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CMS-1403-FC Physi- cian Work Fully Implemented Non- Facility PE Year 2009 Transitional Non- Facility PE Fully Imple- mented Facility PE Year 2009 Transi- tional Facility PE 1 CPT codes and descriptions only are copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply. 2 If values are reflected for codes not payable by Medicare, please note that these values have been established as a courtesy to the general public and are not used for Medicare payment. 1214 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 32141 A Remove/treat lung lesions 27.10 NA NA 11.00 10.16 2.01 090 32150 A Removal of lung lesion(s) 16.70 NA NA 7.74 7.73 2.01 090 32151 A Remove lung foreign body 16.82 NA NA 8.21 8.18 2.04 090 32160 A Open chest heart massage 13.02 NA NA 6.09 5.89 1.31 090 32200 A Drain, open, lung lesion 18.48 NA NA 9.13 9.02 2.14 090 32201 A Drain, percut, lung lesion 3.99 19.76 20.04 1.56 1.50 0.24 000 32215 A Treat chest lining 12.93 NA NA 6.62 6.70 1.69 090 32220 A Release of lung 26.41 NA NA 12.56 12.69 3.57 090 32225 A Partial release of lung 16.63 NA NA 7.81 7.79 2.07 090 32310 A Removal of chest lining 15.16 NA NA 7.26 7.31 2.00 090 32320 A Free/remove chest lining 27.04 NA NA 12.13 12.17 3.52 090 32400 A Needle biopsy chest lining 1.76 2.17 2.17 0.62 0.60 0.10 000 32402 A Open biopsy chest lining 8.89 NA NA 4.97 5.02 1.07 090 32405 A Biopsy, lung or mediastinum 1.93 0.76 0.74 0.76 0.73 0.11 000 32420 A Puncture/clear lung 2.18 NA NA 0.79 0.76 0.12 000 32421 A Thoracentesis for aspiration 1.54 2.40 2.57 0.51 0.50 0.08 000 32422 A Thoracentesis w/tube insert 2.19 2.89 2.98 1.09 1.09 0.12 000 32440 A Removal of lung 27.17 NA NA 11.56 11.92 3.69 090 32442 A Sleeve pneumonectomy 56.37 NA NA 19.28 18.19 3.85 090 32445 A Removal of lung 63.60 NA NA 24.00 21.57 3.72 090 32480 A Partial removal of lung 25.71 NA NA 10.83 11.17 3.50 090 32482 A Bilobectomy 27.28 NA NA 11.79 12.10 3.67 090 32484 A Segmentectomy 25.30 NA NA 10.16 10.49 3.04 090 32486 A Sleeve lobectomy 42.80 NA NA 15.74 15.15 3.52 090 32488 A Completion pneumonectomy 42.83 NA NA 16.33 15.73 3.81 090 32491 R Lung volume reduction 25.09 NA NA 11.57 11.86 2.99 090 32500 A Partial removal of lung 24.48 NA NA 10.86 11.26 3.26 090 32501 A Repair bronchus add-on 4.68 NA NA 1.48 1.50 0.65 ZZZ 32503 A Resect apical lung tumor 31.61 NA NA 12.70 13.33 4.38 090 32504 A Resect apical lung tum/chest 36.41 NA NA 14.62 15.17 5.09 090 3250F I Nonprim loc anat bx site tum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 32540 A Removal of lung lesion 30.22 NA NA 12.58 11.87 2.08 090 32550 A Insert pleural cath 4.17 14.81 16.14 1.63 1.64 0.42 000 32551 A Insertion of chest tube 3.29 NA NA 1.05 1.13 0.43 000 32560 A Treat lung lining chemically 2.19 4.98 5.36 0.63 0.65 0.23 000 32601 A Thoracoscopy, diagnostic 5.45 NA NA 2.21 2.25 0.80 000 32602 A Thoracoscopy, diagnostic 5.95 NA NA 2.35 2.40 0.87 000 32603 A Thoracoscopy, diagnostic 7.80 NA NA 3.00 3.01 1.14 000 32604 A Thoracoscopy, diagnostic 8.77 NA NA 3.36 3.39 1.25 000 32605 A Thoracoscopy, diagnostic 6.92 NA NA 2.59 2.67 1.00 000 32606 A Thoracoscopy, diagnostic 8.39 NA NA 3.15 3.21 1.22 000 32650 A Thoracoscopy, surgical 10.77 NA NA 5.47 5.81 1.58 090 32651 A Thoracoscopy, surgical 18.70 NA NA 8.05 7.87 1.87 090 32652 A Thoracoscopy, surgical 29.00 NA NA 11.80 11.41 2.73 090 32653 A Thoracoscopy, surgical 18.09 NA NA 7.80 7.61 1.89 090 32654 A Thoracoscopy, surgical 20.44 NA NA 8.47 8.26 1.63 090 32655 A Thoracoscopy, surgical 16.09 NA NA 7.25 7.26 1.90 090 32656 A Thoracoscopy, surgical 13.18 NA NA 6.22 6.66 1.90 090
CMS-1403-FC Physi- cian Work Fully Implemented Non- Facility PE Year 2009 Transitional Non- Facility PE Fully Imple- mented Facility PE Year 2009 Transi- tional Facility PE 1 CPT codes and descriptions only are copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply. 2 If values are reflected for codes not payable by Medicare, please note that these values have been established as a courtesy to the general public and are not used for Medicare payment. 1215 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 32657 A Thoracoscopy, surgical 12.85 NA NA 6.28 6.64 2.00 090 32658 A Thoracoscopy, surgical 11.65 NA NA 5.87 6.25 1.70 090 32659 A Thoracoscopy, surgical 11.86 NA NA 6.03 6.40 1.62 090 32660 A Thoracoscopy, surgical 17.69 NA NA 7.75 8.20 2.09 090 32661 A Thoracoscopy, surgical 13.27 NA NA 6.31 6.70 1.93 090 32662 A Thoracoscopy, surgical 14.91 NA NA 6.94 7.43 2.18 090 32663 A Thoracoscopy, surgical 24.56 NA NA 10.02 10.23 2.73 090 32664 A Thoracoscopy, surgical 14.22 NA NA 6.55 6.83 2.33 090 32665 A Thoracoscopy, surgical 21.45 NA NA 8.99 8.80 2.16 090 32800 A Repair lung hernia 15.59 NA NA 7.34 7.38 1.99 090 32810 A Close chest after drainage 14.83 NA NA 7.32 7.39 1.94 090 32815 A Close bronchial fistula 49.79 NA NA 19.65 17.52 3.28 090 32820 A Reconstruct injured chest 22.33 NA NA 10.59 11.01 2.53 090 32850 X Donor pneumonectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 32851 A Lung transplant, single 40.94 NA NA 21.53 23.12 5.58 090 32852 A Lung transplant with bypass 44.65 NA NA 24.03 26.38 6.02 090 32853 A Lung transplant, double 50.11 NA NA 24.19 26.15 7.07 090 32854 A Lung transplant with bypass 53.88 NA NA 27.66 29.50 7.22 090 32855 C Prepare donor lung, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 32856 C Prepare donor lung, double 0.00 0.00 0.00 0.00 0.00 0.00 XXX 32900 A Removal of rib(s) 23.69 NA NA 10.10 10.07 2.94 090 32905 A Revise & repair chest wall 23.17 NA NA 9.87 9.96 3.16 090 32906 A Revise & repair chest wall 29.18 NA NA 11.83 11.92 3.98 090 32940 A Revision of lung 21.22 NA NA 9.00 9.14 2.89 090 32960 A Therapeutic pneumothorax 1.84 1.69 1.70 0.77 0.72 0.16 000 32997 A Total lung lavage 7.31 NA NA 1.83 1.86 0.55 000 32998 A Perq rf ablate tx, pul tumor 5.68 68.21 68.21 2.35 2.35 0.36 000 32999 C Chest surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 33010 A Drainage of heart sac 2.24 NA NA 1.07 1.00 0.14 000 33011 A Repeat drainage of heart sac 2.24 NA NA 0.96 0.92 0.15 000 33015 A Incision of heart sac 8.44 NA NA 5.39 5.29 0.65 090 33020 A Incision of heart sac 14.87 NA NA 6.77 6.79 1.80 090 33025 A Incision of heart sac 13.65 NA NA 6.20 6.25 1.81 090 33030 A Partial removal of heart sac 22.27 NA NA 9.61 9.61 2.84 090 33031 A Partial removal of heart sac 25.30 NA NA 10.37 10.31 3.14 090 33050 A Removal of heart sac lesion 16.85 NA NA 7.80 7.83 2.15 090 33120 A Removal of heart lesion 27.33 NA NA 11.36 11.44 3.70 090 33130 A Removal of heart lesion 24.05 NA NA 10.28 10.26 3.01 090 33140 A Heart revascularize (tmr) 28.26 NA NA 11.35 11.26 2.86 090 33141 A Heart tmr w/other procedure 2.54 NA NA 0.84 1.03 0.69 ZZZ 33202 A Insert epicard eltrd, open 13.15 NA NA 6.31 6.31 1.71 090 33203 A Insert epicard eltrd, endo 13.92 NA NA 6.87 6.87 1.39 090 33206 A Insertion of heart pacemaker 7.31 NA NA 5.13 4.97 0.52 090 33207 A Insertion of heart pacemaker 8.00 NA NA 5.25 5.12 0.59 090 33208 A Insertion of heart pacemaker 8.72 NA NA 5.69 5.47 0.56 090 33210 A Insertion of heart electrode 3.30 NA NA 1.68 1.58 0.18 000 33211 A Insertion of heart electrode 3.39 NA NA 1.55 1.49 0.21 000 33212 A Insertion of pulse generator 5.51 NA NA 3.72 3.64 0.43 090
