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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. 1320 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 78232 A Salivary gland function exam 0.47 2.85 3.07 NA NA 0.20 XXX 78232 TC A Salivary gland function exam 0.00 2.67 2.89 NA NA 0.18 XXX 78232 26 A Salivary gland function exam 0.47 0.18 0.18 0.18 0.18 0.02 XXX 78258 A Esophageal motility study 0.74 5.66 5.04 NA NA 0.17 XXX 78258 TC A Esophageal motility study 0.00 5.36 4.75 NA NA 0.14 XXX 78258 26 A Esophageal motility study 0.74 0.30 0.29 0.30 0.29 0.03 XXX 78261 A Gastric mucosa imaging 0.69 6.08 5.65 NA NA 0.25 XXX 78261 TC A Gastric mucosa imaging 0.00 5.81 5.39 NA NA 0.22 XXX 78261 26 A Gastric mucosa imaging 0.69 0.27 0.26 0.27 0.26 0.03 XXX 78262 A Gastroesophageal reflux exam 0.68 5.91 5.57 NA NA 0.25 XXX 78262 TC A Gastroesophageal reflux exam 0.00 5.67 5.33 NA NA 0.22 XXX 78262 26 A Gastroesophageal reflux exam 0.68 0.24 0.24 0.24 0.24 0.03 XXX 78264 A Gastric emptying study 0.78 7.10 6.44 NA NA 0.25 XXX 78264 TC A Gastric emptying study 0.00 6.80 6.15 NA NA 0.22 XXX 78264 26 A Gastric emptying study 0.78 0.30 0.29 0.30 0.29 0.03 XXX 78267 X Breath tst attain/anal c-14 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78268 X Breath test analysis, c-14 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78270 A Vit B-12 absorption exam 0.20 1.94 1.87 NA NA 0.11 XXX 78270 TC A Vit B-12 absorption exam 0.00 1.87 1.80 NA NA 0.10 XXX 78270 26 A Vit B-12 absorption exam 0.20 0.07 0.07 0.07 0.07 0.01 XXX 78271 A Vit b-12 absrp exam, int fac 0.20 1.94 1.89 NA NA 0.11 XXX 78271 TC A Vit b-12 absrp exam, int fac 0.00 1.88 1.83 NA NA 0.10 XXX 78271 26 A Vit b-12 absrp exam, int fac 0.20 0.06 0.06 0.06 0.06 0.01 XXX 78272 A Vit B-12 absorp, combined 0.27 1.97 2.09 NA NA 0.14 XXX 78272 TC A Vit B-12 absorp, combined 0.00 1.89 2.01 NA NA 0.13 XXX 78272 26 A Vit B-12 absorp, combined 0.27 0.08 0.08 0.08 0.08 0.01 XXX 78278 A Acute GI blood loss imaging 0.99 8.55 7.72 NA NA 0.29 XXX 78278 TC A Acute GI blood loss imaging 0.00 8.16 7.35 NA NA 0.25 XXX 78278 26 A Acute GI blood loss imaging 0.99 0.39 0.37 0.39 0.37 0.04 XXX 78282 C GI protein loss exam 0.00 0.00 0.00 NA NA 0.00 XXX 78282 TC C GI protein loss exam 0.00 0.00 0.00 NA NA 0.00 XXX 78282 26 A GI protein loss exam 0.38 0.15 0.14 0.15 0.14 0.02 XXX 78290 A MeckelÆs divert exam 0.68 8.42 7.16 NA NA 0.19 XXX 78290 TC A MeckelÆs divert exam 0.00 8.16 6.90 NA NA 0.16 XXX 78290 26 A MeckelÆs divert exam 0.68 0.26 0.26 0.26 0.26 0.03 XXX 78291 A Leveen/shunt patency exam 0.88 6.16 5.47 NA NA 0.20 XXX 78291 TC A Leveen/shunt patency exam 0.00 5.82 5.14 NA NA 0.16 XXX 78291 26 A Leveen/shunt patency exam 0.88 0.34 0.33 0.34 0.33 0.04 XXX 78299 C GI nuclear procedure 0.00 0.00 0.00 NA NA 0.00 XXX 78299 TC C GI nuclear procedure 0.00 0.00 0.00 NA NA 0.00 XXX 78299 26 C GI nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78300 A Bone imaging, limited area 0.62 4.19 3.82 NA NA 0.17 XXX 78300 TC A Bone imaging, limited area 0.00 3.95 3.59 NA NA 0.14 XXX 78300 26 A Bone imaging, limited area 0.62 0.24 0.23 0.24 0.23 0.03 XXX 78305 A Bone imaging, multiple areas 0.83 5.44 5.07 NA NA 0.23 XXX 78305 TC A Bone imaging, multiple areas 0.00 5.13 4.77 NA NA 0.19 XXX 78305 26 A Bone imaging, multiple areas 0.83 0.31 0.30 0.31 0.30 0.04 XXX 78306 A Bone imaging, whole body 0.86 6.02 5.67 NA NA 0.26 XXX
