiple
- Page 335 and 336: 335 column includes the current est
- Page 337: Specialty Medicare Allowed Charges
- Page 341 and 342: 341 have undertaken a similar analy
- Page 343 and 344: of the updated GPCI data. For the R
- Page 345 and 346: C. Medicare Telehealth Services In
- Page 347 and 348: 347 TABLE 37--Impact of Proposed Ch
- Page 349 and 350: 349 of the increase to the drug add
- Page 351 and 352: plus current AAP priced drug paymen
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- Page 355 and 356: satisfies the requirements of the i
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- Page 359 and 360: delivery arrangements and would hel
- Page 361 and 362: List of Subjects 42 CFR Part 405 Ad
- Page 363 and 364: (including by refunding amounts in
- Page 365 and 366: (2) Any financial incentives provid
- Page 367 and 368: 7. The authority citation for part
- Page 369 and 370: * * * * * PART 413--PRINCIPLES OF R
- Page 371 and 372: 371 D. Redesignating paragraphs (l)
- Page 373 and 374: 373 (3) The additional nursing hour
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- Page 377 and 378: CAPD and CCPD) when the facility ac
- Page 379 and 380: Indirect Sales means from the manuf
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- Page 385 and 386: 385 (Catalog of Federal Domestic As
- Page 387 and 388: 1. CPT/HCPCS code. This is the CPT
339<br />
Non-Facility Facility<br />
%<br />
%<br />
HCPCS MOD DESCRIPTION<br />
Hemodialysis,<br />
Old New Change Old New Change<br />
90935<br />
one evaluation<br />
Eye exam<br />
N/A N/A N/A $73.14 $69.37 -5%<br />
92012<br />
established pat<br />
Eye exam &<br />
$65.18 $61.63 -5% $37.14 $35.32 -5%<br />
92014<br />
treatment<br />
Insert<br />
intracoronary<br />
$96.26 $91.31 -5% $60.64 $57.66 -5%<br />
92980<br />
stent<br />
Electrocardiogra<br />
N/A N/A N/A $809.11 $786.38 -3%<br />
93000<br />
m, complete<br />
Electrocardiogra<br />
$26.91 $24.23 -10% N/A N/A N/A<br />
93010<br />
m report<br />
Cardiovascular<br />
$9.10 $8.81 -3% $9.10 $8.81 -3%<br />
93015<br />
stress test<br />
Echo exam <strong>of</strong><br />
$108.01 $107.55 0% N/A N/A N/A<br />
93307 26 heart<br />
Left heart<br />
$49.27 $47.67 -3% $49.27 $47.67 -3%<br />
93510 26 catheterization<br />
Chiropractic<br />
$257.32 $252.61 -2% $257.32 $252.61 -2%<br />
98941<br />
manipulation<br />
Office/outpatient<br />
$36.76 $34.78 -5% $31.83 $30.42 -4%<br />
99203<br />
visit, new<br />
Office/outpatient<br />
$97.02 $93.33 -4% $72.38 $69.11 -5%<br />
99213<br />
visit, est<br />
Office/outpatient<br />
$52.68 $50.65 -4% $35.62 $33.96 -5%<br />
99214<br />
visit, est<br />
Initial hospital<br />
$82.62 $79.62 -4% $59.12 $56.30 -5%<br />
99222<br />
care<br />
Initial hospital<br />
N/A N/A N/A $112.93 $107.79 -5%<br />
99223<br />
care<br />
Subsequent<br />
N/A N/A N/A $157.27 $150.29 -4%<br />
99231<br />
hospital care<br />
Subsequent<br />
N/A N/A N/A $34.11 $32.60 -4%<br />
99232<br />
hospital care<br />
Subsequent<br />
N/A N/A N/A $55.71 $53.31 -4%<br />
99233<br />
hospital care<br />
Observ/hosp<br />
N/A N/A N/A $79.21 $75.74 -4%<br />
99236<br />
same date<br />
Hospital<br />
N/A N/A N/A $223.22 $213.40 -4%<br />
99239<br />
discharge day<br />
Office<br />
N/A N/A N/A $96.64 $92.53 -4%<br />
99243<br />
consultation<br />
Office<br />
$122.79 $118.66 -3% $93.99 $90.08 -4%<br />
99244<br />
consultation<br />
Initial inpatient<br />
$172.81 $166.69 -4% $138.70 $133.04 -4%<br />
99253<br />
consult<br />
Initial inpatient<br />
N/A N/A N/A $98.91 $94.99 -4%<br />
99254<br />
consult<br />
Follow-up<br />
N/A N/A N/A $142.12 $136.30 -4%<br />
99261<br />
inpatient consult N/A N/A N/A $22.36 $21.43 -4%
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