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Notice: This CMS-approved document
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CMS-1403-FC 3 1. Electronically. Yo
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CMS-1403-FC 5 FOR FURTHER INFORMATI
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CMS-1403-FC 7 Trisha Brooks, (410)7
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CMS-1403-FC 9 ● The physician sel
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CMS-1403-FC 11 Schedule C. Malpract
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CMS-1403-FC 13 3. Beneficiary Signa
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CMS-1403-FC 15 A. Summary of Issues
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CMS-1403-FC 17 XIII. Waiver of Prop
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CMS-1403-FC 19 BBRA [Medicare, Medi
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CMS-1403-FC 21 E/M Evaluation and m
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CMS-1403-FC 23 MA-PD Medicare Advan
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CMS-1403-FC 25 OSCAR Online Survey
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CMS-1403-FC 27 WAMP Widely availabl
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CMS-1403-FC 29 2. Practice Expense
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CMS-1403-FC 31 extent practicable a
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CMS-1403-FC 33 AMA's Current Proced
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CMS-1403-FC 35 Payment = [(RVU work
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CMS-1403-FC 37 legislation, the PFS
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CMS-1403-FC that time, PE RVUs were
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CMS-1403-FC utilize a “bottom-up
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CMS-1403-FC ● All other expenses,
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CMS-1403-FC b. Allocation of PE to
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CMS-1403-FC combined survey data fr
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CMS-1403-FC for the global componen
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CMS-1403-FC equipment cost per minu
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CMS-1403-FC components), then the i
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CMS-1403-FC indirect PE for all PFS
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CMS-1403-FC • Physical therapy ut
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CMS-1403-FC TABLE 1: Calculation of
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CMS-1403-FC 2. PE Proposals for CY
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CMS-1403-FC The formula for estimat
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CMS-1403-FC arbitrary method for ch
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CMS-1403-FC We received no comments
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CMS-1403-FC (iv) Contractor Pricing
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CMS-1403-FC Response: We will ask t
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Code CMS-1403-FC 2008/9 Description
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CMS-1403-FC TABLE 4: Practice Expen
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CMS-1403-FC B. Geographic Practice
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CMS-1403-FC services, and are adjus
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CMS-1403-FC by at least 5 percent,
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CMS-1403-FC we decided not to proce
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CMS-1403-FC so as part of the CY 20
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CMS-1403-FC In the CY 2008 PFS fina
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CMS-1403-FC are available, we would
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CMS-1403-FC is no duplication of co
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CMS-1403-FC practitioner) at the di
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CMS-1403-FC PFS final rule with com
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CMS-1403-FC individual MNT (or any
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CMS-1403-FC Group DSMT (which compr
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CMS-1403-FC The acuity of a critica
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CMS-1403-FC needed regarding a crit
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CMS-1403-FC errors; enhanced patien
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CMS-1403-FC 99233). For CY 2006, we
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CMS-1403-FC follow-up inpatient con
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CMS-1403-FC As noted previously, CP
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CMS-1403-FC face-to-face encounter
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CMS-1403-FC visits requested by the
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CMS-1403-FC Follow-up inpatient tel
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CMS-1403-FC that were appropriate t
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CMS-1403-FC HCPCS codes 96150 throu
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CMS-1403-FC G0332). The Medicare pa
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CMS-1403-FC code G0332. For CY 2009
