19.02.2013
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CMS-1403-FC 23580 23844 24020 24140 24220 24300 24340 24500 24540 24580 24660 24780 Gainesville, GA Hall County, GA Gary, IN Jasper County, IN Lake County, IN Newton County, IN Porter County, IN Glens Falls, NY Warren County, NY Washington County, NY Goldsboro, NC Wayne County, NC Grand Forks, ND-MN Polk County, MN Grand Forks County, ND Grand Junction, CO Mesa County, CO Grand Rapids-Wyoming, MI Barry County, MI Ionia County, MI Kent County, MI Newaygo County, MI Great Falls, MT Cascade County, MT Greeley, CO Weld County, CO Green Bay, WI Brown County, WI Kewaunee County, WI Oconto County, WI Greensboro-High Point, NC Guilford County, NC Randolph County, NC Rockingham County, NC Greenville, NC Greene County, NC Pitt County, NC 1398 0.9625 0.9774 0.8953 0.9661 0.7994 1.0368 0.9705 0.9282 1.0233 1.0259 0.9522 0.9984 24860 Greenville-Mauldin-Easley, SC 1.0562
CMS-1403-FC 25020 25060 25180 25260 25420 25500 25540 25620 25860 Greenville County, SC Laurens County, SC Pickens County, SC Guayama, PR Arroyo Municipio, PR Guayama Municipio, PR Patillas Municipio, PR Gulfport-Biloxi, MS Hancock County, MS Harrison County, MS Stone County, MS Hagerstown-Martinsburg, MD-WV Washington County, MD Berkeley County, WV Morgan County, WV Hanford-Corcoran, CA Kings County, CA Harrisburg-Carlisle, PA Cumberland County, PA Dauphin County, PA Perry County, PA Harrisonburg, VA Rockingham County, VA Harrisonburg City, VA Hartford-West Hartford-East Hartford, CT Hartford County, CT Middlesex County, CT Tolland County, CT Hattiesburg, MS Forrest County, MS Lamar County, MS Perry County, MS Hickory-Lenoir-Morganton, NC Alexander County, NC Burke County, NC Caldwell County, NC Catawba County, NC 1399 0.7397 0.9541 0.9507 1.1486 0.9672 0.9398 1.1696 0.7753 0.9485 25980 Hinesville-Fort Stewart, GA 1 0.9626
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Page 1 and 2:
Notice: This CMS-approved document
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Page 3 and 4:
CMS-1403-FC 3 1. Electronically. Yo
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Page 5 and 6:
CMS-1403-FC 5 FOR FURTHER INFORMATI
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Page 7 and 8:
CMS-1403-FC 7 Trisha Brooks, (410)7
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Page 9 and 10:
CMS-1403-FC 9 ● The physician sel
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Page 11 and 12:
CMS-1403-FC 11 Schedule C. Malpract
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Page 13 and 14:
CMS-1403-FC 13 3. Beneficiary Signa
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Page 15 and 16:
CMS-1403-FC 15 A. Summary of Issues
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Page 17 and 18:
CMS-1403-FC 17 XIII. Waiver of Prop
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Page 19 and 20:
CMS-1403-FC 19 BBRA [Medicare, Medi
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Page 21 and 22:
CMS-1403-FC 21 E/M Evaluation and m
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Page 23 and 24:
CMS-1403-FC 23 MA-PD Medicare Advan
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Page 25 and 26:
CMS-1403-FC 25 OSCAR Online Survey
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Page 27 and 28:
CMS-1403-FC 27 WAMP Widely availabl
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Page 29 and 30:
CMS-1403-FC 29 2. Practice Expense
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Page 31 and 32:
CMS-1403-FC 31 extent practicable a
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Page 33 and 34:
CMS-1403-FC 33 AMA's Current Proced
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Page 35 and 36:
CMS-1403-FC 35 Payment = [(RVU work
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Page 37 and 38:
CMS-1403-FC 37 legislation, the PFS
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Page 39 and 40:
CMS-1403-FC that time, PE RVUs were
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Page 41 and 42:
CMS-1403-FC utilize a “bottom-up
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Page 43 and 44:
CMS-1403-FC ● All other expenses,
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Page 45 and 46:
CMS-1403-FC b. Allocation of PE to
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Page 47 and 48:
CMS-1403-FC combined survey data fr
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Page 49 and 50:
CMS-1403-FC for the global componen
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Page 51 and 52:
CMS-1403-FC equipment cost per minu
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Page 53 and 54:
CMS-1403-FC components), then the i
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Page 55 and 56:
CMS-1403-FC indirect PE for all PFS
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Page 57 and 58:
CMS-1403-FC • Physical therapy ut
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Page 59 and 60:
CMS-1403-FC TABLE 1: Calculation of
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Page 61 and 62:
CMS-1403-FC 2. PE Proposals for CY
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Page 63 and 64:
CMS-1403-FC The formula for estimat
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Page 65 and 66:
CMS-1403-FC arbitrary method for ch
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Page 67 and 68:
CMS-1403-FC We received no comments
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Page 69 and 70:
CMS-1403-FC (iv) Contractor Pricing
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Page 71 and 72:
CMS-1403-FC Response: We will ask t
