2006 proposed fee schedule - American Society of Clinical Oncology

specialty are scaled to match the aggregate SMS costs, we
propose to adopt a bottom-up method of determining the relative
direct costs for each service. Under this method, the direct
costs would be determined by summing the costs of the
resources – the clinical staff, equipment and supplies –
typically required to provide the service. The costs of the
resources, in turn, would be calculated from the refined
CPEP/RUC inputs in our PE database.
● Eliminate the Nonphysician Work Pool
Now that we have new survey data for the major specialties
that comprise the nonphysician work pool, we would eliminate the
pool and calculate the PE RVUs for the services currently in the
pool by the same methodology used for all other services. This
would allow the use of the refined CPEP/RUC data to price the
direct costs of individual services, rather than utilizing the
pre-1998 charge-based PE RVUs.
● Utilize the Current Indirect PE RVUs, Except for Those
Services Affected by the Accepted Supplementary Survey Data
As described previously, the SMS and supplementary survey
data are the source for the specialty-specific aggregate indirect
costs used in our PE calculations. We then allocate to
particular codes on the basis of the direct costs allocated to a
code and the work RVUs. Although we now believe the CPEP/RUC
data are preferable to the SMS data for determining direct costs,
we have no information that would indicate that the current
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