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CMS-1403-FC Response: The separate
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CMS-1403-FC preadministration-relat
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CMS-1403-FC pricing of IVIG and Med
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CMS-1403-FC CPT Code Short Descript
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CMS-1403-FC percent for the subsequ
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CMS-1403-FC in the same session, on
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CMS-1403-FC jeopardizes beneficiary
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CMS-1403-FC As discussed in the pro
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CMS-1403-FC Note: Under the PFS, CP
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CMS-1403-FC The methodology for dev
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CMS-1403-FC drugs furnished through
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CMS-1403-FC Response: We disagree w
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CMS-1403-FC available to support a
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CMS-1403-FC that there are complica
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CMS-1403-FC administered to a benef
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CMS-1403-FC as we assess potential
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CMS-1403-FC add a modifier to their
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CMS-1403-FC application of the AQ m
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CMS-1403-FC 0.7000. ● A reduction
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CMS-1403-FC so the CY 2009 base com
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CMS-1403-FC patient utilization gro
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CMS-1403-FC make those estimates. A
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CMS-1403-FC After removing the enro
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CMS-1403-FC For CY 2009, we propose
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CMS-1403-FC plain language over pol
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CMS-1403-FC four quarters of ASP pr
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CMS-1403-FC composite rates. The wa
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CMS-1403-FC from the figure in the
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CMS-1403-FC that our goal is the ev
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CMS-1403-FC the average wage index
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CMS-1403-FC Labor Statistics, to de
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CMS-1403-FC been previously deemed
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CMS-1403-FC CBSA where the campuses
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CMS-1403-FC composite rates during
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CMS-1403-FC target amount of compos
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CMS-1403-FC admission. That is, the
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CMS-1403-FC that CMS consider issue
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CMS-1403-FC hold the provider in wh
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CMS-1403-FC Comment: Commenters rai
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CMS-1403-FC who have enrolled in th
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CMS-1403-FC ● Posting IDTF standa
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CMS-1403-FC other diagnostic testin
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CMS-1403-FC entities furnishing mob
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CMS-1403-FC state Radioactive Mater
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CMS-1403-FC equipment and provide t
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CMS-1403-FC Response: We understand
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CMS-1403-FC believe that requiring
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CMS-1403-FC these claims will ensur
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CMS-1403-FC and NPP organizations,
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CMS-1403-FC prior to their enrollin
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CMS-1403-FC The date of approval is
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CMS-1403-FC organizations, and indi
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CMS-1403-FC To assist physician and
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CMS-1403-FC Comment: Several commen
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CMS-1403-FC date of filing and circ
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CMS-1403-FC services are complying
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CMS-1403-FC days when a Presidentia
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CMS-1403-FC effective date under ap
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CMS-1403-FC Comment: The suggestion
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CMS-1403-FC Response: We thank the
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CMS-1403-FC provider enrollment giv
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CMS-1403-FC instead, it will force
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CMS-1403-FC Response: As stated abo
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CMS-1403-FC Comment: One commenter
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CMS-1403-FC In an attempt to ensure
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CMS-1403-FC rule, rather than limit
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CMS-1403-FC changes have occurred,
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CMS-1403-FC Response: While we moni
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CMS-1403-FC records faster and more
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CMS-1403-FC In §424.521(a)(1), we
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CMS-1403-FC practitioners with the
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CMS-1403-FC In June 2002 and Novemb