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Page 73 and 74:
Code CMS-1403-FC 2008/9 Description
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Page 75 and 76:
CMS-1403-FC TABLE 4: Practice Expen
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Page 77 and 78:
CMS-1403-FC B. Geographic Practice
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Page 79 and 80:
CMS-1403-FC services, and are adjus
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Page 81 and 82:
CMS-1403-FC by at least 5 percent,
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Page 83 and 84:
CMS-1403-FC we decided not to proce
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Page 85 and 86:
CMS-1403-FC so as part of the CY 20
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Page 87 and 88:
CMS-1403-FC In the CY 2008 PFS fina
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Page 89 and 90:
CMS-1403-FC are available, we would
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Page 91 and 92:
CMS-1403-FC is no duplication of co
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Page 93 and 94:
CMS-1403-FC practitioner) at the di
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Page 95 and 96:
CMS-1403-FC PFS final rule with com
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Page 97 and 98:
CMS-1403-FC individual MNT (or any
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Page 99 and 100:
CMS-1403-FC Group DSMT (which compr
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Page 101 and 102:
CMS-1403-FC The acuity of a critica
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Page 103 and 104:
CMS-1403-FC needed regarding a crit
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Page 105 and 106:
CMS-1403-FC errors; enhanced patien
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Page 107 and 108:
CMS-1403-FC 99233). For CY 2006, we
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Page 109 and 110:
CMS-1403-FC follow-up inpatient con
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Page 111 and 112:
CMS-1403-FC As noted previously, CP
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Page 113 and 114:
CMS-1403-FC face-to-face encounter
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Page 115 and 116:
CMS-1403-FC visits requested by the
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Page 117 and 118:
CMS-1403-FC Follow-up inpatient tel
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Page 119 and 120:
CMS-1403-FC that were appropriate t
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Page 121 and 122:
CMS-1403-FC HCPCS codes 96150 throu
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Page 123 and 124:
CMS-1403-FC G0332). The Medicare pa
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Page 125 and 126:
CMS-1403-FC code G0332. For CY 2009
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Page 127 and 128:
CMS-1403-FC Response: The separate
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Page 129 and 130:
CMS-1403-FC preadministration-relat
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Page 131 and 132:
CMS-1403-FC pricing of IVIG and Med
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Page 133 and 134:
CMS-1403-FC CPT Code Short Descript
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Page 135 and 136:
CMS-1403-FC percent for the subsequ
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Page 137 and 138:
CMS-1403-FC in the same session, on
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Page 139 and 140:
CMS-1403-FC jeopardizes beneficiary
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Page 141 and 142:
CMS-1403-FC As discussed in the pro
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Page 143 and 144:
CMS-1403-FC Note: Under the PFS, CP
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Page 145 and 146:
CMS-1403-FC The methodology for dev
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Page 147 and 148:
CMS-1403-FC drugs furnished through
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Page 149 and 150:
CMS-1403-FC Response: We disagree w
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Page 151 and 152:
CMS-1403-FC available to support a
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Page 153 and 154:
CMS-1403-FC that there are complica
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Page 155 and 156:
CMS-1403-FC administered to a benef
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Page 157 and 158:
CMS-1403-FC as we assess potential
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Page 159 and 160:
CMS-1403-FC add a modifier to their
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Page 161 and 162:
CMS-1403-FC application of the AQ m
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Page 163 and 164:
CMS-1403-FC 0.7000. ● A reduction
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Page 165 and 166:
CMS-1403-FC so the CY 2009 base com
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Page 167 and 168:
CMS-1403-FC patient utilization gro
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Page 169 and 170:
CMS-1403-FC make those estimates. A
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Page 171 and 172:
CMS-1403-FC After removing the enro
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Page 173 and 174:
CMS-1403-FC For CY 2009, we propose
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Page 175 and 176:
CMS-1403-FC plain language over pol
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CMS-1403-FC four quarters of ASP pr
