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CMS-1403-FC
$20 million from what expenditures would have been in the
absence of these changes. If this threshold is exceeded,
we make adjustments to preserve BN.
Section 133 (b) of the MIPPA requires an alternative
application of the BN adjustment that resulted from the
5-Year Review of work RVUs. The 0.8806 percent BN
adjustment that is currently being applied to the work RVUs
will be removed from the work RVUs and applied to the
physician CF (See the CY 2008 PFS final rule with comment
period (72 FR 66389) for further discussion of the BN
adjustment that resulted from the 5-Year Review of Work
RVUs). See sections III.E. and VII. of this final rule
with comment period for more information on the provisions
of section 133(b) of the MIPPA. The effect of this change
on selected procedures is shown in Table 50.
Table 47 shows the specialty-level impact of the work
and PE RVU changes.
Our estimates of changes in Medicare revenues for PFS
services compare payment rates for CY 2008 with payment
rates for CY 2009 using CY 2007 Medicare utilization for
all years. To the extent that there are year-to-year
changes in the volume and mix of services provided by
physicians, the actual impact on total Medicare revenues
will be different than those shown in Table 47. The
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