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CMS-1403-FC full implementation sch
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CMS-1403-FC with billing agents, cl
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CMS-1403-FC 2. Medicare Billing Pri
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CMS-1403-FC The FPLP is a collectio
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CMS-1403-FC continued enrollment to
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CMS-1403-FC Federal Payment Levy Pr
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CMS-1403-FC Consistent with existin
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CMS-1403-FC facilitate the enrollme
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CMS-1403-FC determination. Specific
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CMS-1403-FC individual practitioner
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CMS-1403-FC determines in February
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CMS-1403-FC Management Manual (IOM
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CMS-1403-FC Response: Based on thes
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CMS-1403-FC or continues to meet th
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CMS-1403-FC to identify and discipl
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CMS-1403-FC save our severe penalti
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CMS-1403-FC affords the supplier ap
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CMS-1403-FC privileges and assess a
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CMS-1403-FC §424.535(a)(10) that w
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CMS-1403-FC documentation for 7 yea
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CMS-1403-FC pharmacies to follow re
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CMS-1403-FC practitioners, includin
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CMS-1403-FC that require a revoked
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CMS-1403-FC provider and supplier e
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CMS-1403-FC K. Amendment to the Exe
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CMS-1403-FC Prescription Fill Statu
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CMS-1403-FC dispensers to move towa
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CMS-1403-FC Following the publicati
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CMS-1403-FC does not respond to the
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CMS-1403-FC facsimiles in all insta
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CMS-1403-FC Similarly, other commen
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CMS-1403-FC proposed rule's publica
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CMS-1403-FC elimination of the comp
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CMS-1403-FC exemption originally cr
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CMS-1403-FC dispensers are not requ
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CMS-1403-FC products, or, where upg
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CMS-1403-FC take time to develop, a
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CMS-1403-FC integrated this technol
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CMS-1403-FC Version 10.2 or higher)
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CMS-1403-FC proposed January 2009 c
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CMS-1403-FC L. Comprehensive Outpat
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CMS-1403-FC examination. In order t
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CMS-1403-FC qualifications for HHAs
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CMS-1403-FC distinction in the lice
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CMS-1403-FC (2) Have successfully c
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CMS-1403-FC risk-taking behaviors,
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CMS-1403-FC Therefore, we proposed
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CMS-1403-FC commenter stated that o
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CMS-1403-FC psychological services
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CMS-1403-FC 3. CORF Conditions of P
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CMS-1403-FC The following is a summ
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CMS-1403-FC We are not making any c
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CMS-1403-FC N. Physician Self-Refer
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CMS-1403-FC arrangements, and the l
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CMS-1403-FC below are related to ea
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CMS-1403-FC clinical practice. With
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CMS-1403-FC In the CY 2009 PFS prop
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CMS-1403-FC would be outside the sc
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CMS-1403-FC reflect objective quali
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CMS-1403-FC quality resulting from
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CMS-1403-FC payments should be reas
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CMS-1403-FC changes in referral pat
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CMS-1403-FC the alternative, we pro
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CMS-1403-FC finalize this condition
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CMS-1403-FC and “quality maintena
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CMS-1403-FC date. We seek comments
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CMS-1403-FC existing exceptions to
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CMS-1403-FC our general rulemaking
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CMS-1403-FC these approaches. We pr
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CMS-1403-FC building in which the b
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CMS-1403-FC were concerned that thi
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CMS-1403-FC supplier will be subjec
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CMS-1403-FC numerical test for the