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Page 179 and 180:
CMS-1403-FC composite rates. The wa
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Page 181 and 182:
CMS-1403-FC from the figure in the
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Page 183 and 184:
CMS-1403-FC that our goal is the ev
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Page 185 and 186:
CMS-1403-FC the average wage index
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Page 187 and 188:
CMS-1403-FC Labor Statistics, to de
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Page 189 and 190:
CMS-1403-FC been previously deemed
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Page 191 and 192:
CMS-1403-FC CBSA where the campuses
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Page 193 and 194:
CMS-1403-FC composite rates during
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Page 195 and 196:
CMS-1403-FC target amount of compos
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Page 197 and 198:
CMS-1403-FC admission. That is, the
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Page 199 and 200:
CMS-1403-FC that CMS consider issue
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Page 201 and 202:
CMS-1403-FC hold the provider in wh
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Page 203 and 204:
CMS-1403-FC Comment: Commenters rai
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Page 205 and 206:
CMS-1403-FC who have enrolled in th
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Page 207 and 208:
CMS-1403-FC ● Posting IDTF standa
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Page 209 and 210:
CMS-1403-FC other diagnostic testin
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Page 211 and 212:
CMS-1403-FC entities furnishing mob
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Page 213 and 214:
CMS-1403-FC state Radioactive Mater
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Page 215 and 216:
CMS-1403-FC equipment and provide t
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Page 217 and 218:
CMS-1403-FC Response: We understand
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Page 219 and 220:
CMS-1403-FC believe that requiring
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Page 221 and 222:
CMS-1403-FC these claims will ensur
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Page 223 and 224:
CMS-1403-FC and NPP organizations,
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Page 225 and 226:
CMS-1403-FC prior to their enrollin
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Page 227 and 228:
CMS-1403-FC The date of approval is
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Page 229 and 230:
CMS-1403-FC organizations, and indi
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Page 231 and 232:
CMS-1403-FC To assist physician and
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Page 233 and 234:
CMS-1403-FC Comment: Several commen
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Page 235 and 236:
CMS-1403-FC date of filing and circ
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Page 237 and 238:
CMS-1403-FC services are complying
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Page 239 and 240:
CMS-1403-FC days when a Presidentia
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Page 241 and 242:
CMS-1403-FC effective date under ap
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Page 243 and 244:
CMS-1403-FC Comment: The suggestion
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Page 245 and 246:
CMS-1403-FC Response: We thank the
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Page 247 and 248:
CMS-1403-FC provider enrollment giv
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Page 249 and 250:
CMS-1403-FC instead, it will force
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Page 251 and 252:
CMS-1403-FC Response: As stated abo
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Page 253 and 254:
CMS-1403-FC Comment: One commenter
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Page 255 and 256:
CMS-1403-FC In an attempt to ensure
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Page 257 and 258:
CMS-1403-FC rule, rather than limit
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Page 259 and 260:
CMS-1403-FC changes have occurred,
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Page 261 and 262:
CMS-1403-FC Response: While we moni
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Page 263 and 264:
CMS-1403-FC records faster and more
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Page 265 and 266:
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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Page 273 and 274:
CMS-1403-FC with billing agents, cl
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Page 275 and 276:
CMS-1403-FC 2. Medicare Billing Pri
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Page 277 and 278:
CMS-1403-FC The FPLP is a collectio
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Page 279 and 280:
CMS-1403-FC continued enrollment to
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Page 281 and 282:
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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Page 293 and 294:
CMS-1403-FC Management Manual (IOM
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Page 295 and 296:
CMS-1403-FC Response: Based on thes
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Page 297 and 298:
CMS-1403-FC or continues to meet th
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CMS-1403-FC to identify and discipl
