Notice: This CMS-approved document has been submitted - Philips ...
Notice: This CMS-approved document has been submitted - Philips ... Notice: This CMS-approved document has been submitted - Philips ...
CMS-1403-FC 10 To assist readers in referencing sections contained in this preamble, we are providing a table of contents. Some of the issues discussed in this preamble affect the payment policies, but do not require changes to the regulations in the Code of Federal Regulations (CFR). Information on the regulation’s impact appears throughout the preamble, and therefore, is not exclusively in section XVI. of this final rule with comment period. I. Background A. Development of the Relative Value System 1. Work RVUs 2. Practice Expense Relative Value Units (PE RVUs) 3. Resource-Based Malpractice RVUs 4. Refinements to the RVUs 5. Adjustments to RVUs are Budget Neutral B. Components of the Fee Schedule Payment Amounts C. Most Recent Changes to Fee Schedule II. Provisions of the Proposed Regulation A. Resource-Based Practice Expense (PE) Relative Value Units (RVUs) 1. Current Methodology 2. PE Proposals for CY 2009 B. Geographic Practice Cost Indices (GPCIs): Locality Discussion
CMS-1403-FC 11 Schedule C. Malpractice RVUs (TC/PC issue) D. Medicare Telehealth Services E. Specific Coding Issues related to Physician Fee 1. Payment for Preadministration-Related Services for Intravenous Infusion of Immune Globulin 2. Multiple Procedure Payment Reduction for Diagnostic Imaging 3. HCPCS Code for Prostate Saturation Biopsies F. Part B Drug Payment 1. Average Sales Price (ASP) Issues 2. Competitive Acquisition Program (CAP) Issues G. Application of the HPSA Bonus Payment H. Provisions Related to Payment for Renal Dialysis Services Furnished by End-Stage Renal Disease (ESRD) Facilities Issues I. Independent Diagnostic Testing Facility (IDTF) J. Physician and Nonphysician Practitioner (NPP) Enrollment Issues K. Amendment to the Exemption for Computer-Generated Facsimile (FAX) Transmissions from the National Council for Prescription Drug Programs (NCPDP) SCRIPT Standard for Transmitting Prescription and Certain Prescription-Related
- Page 1 and 2: Notice: This CMS-approved document
- Page 3 and 4: CMS-1403-FC 3 1. Electronically. Yo
- Page 5 and 6: CMS-1403-FC 5 FOR FURTHER INFORMATI
- Page 7 and 8: CMS-1403-FC 7 Trisha Brooks, (410)7
- Page 9: CMS-1403-FC 9 ● The physician sel
- Page 13 and 14: CMS-1403-FC 13 3. Beneficiary Signa
- Page 15 and 16: CMS-1403-FC 15 A. Summary of Issues
- Page 17 and 18: CMS-1403-FC 17 XIII. Waiver of Prop
- Page 19 and 20: CMS-1403-FC 19 BBRA [Medicare, Medi
- Page 21 and 22: CMS-1403-FC 21 E/M Evaluation and m
- Page 23 and 24: CMS-1403-FC 23 MA-PD Medicare Advan
- Page 25 and 26: CMS-1403-FC 25 OSCAR Online Survey
- Page 27 and 28: CMS-1403-FC 27 WAMP Widely availabl
- Page 29 and 30: CMS-1403-FC 29 2. Practice Expense
- Page 31 and 32: CMS-1403-FC 31 extent practicable a
- Page 33 and 34: CMS-1403-FC 33 AMA's Current Proced
- Page 35 and 36: CMS-1403-FC 35 Payment = [(RVU work
- Page 37 and 38: CMS-1403-FC 37 legislation, the PFS
- Page 39 and 40: CMS-1403-FC that time, PE RVUs were
- Page 41 and 42: CMS-1403-FC utilize a “bottom-up
- Page 43 and 44: CMS-1403-FC ● All other expenses,
- Page 45 and 46: CMS-1403-FC b. Allocation of PE to
- Page 47 and 48: CMS-1403-FC combined survey data fr
- Page 49 and 50: CMS-1403-FC for the global componen
- Page 51 and 52: CMS-1403-FC equipment cost per minu
- Page 53 and 54: CMS-1403-FC components), then the i
- Page 55 and 56: CMS-1403-FC indirect PE for all PFS
- Page 57 and 58: CMS-1403-FC • Physical therapy ut
- Page 59 and 60: CMS-1403-FC TABLE 1: Calculation of
<strong>CMS</strong>-1403-FC 11<br />
Schedule<br />
C. Malpractice RVUs (TC/PC issue)<br />
D. Medicare Telehealth Services<br />
E. Specific Coding Issues related to Physician Fee<br />
1. Payment for Preadministration-Related Services for<br />
Intravenous Infusion of Immune Globulin<br />
2. Multiple Procedure Payment Reduction for<br />
Diagnostic Imaging<br />
3. HCPCS Code for Prostate Saturation Biopsies<br />
F. Part B Drug Payment<br />
1. Average Sales Price (ASP) Issues<br />
2. Competitive Acquisition Program (CAP) Issues<br />
G. Application of the HPSA Bonus Payment<br />
H. Provisions Related to Payment for Renal Dialysis<br />
Services Furnished by End-Stage Renal Disease (ESRD)<br />
Facilities<br />
Issues<br />
I. Independent Diagnostic Testing Facility (IDTF)<br />
J. Physician and Nonphysician Practitioner (NPP)<br />
Enrollment Issues<br />
K. Amendment to the Exemption for Computer-Generated<br />
Facsimile (FAX) Transmissions from the National Council for<br />
Prescription Drug Programs (NCPDP) SCRIPT Standard for<br />
Transmitting Prescription and Certain Prescription-Related
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