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. 1321 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 78306 TC A Bone imaging, whole body 0.00 5.69 5.35 NA NA 0.22 XXX 78306 26 A Bone imaging, whole body 0.86 0.33 0.32 0.33 0.32 0.04 XXX 78315 A Bone imaging, 3 phase 1.02 8.54 7.70 NA NA 0.29 XXX 78315 TC A Bone imaging, 3 phase 0.00 8.14 7.32 NA NA 0.25 XXX 78315 26 A Bone imaging, 3 phase 1.02 0.40 0.38 0.40 0.38 0.04 XXX 78320 A Bone imaging (3D) 1.04 5.36 5.60 NA NA 0.35 XXX 78320 TC A Bone imaging (3D) 0.00 4.96 5.21 NA NA 0.31 XXX 78320 26 A Bone imaging (3D) 1.04 0.40 0.39 0.40 0.39 0.04 XXX 78350 N Bone mineral, single photon 0.22 0.59 0.65 NA NA 0.06 XXX 78350 TC N Bone mineral, single photon 0.00 0.52 0.58 NA NA 0.05 XXX 78350 26 N Bone mineral, single photon 0.22 0.07 0.07 0.07 0.07 0.01 XXX 78351 N Bone mineral, dual photon 0.30 NA NA 0.10 0.11 0.01 XXX 78399 C Musculoskeletal nuclear exam 0.00 0.00 0.00 NA NA 0.00 XXX 78399 TC C Musculoskeletal nuclear exam 0.00 0.00 0.00 NA NA 0.00 XXX 78399 26 C Musculoskeletal nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78414 C Non-imaging heart function 0.00 0.00 0.00 NA NA 0.00 XXX 78414 TC C Non-imaging heart function 0.00 0.00 0.00 NA NA 0.00 XXX 78414 26 A Non-imaging heart function 0.45 0.12 0.13 0.12 0.13 0.02 XXX 78428 A Cardiac shunt imaging 0.78 5.00 4.40 NA NA 0.16 XXX 78428 TC A Cardiac shunt imaging 0.00 4.65 4.06 NA NA 0.13 XXX 78428 26 A Cardiac shunt imaging 0.78 0.35 0.34 0.35 0.34 0.03 XXX 78445 A Vascular flow imaging 0.49 4.46 3.86 NA NA 0.13 XXX 78445 TC A Vascular flow imaging 0.00 4.27 3.68 NA NA 0.11 XXX 78445 26 A Vascular flow imaging 0.49 0.19 0.18 0.19 0.18 0.02 XXX 78456 A Acute venous thrombus image 1.00 9.42 8.16 NA NA 0.33 XXX 78456 TC A Acute venous thrombus image 0.00 8.91 7.70 NA NA 0.29 XXX 78456 26 A Acute venous thrombus image 1.00 0.51 0.46 0.51 0.46 0.04 XXX 78457 A Venous thrombosis imaging 0.77 4.63 4.21 NA NA 0.17 XXX 78457 TC A Venous thrombosis imaging 0.00 4.34 3.93 NA NA 0.14 XXX 78457 26 A Venous thrombosis imaging 0.77 0.29 0.28 0.29 0.28 0.03 XXX 78458 A Ven thrombosis images, bilat 0.90 4.61 4.55 NA NA 0.25 XXX 78458 TC A Ven thrombosis images, bilat 0.00 4.26 4.21 NA NA 0.21 XXX 78458 26 A Ven thrombosis images, bilat 0.90 0.35 0.34 0.35 0.34 0.04 XXX 78459 C Heart muscle imaging (PET) 0.00 0.00 0.00 NA NA 0.00 XXX 78459 TC C Heart muscle imaging (PET) 0.00 0.00 0.00 NA NA 0.00 XXX 78459 26 A Heart muscle imaging (PET) 1.50 0.68 0.65 0.68 0.65 0.05 XXX 78460 A Heart muscle blood, single 0.86 4.61 4.13 NA NA 0.17 XXX 78460 TC A Heart muscle blood, single 0.00 4.26 3.80 NA NA 0.13 XXX 78460 26 A Heart muscle blood, single 0.86 0.35 0.33 0.35 0.33 0.04 XXX 78461 A Heart muscle blood, multiple 1.23 4.02 4.31 NA NA 0.30 XXX 78461 TC A Heart muscle blood, multiple 0.00 3.52 3.83 NA NA 0.25 XXX 78461 26 A Heart muscle blood, multiple 1.23 0.50 0.48 0.50 0.48 0.05 XXX 78464 A Heart image (3d), single 1.09 5.64 6.11 NA NA 0.41 XXX 78464 TC A Heart image (3d), single 0.00 5.12 5.62 NA NA 0.37 XXX 78464 26 A Heart image (3d), single 1.09 0.52 0.49 0.52 0.49 0.04 XXX 78465 A Heart image (3d), multiple 1.46 10.96 11.32 NA NA 0.67 XXX 78465 TC A Heart image (3d), multiple 0.00 10.23 10.64 NA NA 0.62 XXX 78465 26 A Heart image (3d), multiple 1.46 0.73 0.68 0.73 0.68 0.05 XXX
