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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. 1356 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 96111 A Developmental test, extend 2.60 0.76 0.83 0.64 0.75 0.18 XXX 96116 A Neurobehavioral status exam 1.86 0.54 0.61 0.42 0.47 0.18 XXX 96118 A Neuropsych tst by psych/phys 1.86 0.82 0.96 0.34 0.41 0.18 XXX 96119 A Neuropsych testing by tec 0.55 1.43 1.33 0.10 0.13 0.18 XXX 96120 A Neuropsych tst admin w/comp 0.51 1.58 1.37 0.11 0.13 0.02 XXX 96125 A Cognitive test by hc pro 1.70 0.77 0.77 0.38 0.38 0.16 XXX 96150 A Assess hlth/behave, init 0.50 0.10 0.12 0.09 0.11 0.01 XXX 96151 A Assess hlth/behave, subseq 0.48 0.10 0.12 0.09 0.11 0.01 XXX 96152 A Intervene hlth/behave, indiv 0.46 0.09 0.11 0.08 0.10 0.01 XXX 96153 A Intervene hlth/behave, group 0.10 0.02 0.03 0.02 0.02 0.01 XXX 96154 A Interv hlth/behav, fam w/pt 0.45 0.09 0.11 0.08 0.10 0.01 XXX 96155 N Interv hlth/behav fam no pt 0.44 0.15 0.16 0.15 0.15 0.02 XXX 96360 A Hydration iv infusion, init 0.17 1.29 1.33 NA NA 0.07 XXX 96361 A Hydrate iv infusion, add-on 0.09 0.31 0.33 NA NA 0.04 ZZZ 96365 A Ther/proph/diag iv inf, init 0.21 1.58 1.63 NA NA 0.07 XXX 96366 A Ther/proph/diag iv inf addon 0.18 0.37 0.39 NA NA 0.04 ZZZ 96367 A Tx/proph/dg addl seq iv inf 0.19 0.68 0.73 NA NA 0.04 ZZZ 96368 A Ther/diag concurrent inf 0.17 0.34 0.36 NA NA 0.04 ZZZ 96369 A Sc ther infusion, up to 1 hr 0.21 3.86 3.88 NA NA 0.06 XXX 96370 A Sc ther infusion, addl hr 0.18 0.22 0.22 NA NA 0.04 ZZZ 96371 A Sc ther infusion, reset pump 0.00 2.04 2.00 NA NA 0.01 ZZZ 96372 A Ther/proph/diag inj, sc/im 0.17 0.43 0.40 NA NA 0.01 XXX 96373 A Ther/proph/diag inj, ia 0.17 0.30 0.31 NA NA 0.02 XXX 96374 A Ther/proph/diag inj, iv push 0.18 1.28 1.29 NA NA 0.04 XXX 96375 A Tx/pro/dx inj new drug addon 0.10 0.50 0.52 NA NA 0.04 ZZZ 96376 X Tx/pro/dx inj new drug adon 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 96379 C Ther/prop/diag inj/inf proc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96401 A Chemo, anti-neopl, sq/im 0.21 1.81 1.65 NA NA 0.01 XXX 96402 A Chemo hormon antineopl sq/im 0.19 0.75 0.82 NA NA 0.01 XXX 96405 A Chemo intralesional, up to 7 0.52 1.56 1.79 0.25 0.25 0.03 000 96406 A Chemo intralesional over 7 0.80 2.19 2.40 0.34 0.33 0.03 000 96409 A Chemo, iv push, sngl drug 0.24 2.75 2.80 NA NA 0.06 XXX 96411 A Chemo, iv push, addl drug 0.20 1.48 1.51 NA NA 0.06 ZZZ 96413 A Chemo, iv infusion, 1 hr 0.28 3.56 3.73 NA NA 0.08 XXX 96415 A Chemo, iv infusion, addl hr 0.19 0.64 0.67 NA NA 0.07 ZZZ 96416 A Chemo prolong infuse w/pump 0.21 4.01 4.17 NA NA 0.08 XXX 96417 A Chemo iv infus each addl seq 0.21 1.70 1.76 NA NA 0.07 ZZZ 96420 A Chemo, ia, push tecnique 0.17 2.76 2.74 NA NA 0.08 XXX 96422 A Chemo ia infusion up to 1 hr 0.17 4.47 4.57 NA NA 0.08 XXX 96423 A Chemo ia infuse each addl hr 0.17 1.98 1.96 NA NA 0.02 ZZZ 96425 A Chemotherapy,infusion method 0.17 4.50 4.50 NA NA 0.08 XXX 96440 A Chemotherapy, intracavitary 2.37 15.97 14.04 1.09 1.13 0.17 000 96445 A Chemotherapy, intracavitary 2.20 4.73 5.57 0.80 0.90 0.14 000 96450 A Chemotherapy, into CNS 1.53 3.21 4.15 0.66 0.82 0.09 000 96521 A Refill/maint, portable pump 0.21 3.07 3.25 NA NA 0.06 XXX 96522 A Refill/maint pump/resvr syst 0.21 2.73 2.72 NA NA 0.06 XXX 96523 T Irrig drug delivery device 0.04 0.63 0.65 NA NA 0.01 XXX 96542 A Chemotherapy injection 0.75 2.44 2.90 0.37 0.44 0.07 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. 