2006 proposed fee schedule - American Society of Clinical Oncology

NPWP Step 1--Calculation of the SMS Cost Pool for Each
Specialty
This step parallels the calculations described above
for the standard “top-down” PE allocation methodology. For
codes in the nonphysician work pool, the direct and indirect
SMS costs are set equal to the weighted average of the PE/HR
for the specialties that provide the services in the pool.
Clinical staff time is substituted for physician time in the
calculation. The clinical staff time for the code is from
CPEP data. Otherwise, the calculation is similar to the
method described previously for codes with physician time.
The following example in Table 8 illustrates this
calculation for hypothetical code 00002. In this example,
the average clinical payroll PE/HR for all specialties in
the nonphysician work pool is $12.30 and the clinical staff
time for code 00002 is 116 minutes.
TABLE 8--Calculate SMS Cost Pools for Nonphysician Work Pool
Non-Physician Work Pool
Methodology (NPWP)
Clinical
Payroll
Medical
Supplies
Medical
Equipmen
t
Indirect
Expenses
42
Total*
(A) (B) (C) (D) (E)
(a) NPWP - PE/HR $12.30 $7.40 $3.20 $46.30 $69.00
(b) NPWP - PE/Minute $0.21 $0.12 $0.05 $0.77 $1.15
(c)
Clinical Staff Time -
00002
116 116 116 116 116
(d) Number of Services 105,095 105,095 105,095 105,095 105,095
(e)
Total - NPWP "SMS"
Pool
$2,499,159 $1,503,559 $650,188 $9,407,404 $14,019,673
(b) = (a)/60
(e) = (b)*(c)*(d)
* Components may not add to totals due to rounding.