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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
Page 541 and 542:
CMS-1403-FC administrative burden t
Page 543 and 544:
CMS-1403-FC requested that more det
Page 545 and 546:
CMS-1403-FC incentive payments for
Page 547 and 548:
CMS-1403-FC December 31, 2009 and J
Page 549 and 550:
CMS-1403-FC the reporting period fo
Page 551 and 552:
CMS-1403-FC proposed to carry forwa
Page 553 and 554:
CMS-1403-FC measures group is appli
Page 555 and 556:
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 1169 and 1170:
Page 1171 and 1172:
Page 1173 and 1174:
Page 1175 and 1176:
Page 1177 and 1178:
Page 1179 and 1180:
Page 1181 and 1182:
Page 1183 and 1184:
Page 1185 and 1186:
Page 1187 and 1188:
Page 1189 and 1190:
Page 1191 and 1192:
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Page 1199 and 1200:
Page 1201 and 1202:
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Page 1207 and 1208:
Page 1209 and 1210:
Page 1211 and 1212:
Page 1213 and 1214:
Page 1215 and 1216:
Page 1217 and 1218:
Page 1219 and 1220:
Page 1221 and 1222:
Page 1223 and 1224:
Page 1225 and 1226:
Page 1227 and 1228:
Page 1229 and 1230:
Page 1231 and 1232:
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Page 1235 and 1236:
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Page 1243 and 1244:
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Page 1247 and 1248:
Page 1249 and 1250:
Page 1251 and 1252:
Page 1253 and 1254:
Page 1255 and 1256:
Page 1257 and 1258:
Page 1259 and 1260:
Page 1261 and 1262:
Page 1263 and 1264:
Page 1265 and 1266:
Page 1267 and 1268:
Page 1269 and 1270: CMS-1403-FC Physi- cian Work Fully
Page 1319: CMS-1403-FC Physi- cian Work Fully
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:
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CMS-1403-FC 78122 Blood volume 7813
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CMS-1403-FC 96125 Cognitive test by
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CMS-1403-FC 70240 X-ray exam, pitui
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CMS-1403-FC 72120 X-ray exam of low
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CMS-1403-FC 73720 Mri lwr extremity
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CMS-1403-FC 76856 Us exam, pelvic,
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CMS-1403-FC 78456 Acute venous thro
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CMS-1403-FC 93320 Doppler echo exam
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CMS-1403-FC A9571 Indium In-111 aut
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CMS-1403-FC 77333 Radiation treatme
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CMS-1403-FC C2638 Brachytx, strande
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CMS-1403-FC P3000 Screen pap by tec
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