1357 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 96549 C Chemotherapy, unspecified 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96567 A Photodynamic tx, skin 0.00 3.61 3.20 NA NA 0.04 XXX 96570 A Photodynamic tx, 30 min 1.10 0.41 0.40 0.41 0.40 0.11 ZZZ 96571 A Photodynamic tx, addl 15 min 0.55 0.19 0.19 0.19 0.19 0.03 ZZZ 96900 A Ultraviolet light therapy 0.00 0.55 0.52 NA NA 0.02 XXX 96902 B Trichogram 0.41 0.16 0.16 0.14 0.14 0.01 XXX 96904 R Whole body photography 0.00 1.77 1.77 NA NA 0.01 XXX 96910 A Photochemotherapy with UV-B 0.00 1.93 1.70 NA NA 0.04 XXX 96912 A Photochemotherapy with UV-A 0.00 2.48 2.18 NA NA 0.05 XXX 96913 A Photochemotherapy, UV-A or B 0.00 3.44 3.00 NA NA 0.10 XXX 96920 A Laser tx, skin < 250 sq cm 1.15 3.51 3.27 0.60 0.59 0.02 000 96921 A Laser tx, skin 250-500 sq cm 1.17 3.32 3.15 0.55 0.55 0.03 000 96922 A Laser tx, skin > 500 sq cm 2.10 4.55 4.30 1.10 0.98 0.04 000 96999 C Dermatological procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97001 A Pt evaluation 1.20 0.67 0.69 NA NA 0.05 XXX 97002 A Pt re-evaluation 0.60 0.41 0.42 NA NA 0.02 XXX 97003 A Ot evaluation 1.20 0.77 0.80 NA NA 0.06 XXX 97004 A Ot re-evaluation 0.60 0.54 0.57 NA NA 0.02 XXX 97005 I Athletic train eval 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97006 I Athletic train reeval 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97010 B Hot or cold packs therapy 0.06 0.07 0.06 NA NA 0.01 XXX 97012 A Mechanical traction therapy 0.25 0.14 0.14 NA NA 0.01 XXX 97014 I Electric stimulation therapy 0.18 0.18 0.18 NA NA 0.01 XXX 97016 A Vasopneumatic device therapy 0.18 0.24 0.23 NA NA 0.01 XXX 97018 A Paraffin bath therapy 0.06 0.16 0.15 NA NA 0.01 XXX 97022 A Whirlpool therapy 0.17 0.33 0.30 NA NA 0.01 XXX 97024 A Diathermy eg, microwave 0.06 0.08 0.08 NA NA 0.01 XXX 97026 A Infrared therapy 0.06 0.07 0.07 NA NA 0.01 XXX 97028 A Ultraviolet therapy 0.08 0.09 0.08 NA NA 0.01 XXX 97032 A Electrical stimulation 0.25 0.20 0.19 NA NA 0.01 XXX 97033 A Electric current therapy 0.26 0.44 0.40 NA NA 0.01 XXX 97034 A Contrast bath therapy 0.21 0.20 0.19 NA NA 0.01 XXX 97035 A Ultrasound therapy 0.21 0.10 0.10 NA NA 0.01 XXX 97036 A Hydrotherapy 0.28 0.44 0.41 NA NA 0.01 XXX 97039 C Physical therapy treatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97110 A Therapeutic exercises 0.45 0.32 0.31 NA NA 0.02 XXX 97112 A Neuromuscular reeducation 0.45 0.35 0.34 NA NA 0.01 XXX 97113 A Aquatic therapy/exercises 0.44 0.53 0.50 NA NA 0.01 XXX 97116 A Gait training therapy 0.40 0.28 0.27 NA NA 0.01 XXX 97124 A Massage therapy 0.35 0.27 0.26 NA NA 0.01 XXX 97139 C Physical medicine procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97140 A Manual therapy 0.43 0.29 0.28 NA NA 0.01 XXX 97150 A Group therapeutic procedures 0.27 0.22 0.21 NA NA 0.01 XXX 97530 A Therapeutic activities 0.44 0.38 0.37 NA NA 0.01 XXX 97532 A Cognitive skills development 0.44 0.22 0.22 NA NA 0.01 XXX 97533 A Sensory integration 0.44 0.27 0.27 NA NA 0.01 XXX 97535 A Self care mngment training 0.45 0.38 0.36 NA NA 0.01 XXX 97537 A Community/work reintegration 0.45 0.28 0.28 NA NA 0.01 XXX