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CMS-1403-FC space in which the orde
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CMS-1403-FC disadvantage nonproblem
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CMS-1403-FC would be simpler to not
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CMS-1403-FC IDTF standards in §410
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CMS-1403-FC that rule, the Governme
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CMS-1403-FC with comment period, th
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CMS-1403-FC 1842(n)(1) of the Act,
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CMS-1403-FC anti-markup provisions
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CMS-1403-FC her group practice woul
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CMS-1403-FC A commenter representin
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CMS-1403-FC tenens arrangements cou
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CMS-1403-FC other supplier. We are
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CMS-1403-FC on pathology reports or
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CMS-1403-FC patients. According to
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CMS-1403-FC from sharing a practice
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CMS-1403-FC Group A orders the TC a
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CMS-1403-FC physicians the flexibil
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CMS-1403-FC Response: We recognize
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CMS-1403-FC Response: Because the d
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CMS-1403-FC limited by the proposed
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CMS-1403-FC Response: With respect
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CMS-1403-FC to focus on the medical
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CMS-1403-FC service” approach bec
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CMS-1403-FC have the right to recei
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CMS-1403-FC 2 approach finalized he
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CMS-1403-FC the ordering physician
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CMS-1403-FC ensure an adequate nexu
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CMS-1403-FC entity” should be def
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CMS-1403-FC between the performing
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CMS-1403-FC supplier” to encompas
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CMS-1403-FC to continue to provide
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CMS-1403-FC requirements of the Alt
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CMS-1403-FC supervised in the offic
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CMS-1403-FC reducing access to care
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CMS-1403-FC commenter supported ado
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CMS-1403-FC “outside supplier,”
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CMS-1403-FC group could recover onl
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CMS-1403-FC incurred, thereby compe
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CMS-1403-FC needed to provide the t
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CMS-1403-FC performing supplier for
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CMS-1403-FC providers, the services
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CMS-1403-FC commenter also expresse
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CMS-1403-FC overutilization of in-o
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CMS-1403-FC provisions for single-s
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CMS-1403-FC we did not propose such
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CMS-1403-FC and PCs supervised or p
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CMS-1403-FC provisions will not app
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CMS-1403-FC (Pub. L. 110-173) (MMSE
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CMS-1403-FC reporting data on quali
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CMS-1403-FC PQRI and a more detaile
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CMS-1403-FC and our responses to th
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CMS-1403-FC provisions of the Priva
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CMS-1403-FC reducing eligible profe
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CMS-1403-FC administrative or judic
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CMS-1403-FC professionals who did n
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CMS-1403-FC base the incentive paym
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CMS-1403-FC A few commenters noted
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CMS-1403-FC administrative burden t
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CMS-1403-FC requested that more det
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CMS-1403-FC incentive payments for
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CMS-1403-FC December 31, 2009 and J
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CMS-1403-FC the reporting period fo
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CMS-1403-FC proposed to carry forwa
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CMS-1403-FC measures group is appli
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CMS-1403-FC measures results and nu
Page 557 and 558:
CMS-1403-FC (Delmarva Foundation fo
Page 559 and 560:
CMS-1403-FC registries to report on
Page 561 and 562:
CMS-1403-FC reporting options for r
Page 563 and 564:
CMS-1403-FC incentive payment for P
Page 565 and 566:
CMS-1403-FC to report 2009 PQRI qua
Page 567 and 568:
CMS-1403-FC Comment: We received nu
Page 569 and 570:
CMS-1403-FC Comment: One comment su
Page 571 and 572:
CMS-1403-FC quality measures result
Page 573 and 574:
CMS-1403-FC requirements listed on
Page 575 and 576:
CMS-1403-FC a data submission vendo
Page 577 and 578:
CMS-1403-FC As we stated in the CY
Page 579 and 580:
CMS-1403-FC whether eligible profes
Page 581 and 582:
CMS-1403-FC ● Agree that the regi
Page 583 and 584:
CMS-1403-FC soon thereafter as is t
Page 585 and 586:
CMS-1403-FC Comment: We received ma
Page 587 and 588:
Page 589 and 590:
CMS-1403-FC additional 2.0 percent
Page 591 and 592:
CMS-1403-FC EHRs in 2009. The measu
Page 593 and 594:
CMS-1403-FC i. Overview and Summary
Page 595 and 596:
CMS-1403-FC voluntary consensus sta
Page 597 and 598:
Page 599 and 600:
CMS-1403-FC the AMA-PCPI should be
Page 601 and 602:
CMS-1403-FC are appropriate and do
Page 603 and 604:
CMS-1403-FC to make any changes to
Page 605 and 606:
CMS-1403-FC post the measures for p
Page 607 and 608:
CMS-1403-FC beneficiaries. We now h
Page 609 and 610:
CMS-1403-FC identified in Tables 15
Page 611 and 612:
CMS-1403-FC important difference in
Page 613 and 614:
CMS-1403-FC not use Measures #73 Ca
Page 615 and 616:
CMS-1403-FC measures, but which are
Page 617 and 618:
CMS-1403-FC with comment period. Ho
Page 619 and 620:
CMS-1403-FC ● Measure #41 Osteopo
Page 621 and 622:
CMS-1403-FC professional to simply
Page 623 and 624:
CMS-1403-FC measures. We consider t
Page 625 and 626:
CMS-1403-FC Measure Number and Titl
Page 627 and 628:
CMS-1403-FC Measure Number and Titl
Page 629 and 630:
CMS-1403-FC ● Measure #120 CKD: A
Page 631 and 632:
CMS-1403-FC For the 2009 PQRI quali
Page 633 and 634:
CMS-1403-FC rule indicated that the
Page 635 and 636:
CMS-1403-FC Response: As suggested
Page 637 and 638:
CMS-1403-FC required for the measur
Page 639 and 640:
CMS-1403-FC ● Achievement of NQF
Page 641 and 642:
CMS-1403-FC These additional measur
Page 643 and 644:
CMS-1403-FC We did not include this
Page 645 and 646:
CMS-1403-FC Comment: Many commenter
Page 647 and 648:
CMS-1403-FC groups must have a part
Page 649 and 650:
CMS-1403-FC selected for inclusion
Page 651 and 652:
CMS-1403-FC Measure Title Measure S
Page 653 and 654:
CMS-1403-FC proposed HIV/AIDS measu
Page 655 and 656:
CMS-1403-FC set of denominator spec
Page 657 and 658:
CMS-1403-FC results, for this purpo
Page 659 and 660:
CMS-1403-FC informed decision-makin
Page 661 and 662:
Page 663 and 664:
CMS-1403-FC prior commitments that
Page 665 and 666:
CMS-1403-FC groups who successfully
Page 667 and 668:
CMS-1403-FC ● Eligible profession
Page 669 and 670:
CMS-1403-FC patients, families, and
Page 671 and 672:
CMS-1403-FC that have satisfactoril
Page 673 and 674:
CMS-1403-FC e-prescribing quality m
Page 675 and 676:
CMS-1403-FC Douglas S. and Friedman
Page 677 and 678:
CMS-1403-FC subsequent year, if the
Page 679 and 680:
CMS-1403-FC eligible professional f
Page 681 and 682:
CMS-1403-FC and is included in the
Page 683 and 684:
CMS-1403-FC The measure becomes app
Page 685 and 686:
CMS-1403-FC is, Measure #125) appli
Page 687 and 688:
CMS-1403-FC outpatient setting. Whi
Page 689 and 690:
CMS-1403-FC ability of an electroni
Page 691 and 692:
CMS-1403-FC October 2005 (hereinaft
Page 693 and 694:
CMS-1403-FC We are aware that there
Page 695 and 696:
CMS-1403-FC provided during the enc
Page 697 and 698:
CMS-1403-FC denominator of a measur
Page 699 and 700:
CMS-1403-FC cases. If the is determ
Page 701 and 702:
CMS-1403-FC during 2009; and (3) wh
Page 703 and 704:
CMS-1403-FC on this quality measure
Page 705 and 706:
CMS-1403-FC become effective until
Page 707 and 708:
CMS-1403-FC and CY 2007 PFS final r
Page 709 and 710:
CMS-1403-FC directly affected by th
Page 711 and 712:
CMS-1403-FC requires advanced pract
Page 713 and 714:
CMS-1403-FC applaud CMS for recogni
Page 715 and 716:
CMS-1403-FC standardization of DNP
Page 717 and 718:
CMS-1403-FC for the most part, been
Page 719 and 720:
CMS-1403-FC that the requirement fo
Page 721 and 722:
CMS-1403-FC degree in radiologic te
Page 723 and 724:
CMS-1403-FC the physicians that fur
Page 725 and 726:
CMS-1403-FC is associated with a te
Page 727 and 728:
CMS-1403-FC facility in which a tec
Page 729 and 730:
CMS-1403-FC by the Medicare program
Page 731 and 732:
CMS-1403-FC pressure (CPAP)” and
Page 733 and 734:
CMS-1403-FC for example chronic obs
Page 735 and 736:
CMS-1403-FC thus they believe leadi
Page 737 and 738:
CMS-1403-FC Excepting attended faci
Page 739 and 740:
CMS-1403-FC supplier separately. Ho
Page 741 and 742:
CMS-1403-FC final rule’s provisio
Page 743 and 744:
CMS-1403-FC as a DME supplier and p
Page 745 and 746:
CMS-1403-FC Moreover, given our gen
Page 747 and 748:
CMS-1403-FC resources and infrastru
Page 749 and 750:
Page 751 and 752:
CMS-1403-FC organization through a
Page 753 and 754:
CMS-1403-FC After reviewing the pub
Page 755 and 756:
CMS-1403-FC the nonparticipating ho
Page 757 and 758:
CMS-1403-FC be costly and burdensom
Page 759 and 760:
CMS-1403-FC adopting our proposal t
Page 761 and 762:
CMS-1403-FC We are not persuaded to
Page 763 and 764:
CMS-1403-FC §424.36(b)(6)(ii)(C)(2
Page 765 and 766:
CMS-1403-FC be made to obtain the s
Page 767 and 768:
CMS-1403-FC willing to sign at the
Page 769 and 770:
CMS-1403-FC and not suppliers, may
Page 771 and 772:
CMS-1403-FC crew member would have
Page 773 and 774:
CMS-1403-FC In order to determine f
Page 775 and 776:
CMS-1403-FC retrieval of the variou
Page 777 and 778:
CMS-1403-FC plan that demonstrates
Page 779 and 780:
CMS-1403-FC conviction, license sus
Page 781 and 782:
CMS-1403-FC The following is a summ
Page 783 and 784:
CMS-1403-FC faith reduces the time
Page 785 and 786:
CMS-1403-FC suspension or revocatio
Page 787 and 788:
CMS-1403-FC 9 percent per year. 2 I
Page 789 and 790:
CMS-1403-FC magnetic resonance imag
Page 791 and 792:
CMS-1403-FC Committee for Quality A
Page 793 and 794:
CMS-1403-FC measures in CMS’ VBP
Page 795 and 796:
CMS-1403-FC the Boston program site
Page 797 and 798:
CMS-1403-FC conditions that are hig
Page 799 and 800:
CMS-1403-FC reports? ● Do physici
Page 801 and 802:
CMS-1403-FC most Evaluation and Man
Page 803 and 804:
CMS-1403-FC III. Medicare Improveme
Page 805 and 806:
CMS-1403-FC Specifically, section 1
Page 807 and 808:
CMS-1403-FC period. The public will
Page 809 and 810:
CMS-1403-FC Section 101(b) of the M
Page 811 and 812:
CMS-1403-FC 1 year after the effect
Page 813 and 814:
CMS-1403-FC applies to both adult m
Page 815 and 816:
CMS-1403-FC period is limited to th
Page 817 and 818:
CMS-1403-FC 2007 through 2010. In a
Page 819 and 820:
CMS-1403-FC Section 1848(m)(3)(D) o
Page 821 and 822:
CMS-1403-FC In addition to the prov
Page 823 and 824:
CMS-1403-FC during the 2009 and 201
Page 825 and 826:
CMS-1403-FC prescribers for 2009 ar
