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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. 1366 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 G0406 A Telhealth inpt consult 15min 0.76 NA NA 0.25 0.24 0.03 XXX G0407 A Telheath inpt consult 25min 1.39 NA NA 0.44 0.42 0.04 XXX G0408 A Telhealth inpt consult 35min 2.00 NA NA 0.62 0.59 0.06 XXX G0409 A CORF related serv 15 mins ea 0.00 0.23 0.23 NA NA 0.01 XXX G0410 X Grp psych partial hosp 45-50 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0411 X Inter active grp psych parti 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0412 A Open tx iliac spine uni/bil 10.45 NA NA 6.57 6.71 1.98 090 G0413 A Pelvic ring fracture uni/bil 15.73 NA NA 9.48 9.53 2.64 090 G0414 A Pelvic ring fx treat int fix 14.65 NA NA 9.00 9.31 2.42 090 G0415 A Open tx post pelvic fxcture 20.93 NA NA 11.73 11.68 3.49 090 G0416 A Sat biopsy prostate 1-20 spc 3.09 13.96 13.96 NA NA 0.54 XXX G0416 TC A Sat biopsy prostate 1-20 spc 0.00 12.14 12.14 NA NA 0.30 XXX G0416 26 A Sat biopsy prostate 1-20 spc 3.09 1.82 1.82 1.82 1.82 0.24 XXX G0417 A Sat biopsy prostate 21-40 5.86 27.26 27.26 NA NA 1.06 XXX G0417 TC A Sat biopsy prostate 21-40 0.00 23.71 23.71 NA NA 0.60 XXX G0417 26 A Sat biopsy prostate 21-40 5.86 3.55 3.55 3.55 3.55 0.46 XXX G0418 A Sat biopsy prostate 41-60 10.30 46.56 46.56 NA NA 1.80 XXX G0418 TC A Sat biopsy prostate 41-60 0.00 40.50 40.50 NA NA 1.03 XXX G0418 26 A Sat biopsy prostate 41-60 10.30 6.06 6.06 6.06 6.06 0.77 XXX G0419 A Sat biopsy prostate: >60 11.61 55.86 55.86 NA NA 2.16 XXX G0419 TC A Sat biopsy prostate: >60 0.00 48.60 48.60 NA NA 1.23 XXX G0419 26 A Sat biopsy prostate: >60 11.61 7.26 7.26 7.26 7.26 0.93 XXX G3001 X Admin + supply, tositumomab 0.00 0.00 0.00 0.00 0.00 0.00 XXX G8489 X CAD measures grp 0.00 0.00 0.00 0.00 0.00 0.00 XXX G8490 X RA measures grp 0.00 0.00 0.00 0.00 0.00 0.00 XXX G8491 X HIV/AIDS measures grp 0.00 0.00 0.00 0.00 0.00 0.00 XXX G8492 X Prev Care measures grp 0.00 0.00 0.00 0.00 0.00 0.00 XXX G8493 X Back pain measures grp 0.00 0.00 0.00 0.00 0.00 0.00 XXX G8494 X DM meas qual act perform 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9001 X MCCD, initial rate 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9002 X MCCD,maintenance rate 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9003 X MCCD, risk adj hi, initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9004 X MCCD, risk adj lo, initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9005 X MCCD, risk adj, maintenance 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9006 X MCCD, Home monitoring 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9007 X MCCD, sch team conf 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9008 X Mccd,phys coor-care ovrsght 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9009 X MCCD, risk adj, level 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9010 X MCCD, risk adj, level 4 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9011 X MCCD, risk adj, level 5 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9012 X Other Specified Case Mgmt 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9013 N ESRD demo bundle level I 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9014 N ESRD demo bundle-level II 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9016 N Demo-smoking cessation coun 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9017 X Amantadine HCL 100mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9018 X Zanamivir,inhalation pwd 10m 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9019 X Oseltamivir phosphate 75mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9020 X Rimantadine HCL 100mg oral 0.00 0.00 0.00 0.00 0.00 0.00 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. 1367 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 G9033 X Amantadine HCL oral brand 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9034 X Zanamivir, inh pwdr, brand 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9035 X Oseltamivir phosp, brand 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9036 X Rimantadine HCL, brand 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9041 A Low vision rehab occupationa 0.44 0.15 0.18 0.15 0.18 0.01 XXX G9042 A Low vision rehab orient/mobi 0.10 0.03 0.10 0.03 0.10 0.01 XXX G9043 A Low vision lowvision therapi 0.10 0.03 0.09 0.03 0.09 0.01 XXX G9044 A Low vision rehabilate teache 0.10 0.03 0.08 0.03 0.08 0.01 XXX G9140 X Frontier extended stay demo 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0064 A Visit for drug monitoring 0.37 0.87 0.74 0.07 0.08 0.01 XXX P3001 A Screening pap smear by phys 0.42 0.37 0.31 0.37 0.31 0.02 XXX Q0035 A Cardiokymography 0.17 0.29 0.33 NA NA 0.03 XXX Q0035 TC A Cardiokymography 0.00 0.24 0.28 NA NA 0.02 XXX Q0035 26 A Cardiokymography 0.17 0.05 0.05 0.05 0.05 0.01 XXX Q0091 A Obtaining screen pap smear 0.37 0.73 0.72 0.10 0.11 0.02 XXX Q0092 A Set up port xray equipment 0.00 0.47 0.44 0.47 0.44 0.01 XXX Q3001 C Brachytherapy Radioelements 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3014 X Telehealth facility fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0070 C Transport portable x-ray 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0075 C Transport port x-ray multipl 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0076 B Transport portable EKG 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5299 R Hearing service 0.00 0.00 0.00 0.00 0.00 0.00 XXX
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<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 />
1367<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 />
G9033 X Amantadine HCL oral brand 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />
G9034 X Zanamivir, inh pwdr, brand 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />
G9035 X Oseltamivir phosp, brand 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />
G9036 X Rimantadine HCL, brand 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />
G9041 A Low vision rehab occupationa 0.44 0.15 0.18 0.15 0.18 0.01 XXX<br />
G9042 A Low vision rehab orient/mobi 0.10 0.03 0.10 0.03 0.10 0.01 XXX<br />
G9043 A Low vision lowvision therapi 0.10 0.03 0.09 0.03 0.09 0.01 XXX<br />
G9044 A Low vision rehabilate teache 0.10 0.03 0.08 0.03 0.08 0.01 XXX<br />
G9140 X Frontier extended stay demo 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />
M0064 A Visit for drug monitoring 0.37 0.87 0.74 0.07 0.08 0.01 XXX<br />
P3001 A Screening pap smear by phys 0.42 0.37 0.31 0.37 0.31 0.02 XXX<br />
Q0035 A Cardiokymography 0.17 0.29 0.33 NA NA 0.03 XXX<br />
Q0035 TC A Cardiokymography 0.00 0.24 0.28 NA NA 0.02 XXX<br />
Q0035 26 A Cardiokymography 0.17 0.05 0.05 0.05 0.05 0.01 XXX<br />
Q0091 A Obtaining screen pap smear 0.37 0.73 0.72 0.10 0.11 0.02 XXX<br />
Q0092 A Set up port xray equipment 0.00 0.47 0.44 0.47 0.44 0.01 XXX<br />
Q3001 C Brachytherapy Radioelements 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />
Q3014 X Telehealth facility fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />
R0070 C Transport portable x-ray 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />
R0075 C Transport port x-ray multipl 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />
R0076 B Transport portable EKG 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />
V5299 R Hearing service 0.00 0.00 0.00 0.00 0.00 0.00 XXX
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