<strong>CMS</strong>-1403-FC<br />

Physi-<br />

cian<br />

Work<br />

Fully<br />

Implemented<br />

Non-<br />

Facility<br />

PE<br />

Year<br />

2009<br />

Transitional<br />

Non-<br />

Facility<br />

PE<br />

Fully<br />

Imple-<br />

mented<br />

Facility<br />

PE<br />

Year<br />

2009<br />

Transi-<br />

tional<br />

Facility<br />

PE<br />

1 CPT codes and descriptions only are copyright 2008 American Medical Association. All Rights<br />

Reserved. Applicable FARS/DFARS apply.<br />

2 If values are reflected for codes not payable by Medicare, please note that these values have <strong>been</strong><br />

established as a courtesy to the general public and are not used for Medicare<br />

payment.<br />

1356<br />

Mal-<br />

Practice<br />

RVUs 2 Global<br />

CPT 1 /<br />

HCPCS Mod Status Description<br />

RVUs 2<br />

RVUs 2<br />

RVUs 2<br />

RVUs 2<br />

RVUs 2<br />

96111 A Developmental test, extend 2.60 0.76 0.83 0.64 0.75 0.18 XXX<br />

96116 A Neurobehavioral status exam 1.86 0.54 0.61 0.42 0.47 0.18 XXX<br />

96118 A Neuropsych tst by psych/phys 1.86 0.82 0.96 0.34 0.41 0.18 XXX<br />

96119 A Neuropsych testing by tec 0.55 1.43 1.33 0.10 0.13 0.18 XXX<br />

96120 A Neuropsych tst admin w/comp 0.51 1.58 1.37 0.11 0.13 0.02 XXX<br />

96125 A Cognitive test by hc pro 1.70 0.77 0.77 0.38 0.38 0.16 XXX<br />

96150 A Assess hlth/behave, init 0.50 0.10 0.12 0.09 0.11 0.01 XXX<br />

96151 A Assess hlth/behave, subseq 0.48 0.10 0.12 0.09 0.11 0.01 XXX<br />

96152 A Intervene hlth/behave, indiv 0.46 0.09 0.11 0.08 0.10 0.01 XXX<br />

96153 A Intervene hlth/behave, group 0.10 0.02 0.03 0.02 0.02 0.01 XXX<br />

96154 A Interv hlth/behav, fam w/pt 0.45 0.09 0.11 0.08 0.10 0.01 XXX<br />

96155 N Interv hlth/behav fam no pt 0.44 0.15 0.16 0.15 0.15 0.02 XXX<br />

96360 A Hydration iv infusion, init 0.17 1.29 1.33 NA NA 0.07 XXX<br />

96361 A Hydrate iv infusion, add-on 0.09 0.31 0.33 NA NA 0.04 ZZZ<br />

96365 A Ther/proph/diag iv inf, init 0.21 1.58 1.63 NA NA 0.07 XXX<br />

96366 A Ther/proph/diag iv inf addon 0.18 0.37 0.39 NA NA 0.04 ZZZ<br />

96367 A Tx/proph/dg addl seq iv inf 0.19 0.68 0.73 NA NA 0.04 ZZZ<br />

96368 A Ther/diag concurrent inf 0.17 0.34 0.36 NA NA 0.04 ZZZ<br />