Page 827 and 828:
CMS-1403-FC requirement by making a
Page 829 and 830:
CMS-1403-FC continue to bill the Me
Page 831 and 832:
CMS-1403-FC therapy and speech-lang
Page 833 and 834:
CMS-1403-FC ● Section 1835(a) of
Page 835 and 836:
CMS-1403-FC The amendments made by
Page 837 and 838:
CMS-1403-FC national associations a
Page 839 and 840:
CMS-1403-FC On November 9, 2006, we
Page 841 and 842:
CMS-1403-FC our regulations states
Page 843 and 844:
CMS-1403-FC rental period. The supp
Page 845 and 846:
CMS-1403-FC reasonable useful lifet
Page 847 and 848:
CMS-1403-FC to use the equipment be
Page 849 and 850:
CMS-1403-FC oxygen contents after t
Page 851 and 852:
CMS-1403-FC the oxygen contents and
Page 853 and 854:
CMS-1403-FC Section 414.210(e)(2) a
Page 855 and 856:
CMS-1403-FC reported to us that, ba
Page 857 and 858:
CMS-1403-FC non-routine maintenance
Page 859 and 860:
CMS-1403-FC As a result, we will ma
Page 861 and 862:
CMS-1403-FC 31, 2009 amounts for gr
Page 863 and 864:
CMS-1403-FC under section 332(a)(1)
Page 865 and 866:
CMS-1403-FC furnishing services via
Page 867 and 868:
CMS-1403-FC required to furnish dir
Page 869 and 870:
CMS-1403-FC mental health services
Page 871 and 872:
CMS-1403-FC Skilled Nursing Facilit
Page 873 and 874:
CMS-1403-FC where the SNF resident
Page 875 and 876:
CMS-1403-FC describes the methodolo
Page 877 and 878:
CMS-1403-FC The RUC has created the
Page 879 and 880:
CMS-1403-FC Response: Although we r
Page 881 and 882:
CMS-1403-FC occurring code pairs. T
Page 883 and 884:
CMS-1403-FC a standing panel of exp
Page 885 and 886:
CMS-1403-FC extraction of the assoc
Page 887 and 888:
CMS-1403-FC TABLE 26: AMA RUC Recom
Page 889 and 890:
CMS-1403-FC AMA RUC Rec Site of Ser
Page 891 and 892:
Page 893 and 894:
Page 895 and 896:
CMS-1403-FC Note: The RUC reviewed
Page 897 and 898:
CMS-1403-FC C. Interim 2008 Codes 1
Page 899 and 900:
CMS-1403-FC national noncoverage de
Page 901 and 902:
CMS-1403-FC CPT codes for 2008. In
Page 903 and 904:
CMS-1403-FC associated work RVUs, t
Page 905 and 906:
CMS-1403-FC CPT 1 AMA RUC Work RVU
Page 907 and 908:
CMS-1403-FC # New CPT code. 1 All C
Page 909 and 910:
CMS-1403-FC ● 27218, Open treatme
Page 911 and 912:
CMS-1403-FC RVUs for G0412; 15.73 w
Page 913 and 914:
CMS-1403-FC Therefore, we disagree
Page 915 and 916:
CMS-1403-FC generally contractor pr
Page 917 and 918:
CMS-1403-FC In addition, we believe
Page 919 and 920:
CMS-1403-FC RVU for CPT code 93289
Page 921 and 922:
CMS-1403-FC time to better understa
Page 923 and 924:
CMS-1403-FC ● 93306, Echocardiogr
Page 925 and 926:
CMS-1403-FC Although not discussed
Page 927 and 928:
CMS-1403-FC for New and Revised 200
Page 929 and 930:
CMS-1403-FC item. In addition, the
Page 931 and 932:
CMS-1403-FC 90956, 90957, 90958, 90
Page 933 and 934:
CMS-1403-FC place of these two new
Page 935 and 936:
CMS-1403-FC beneficiary or any othe
Page 937 and 938:
CMS-1403-FC ● Adding the followin
Page 939 and 940:
CMS-1403-FC Tables 29 and 30 also i
Page 941 and 942:
CMS-1403-FC RADIOLOGY AND CERTAIN O
Page 943 and 944:
CMS-1403-FC 93320 Doppler echo exam
Page 945 and 946:
CMS-1403-FC index data, that the hi
Page 947 and 948:
CMS-1403-FC TABLE 32: Increase in t
Page 949 and 950:
CMS-1403-FC C. The Update Adjustmen
Page 951 and 952:
CMS-1403-FC end of the prior year a
Page 953 and 954:
CMS-1403-FC CY 2009, the statute re
Page 955 and 956:
CMS-1403-FC Actual08 = Estimated Ac
Page 957 and 958:
CMS-1403-FC 1848(f)(3)(C)(i) of the
Page 959 and 960:
CMS-1403-FC ● Screening mammograp
Page 961 and 962:
CMS-1403-FC payments while promotin
Page 963 and 964:
CMS-1403-FC E. Final Sustainable Gr
Page 965 and 966:
CMS-1403-FC included in the SGR (us
Page 967 and 968:
CMS-1403-FC that this figure will c
Page 969 and 970:
CMS-1403-FC physicians' services in
Page 971 and 972:
CMS-1403-FC imaging services, the M
Page 973 and 974:
CMS-1403-FC CY 2007. Table 42 illus
Page 975 and 976:
CMS-1403-FC year to the entire year
Page 977 and 978:
CMS-1403-FC the CF. Therefore, this
Page 979 and 980:
CMS-1403-FC estimate that CY 2009 R
Page 981 and 982:
CMS-1403-FC Table 44: Calculation o
Page 983 and 984:
CMS-1403-FC XI. Payment for Certain
Page 985 and 986:
CMS-1403-FC In the Competitive Acqu
Page 987 and 988:
CMS-1403-FC glasses, hand magnifier
Page 989 and 990:
CMS-1403-FC Our interpretation of t
Page 991 and 992:
CMS-1403-FC Response: We understand
Page 993 and 994:
CMS-1403-FC defines “eyeglass”
Page 995 and 996:
CMS-1403-FC this statutory exclusio
Page 997 and 998:
CMS-1403-FC advances in the use of
Page 999 and 1000:
CMS-1403-FC is paid for his or her
Page 1001 and 1002:
CMS-1403-FC XII. Provisions of the
Page 1003 and 1004:
CMS-1403-FC these RUC recommendatio
Page 1005 and 1006:
CMS-1403-FC services. We believe a
Page 1007 and 1008:
CMS-1403-FC Section 144(b) of the M
Page 1009 and 1010:
CMS-1403-FC rulemaking with respect
Page 1011 and 1012:
CMS-1403-FC (respectively) of this
Page 1013 and 1014:
CMS-1403-FC completing and submitti
Page 1015 and 1016:
CMS-1403-FC §424.516(d)(1). Additi
Page 1017 and 1018:
CMS-1403-FC to several associated i
Page 1019 and 1020:
CMS-1403-FC incentive payment for 2
Page 1021 and 1022:
CMS-1403-FC year of PQRI reporting)
Page 1023 and 1024:
CMS-1403-FC Based on the assumption
Page 1025 and 1026:
CMS-1403-FC these activities for th
Page 1027 and 1028:
CMS-1403-FC per hour, we estimate t
Page 1029 and 1030:
CMS-1403-FC Because of the large nu
Page 1031 and 1032:
CMS-1403-FC threshold, and hence al
Page 1033 and 1034:
CMS-1403-FC shoes, the regulation i
Page 1035 and 1036:
CMS-1403-FC with comment period for
Page 1037 and 1038:
CMS-1403-FC substance of State laws
Page 1039 and 1040:
CMS-1403-FC $20 million from what e
Page 1041 and 1042:
CMS-1403-FC ● Impact of Work RVU
Page 1043 and 1044:
CMS-1403-FC imaging services from t
Page 1045 and 1046:
CMS-1403-FC ● Impact of section 1
Page 1047 and 1048:
CMS-1403-FC management, could have
Page 1049 and 1050:
CMS-1403-FC Table 50 illustrates, f
Page 1051 and 1052:
CMS-1403-FC CPT/ HCPCS Mod Descript
Page 1053 and 1054:
CMS-1403-FC impact associated with
Page 1055 and 1056:
CMS-1403-FC The fourth column shows
Page 1057 and 1058:
CMS-1403-FC the CY 2007 claims. The
Page 1059 and 1060:
CMS-1403-FC 1059 4/This column show
Page 1061 and 1062:
CMS-1403-FC requirements is to allo
Page 1063 and 1064:
CMS-1403-FC This amendment of the e
Page 1065 and 1066:
CMS-1403-FC 4 minutes per call, lab
