2006 proposed fee schedule - American Society of Clinical Oncology

current approach. Specialties should no longer experience the
wide fluctuations in payment for a given service due to an
aberrant direct cost scaling factor. Direct PEs should only
change for a service if it is further refined or when prices are
updated, while indirect PEs should change only when there are
changes in the mix of specialties performing the service or with
the use of any future new survey data for indirect costs.
We recognize that there are still some outstanding issues
that need further consideration, as well as input from the
medical community. For example, although we believe that the
elimination of the nonphysician work pool would be, on the
whole, a positive step, some practitioner services, such as
audiology and medical nutrition therapy, would be significantly
impacted by the proposed change. In addition, there are still
services, such as the ESRD visit codes, for which we have no
direct input information. Also, as mentioned above, we do not
have current SMS or supplementary survey data to calculate the
indirect costs for most specialties. Further, we do not yet
have accurate utilization for the new drug administration codes
that were created in response to the MMA provision on drug
administration. Therefore, we are not proposing to change the
RVU for these services at this time, but to include them under
our proposed methodology in next year’s rule when we have
appropriate data. The proposed transition period would give us
the opportunity to work with the affected specialties to collect
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