96369 A Sc ther infusion, up to 1 hr 0.21 3.86 3.88 NA NA 0.06 XXX<br />

96370 A Sc ther infusion, addl hr 0.18 0.22 0.22 NA NA 0.04 ZZZ<br />

96371 A Sc ther infusion, reset pump 0.00 2.04 2.00 NA NA 0.01 ZZZ<br />

96372 A Ther/proph/diag inj, sc/im 0.17 0.43 0.40 NA NA 0.01 XXX<br />

96373 A Ther/proph/diag inj, ia 0.17 0.30 0.31 NA NA 0.02 XXX<br />

96374 A Ther/proph/diag inj, iv push 0.18 1.28 1.29 NA NA 0.04 XXX<br />

96375 A Tx/pro/dx inj new drug addon 0.10 0.50 0.52 NA NA 0.04 ZZZ<br />

96376 X Tx/pro/dx inj new drug adon 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ<br />

96379 C Ther/prop/diag inj/inf proc 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

96401 A Chemo, anti-neopl, sq/im 0.21 1.81 1.65 NA NA 0.01 XXX<br />

96402 A Chemo hormon antineopl sq/im 0.19 0.75 0.82 NA NA 0.01 XXX<br />

96405 A Chemo intralesional, up to 7 0.52 1.56 1.79 0.25 0.25 0.03 000<br />

96406 A Chemo intralesional over 7 0.80 2.19 2.40 0.34 0.33 0.03 000<br />

96409 A Chemo, iv push, sngl drug 0.24 2.75 2.80 NA NA 0.06 XXX<br />

96411 A Chemo, iv push, addl drug 0.20 1.48 1.51 NA NA 0.06 ZZZ<br />

96413 A Chemo, iv infusion, 1 hr 0.28 3.56 3.73 NA NA 0.08 XXX<br />

96415 A Chemo, iv infusion, addl hr 0.19 0.64 0.67 NA NA 0.07 ZZZ<br />

96416 A Chemo prolong infuse w/pump 0.21 4.01 4.17 NA NA 0.08 XXX<br />

96417 A Chemo iv infus each addl seq 0.21 1.70 1.76 NA NA 0.07 ZZZ<br />

96420 A Chemo, ia, push tecnique 0.17 2.76 2.74 NA NA 0.08 XXX<br />

96422 A Chemo ia infusion up to 1 hr 0.17 4.47 4.57 NA NA 0.08 XXX<br />

96423 A Chemo ia infuse each addl hr 0.17 1.98 1.96 NA NA 0.02 ZZZ<br />

96425 A Chemotherapy,infusion method 0.17 4.50 4.50 NA NA 0.08 XXX<br />

96440 A Chemotherapy, intracavitary 2.37 15.97 14.04 1.09 1.13 0.17 000<br />

96445 A Chemotherapy, intracavitary 2.20 4.73 5.57 0.80 0.90 0.14 000<br />

96450 A Chemotherapy, into CNS 1.53 3.21 4.15 0.66 0.82 0.09 000<br />

96521 A Refill/maint, portable pump 0.21 3.07 3.25 NA NA 0.06 XXX<br />

96522 A Refill/maint pump/resvr syst 0.21 2.73 2.72 NA NA 0.06 XXX<br />

96523 T Irrig drug delivery device 0.04 0.63 0.65 NA NA 0.01 XXX<br />

96542 A Chemotherapy injection 0.75 2.44 2.90 0.37 0.44 0.07 XXX

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