Page 1067 and 1068:
CMS-1403-FC e-prescribing and who m
Page 1069 and 1070:
CMS-1403-FC anti-markup provisions
Page 1071 and 1072:
CMS-1403-FC approximately $50 per h
Page 1073 and 1074:
CMS-1403-FC e-prescribing measure i
Page 1075 and 1076:
CMS-1403-FC we estimate that each e
Page 1077 and 1078:
CMS-1403-FC P. Prohibition Concerni
Page 1079 and 1080:
CMS-1403-FC that provides a calcula
Page 1081 and 1082:
CMS-1403-FC treatment) that occur a
Page 1083 and 1084:
CMS-1403-FC locality (+5.37 percent
Page 1085 and 1086:
CMS-1403-FC additional rental payme
Page 1087 and 1088:
CMS-1403-FC T. Competitive Acquisit
Page 1089 and 1090:
CMS-1403-FC Program; II.T. Electron
Page 1091 and 1092:
CMS-1403-FC which means that in 200
Page 1093 and 1094:
CMS-1403-FC List of Subjects 42 CFR
Page 1095 and 1096:
CMS-1403-FC For the reasons set for
Page 1097 and 1098:
CMS-1403-FC (1) Except as specified
Page 1099 and 1100:
CMS-1403-FC pressure, a visual acui
Page 1101 and 1102:
CMS-1403-FC (ii) A speech-language
Page 1103 and 1104:
CMS-1403-FC during the hours that t
Page 1105 and 1106:
CMS-1403-FC (i) Be certified as a n
Page 1107 and 1108:
CMS-1403-FC 14. Section 410.155 is
Page 1109 and 1110:
CMS-1403-FC prostate cancer screeni
Page 1111 and 1112:
CMS-1403-FC B. Amending the definit
Page 1113 and 1114:
CMS-1403-FC The revisions and addit
Page 1115 and 1116:
CMS-1403-FC or institution other th
Page 1117 and 1118:
CMS-1403-FC substantially all (whic
Page 1119 and 1120:
CMS-1403-FC psychiatric diagnostic
Page 1121 and 1122:
CMS-1403-FC repairing, maintaining,
Page 1123 and 1124:
CMS-1403-FC B. Deleting paragraph (
Page 1125 and 1126:
CMS-1403-FC during any period of me
Page 1127 and 1128:
CMS-1403-FC (c)(1). A. Revising the
Page 1129 and 1130:
CMS-1403-FC * * * * * (b) * * * (2)
Page 1131 and 1132:
CMS-1403-FC assigned to such drug p
Page 1133 and 1134:
CMS-1403-FC 33. In §415.130(d), th
Page 1135 and 1136:
CMS-1403-FC (6) An ambulance provid
Page 1137 and 1138:
CMS-1403-FC §424.57 Special paymen
Page 1139 and 1140:
CMS-1403-FC Final adverse action me
Page 1141 and 1142:
CMS-1403-FC (b) Reporting requireme
Page 1143 and 1144:
CMS-1403-FC of Medicare billing pri
Page 1145 and 1146:
CMS-1403-FC (a) Physicians, nonphys
Page 1147 and 1148:
CMS-1403-FC * * * * * (g) Effective
Page 1149 and 1150:
CMS-1403-FC that meet the qualifica
Page 1151 and 1152:
CMS-1403-FC (3) Have equivalent tra
Page 1153 and 1154:
CMS-1403-FC §485.711 Condition of
Page 1155 and 1156:
CMS-1403-FC Subpart C--Conditions f
Page 1157 and 1158:
CMS-1403-FC Authority: Catalog of F
Page 1159 and 1160:
CMS-1403-FC Addendum B means that C
Page 1161 and 1162:
CMS-1403-FC which they are incident
Page 1163 and 1164: CMS-1403-FC T = There are RVUs for
Page 1165 and 1166: CMS-1403-FC ADDENDUM B: Relative Va
Page 1167 and 1168: CMS-1403-FC Physi- cian Work Fully
Page 1213: CMS-1403-FC Physi- cian Work Fully
Page 1265 and 1266:
CMS-1403-FC Physi- cian Work Fully
Page 1267 and 1268:
Page 1269 and 1270:
Page 1271 and 1272:
Page 1273 and 1274:
Page 1275 and 1276:
Page 1277 and 1278:
Page 1279 and 1280:
Page 1281 and 1282:
Page 1283 and 1284:
Page 1285 and 1286:
Page 1287 and 1288:
Page 1289 and 1290:
Page 1291 and 1292:
Page 1293 and 1294:
Page 1295 and 1296:
Page 1297 and 1298:
Page 1299 and 1300:
Page 1301 and 1302:
Page 1303 and 1304:
Page 1305 and 1306:
Page 1307 and 1308:
Page 1309 and 1310:
Page 1311 and 1312:
Page 1313 and 1314:
Page 1315 and 1316:
Page 1317 and 1318:
Page 1319 and 1320:
Page 1321 and 1322:
Page 1323 and 1324:
Page 1325 and 1326:
Page 1327 and 1328:
Page 1329 and 1330:
Page 1331 and 1332:
Page 1333 and 1334:
Page 1335 and 1336:
Page 1337 and 1338:
Page 1339 and 1340:
Page 1341 and 1342:
Page 1343 and 1344:
Page 1345 and 1346:
Page 1347 and 1348:
Page 1349 and 1350:
Page 1351 and 1352:
Page 1353 and 1354:
Page 1355 and 1356:
Page 1357 and 1358:
Page 1359 and 1360:
Page 1361 and 1362:
Page 1363 and 1364:
Page 1365 and 1366:
Page 1367 and 1368:
Page 1369 and 1370:
CMS-1403-FC CPT 1 / HCPCS Mod Statu
Page 1371 and 1372:
CMS-1403-FC CPT 1 / HCPCS Mod Statu
Page 1373 and 1374:
Page 1375 and 1376:
CMS-1403-FC Contractor Locality Loc
Page 1377 and 1378:
CMS-1403-FC ADDENDUM E: 2009 Geogra
Page 1379 and 1380:
CMS-1403-FC Work** PE MP Contractor
Page 1381 and 1382:
CMS-1403-FC 70492 Ct soft tissue ne
Page 1383 and 1384:
CMS-1403-FC 73201 Ct upper extremit
Page 1385 and 1386:
CMS-1403-FC 10780 10900 11020 11100
Page 1387 and 1388:
CMS-1403-FC 12420 12540 12580 12620
Page 1389 and 1390:
CMS-1403-FC 14060 14260 14484 14500
Page 1391 and 1392:
CMS-1403-FC 16820 16860 16940 16974
Page 1393 and 1394:
CMS-1403-FC 17980 18020 18140 18580
Page 1395 and 1396:
CMS-1403-FC 19804 20020 20100 20220
Page 1397 and 1398:
CMS-1403-FC 22500 22520 22540 22660
Page 1399 and 1400:
CMS-1403-FC 25020 25060 25180 25260
Page 1401 and 1402:
CMS-1403-FC 26980 27060 27100 27140
Page 1403 and 1404:
CMS-1403-FC 28700 28740 28940 29020
Page 1405 and 1406:
CMS-1403-FC 30860 30980 31020 31084
Page 1407 and 1408:
CMS-1403-FC 33140 33260 33340 33460
Page 1409 and 1410:
CMS-1403-FC 35300 35380 35644 35660
Page 1411 and 1412:
CMS-1403-FC 37340 37380 37460 37620
Page 1413 and 1414:
CMS-1403-FC 39300 39340 39380 39460
Page 1415 and 1416:
CMS-1403-FC 40580 40660 40900 40980
Page 1417 and 1418:
CMS-1403-FC 41940 41980 Sabana Gran
Page 1419 and 1420:
CMS-1403-FC 43340 43580 43620 43780
Page 1421 and 1422:
CMS-1403-FC 45940 46060 46140 46220
Page 1423 and 1424:
CMS-1403-FC 47940 48140 48260 48300
Page 1425 and 1426:
CMS-1403-FC 1425
Page 1427 and 1428:
CMS-1403-FC CBSA Code Nonurban Area
Page 1429 and 1430:
CMS-1403-FC HCPCS Descriptor 71260
Page 1431 and 1432:
Page 1433 and 1434:
Page 1435 and 1436:
Page 1437 and 1438:
CMS-1403-FC 78122 Blood volume 7813
Page 1439 and 1440:
CMS-1403-FC 96125 Cognitive test by
Page 1441 and 1442:
CMS-1403-FC 70240 X-ray exam, pitui
Page 1443 and 1444:
CMS-1403-FC 72120 X-ray exam of low
Page 1445 and 1446:
CMS-1403-FC 73720 Mri lwr extremity
Page 1447 and 1448:
CMS-1403-FC 76856 Us exam, pelvic,
Page 1449 and 1450:
CMS-1403-FC 78456 Acute venous thro
Page 1451 and 1452:
CMS-1403-FC 93320 Doppler echo exam
Page 1453 and 1454:
CMS-1403-FC A9571 Indium In-111 aut
Page 1455 and 1456:
CMS-1403-FC 77333 Radiation treatme
Page 1457 and 1458:
CMS-1403-FC C2638 Brachytx, strande
Page 1459:
CMS-1403-FC P3000 Screen pap by tec
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