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
session only when a patient receives a dialysis treatment 376 (normally three times a week for hemodialysis). Continuous cycling peritoneal dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD) are daily treatment modalities; ESRD facilities are paid the equivalent of three hemodialysis treatments for each week that CCPD and CAPD treatments are provided. (2) If a pediatric ESRD facility elects to train all its patients using a particular treatment modality more often than during each dialysis treatment and, as a result, the number of billable training dialysis sessions is less than the number of actual training sessions, the facility may request a composite rate exception, limited to the lesser of the-- or (i) Facility's projected training cost per treatment; (ii) Cost per treatment the facility receives in training a patient if it had trained patients only during a dialysis treatment, that is, three times per week. (3) An ESRD facility may bill a maximum of 25 training sessions per patient for hemodialysis training and 15 sessions for CCPD and CAPD training. (4) In computing the payment amount under an accelerated training exception, CMS uses a minimum number of training sessions per patient (15 for hemodialysis and 5 for
CAPD and CCPD) when the facility actually provides fewer than the minimum number of training sessions. (5) To justify an accelerated training exception 377 request, an ESRD facility must document that a significant number of training sessions for a particular modality are provided during a shorter but more condensed period. (6) The facility must submit with the exception request a list of patients, by modality, trained during the most recent cost report period. The list must include each beneficiary's-- (i) Name; (ii) Age; and (iii) Training status (completed, not completed, being retrained, or in the process of being trained). (7) The total treatments from the patient list must be the same as the total treatments reported on the cost report filed with the request. §413.192 [Removed] 18. Section 413.192 is removed. PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES 19. The authority citation for part 414 continues to read as follows: Authority: Secs. 1102, 1871, and 1881(b)(1) of the Social Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1)).
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CAPD and CCPD) when the facility actually provides fewer<br />
than the minimum number <strong>of</strong> training sessions.<br />
(5) To justify an accelerated training exception<br />
377<br />
request, an ESRD facility must document that a significant<br />
number <strong>of</strong> training sessions for a particular modality are<br />
provided during a shorter but more condensed period.<br />
(6) The facility must submit with the exception<br />
request a list <strong>of</strong> patients, by modality, trained during the<br />
most recent cost report period. The list must include each<br />
beneficiary's--<br />
(i) Name;<br />
(ii) Age; and<br />
(iii) Training status (completed, not completed, being<br />
retrained, or in the process <strong>of</strong> being trained).<br />
(7) The total treatments from the patient list must be<br />
the same as the total treatments reported on the cost report<br />
filed with the request.<br />
§413.192 [Removed]<br />
18. Section 413.192 is removed.<br />
PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH<br />
SERVICES<br />
19. The authority citation for part 414 continues to<br />
read as follows:<br />
Authority: Secs. 1102, 1871, and 1881(b)(1) <strong>of</strong> the Social<br />
Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1)).