2006 proposed fee schedule - American Society of Clinical Oncology

procedure: $27,305,408. In this example, the clinical labor
cost for all other services performed by this specialty is
$831,618,600. Therefore, the entire clinical labor CPEP
expense pool for the specialty is $858,924,008. Step 2 is
repeated to calculate the CPEP supply and equipment costs.
TABLE 2--Calculation of CPEP Cost Pool
Standard
Methodology
Clinical
Labor
Supplies Equipment
(A) (B) (C)
(a) CPT 00001 $65.23 $52.49 $1,556.86
(b) Allowed Services 418,602 418,602 418,602
Subtotal
(c)
$27,305,408 $21,972,838 $651,704,875
All Other
(d)
Services
$831,618,600 $389,921,779 $5,277,570,148
(e) Total CPEP Pool
(c) = (a)*(b)
(e) = (c) + (d)
$858,924,008 $411,894,617 $5,929,275,023
Step 3--Calculation and Application of Scaling Factors
This step ensures that the total of the CPEP costs
across all procedures performed by the specialty equates
with the total direct costs for the specialty as reflected
by the SMS data. To accomplish this, the CPEP data are
scaled to SMS data by means of a scaling factor so that the
total CPEP costs for each specialty equals the total SMS
cost for the specialty. (The scaling factor is calculated
by dividing the specialty’s SMS pool by the specialty’s CPEP
pool.)
The unscaled CPEP cost per procedure value, at the
direct cost level, is then multiplied by the respective
specialty scalar to yield the scaled CPEP procedure value.
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