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Page 301 and 302:
CMS-1403-FC Response: We disagree w
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CMS-1403-FC save our severe penalti
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Page 305 and 306:
CMS-1403-FC Response: We disagree w
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Page 307 and 308:
CMS-1403-FC affords the supplier ap
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Page 309 and 310:
CMS-1403-FC privileges and assess a
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Page 311 and 312:
CMS-1403-FC §424.535(a)(10) that w
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Page 313 and 314:
CMS-1403-FC documentation for 7 yea
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Page 315 and 316:
CMS-1403-FC pharmacies to follow re
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Page 317 and 318:
CMS-1403-FC Comment: One commenter
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Page 319 and 320:
CMS-1403-FC practitioners, includin
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Page 321 and 322:
CMS-1403-FC that require a revoked
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Page 323 and 324:
CMS-1403-FC provider and supplier e
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Page 325 and 326:
CMS-1403-FC K. Amendment to the Exe
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Page 327 and 328:
CMS-1403-FC Prescription Fill Statu
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Page 329 and 330:
CMS-1403-FC dispensers to move towa
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Page 331 and 332:
CMS-1403-FC Following the publicati
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Page 333 and 334:
CMS-1403-FC does not respond to the
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Page 335 and 336:
CMS-1403-FC facsimiles in all insta
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Page 337 and 338:
CMS-1403-FC Similarly, other commen
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Page 339 and 340:
CMS-1403-FC proposed rule's publica
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Page 341 and 342:
CMS-1403-FC elimination of the comp
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Page 343 and 344:
CMS-1403-FC exemption originally cr
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Page 345 and 346:
CMS-1403-FC dispensers are not requ
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Page 347 and 348:
CMS-1403-FC products, or, where upg
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Page 349 and 350:
CMS-1403-FC take time to develop, a
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Page 351 and 352:
CMS-1403-FC integrated this technol
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Page 353 and 354:
CMS-1403-FC Version 10.2 or higher)
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Page 355 and 356:
CMS-1403-FC proposed January 2009 c
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Page 357 and 358:
CMS-1403-FC L. Comprehensive Outpat
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Page 359 and 360:
CMS-1403-FC examination. In order t
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Page 361 and 362:
CMS-1403-FC qualifications for HHAs
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Page 363 and 364:
CMS-1403-FC distinction in the lice
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Page 365 and 366:
CMS-1403-FC (2) Have successfully c
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Page 367 and 368:
CMS-1403-FC risk-taking behaviors,
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Page 369 and 370:
CMS-1403-FC Therefore, we proposed
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Page 371 and 372:
CMS-1403-FC commenter stated that o
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Page 373 and 374:
CMS-1403-FC psychological services
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Page 375 and 376:
CMS-1403-FC 3. CORF Conditions of P
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Page 377 and 378:
CMS-1403-FC Therefore, we proposed
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Page 379 and 380:
CMS-1403-FC Therefore, we proposed
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Page 381 and 382:
CMS-1403-FC The following is a summ
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Page 383 and 384:
CMS-1403-FC We are not making any c
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Page 385 and 386:
CMS-1403-FC N. Physician Self-Refer
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Page 387 and 388:
CMS-1403-FC arrangements, and the l
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Page 389 and 390:
CMS-1403-FC below are related to ea
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Page 391 and 392:
CMS-1403-FC clinical practice. With
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Page 393 and 394:
CMS-1403-FC In the CY 2009 PFS prop
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Page 395 and 396:
CMS-1403-FC would be outside the sc
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Page 397 and 398:
CMS-1403-FC reflect objective quali
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Page 399 and 400:
CMS-1403-FC quality resulting from
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Page 401 and 402:
CMS-1403-FC payments should be reas
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Page 403 and 404:
CMS-1403-FC changes in referral pat
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Page 405 and 406:
CMS-1403-FC the alternative, we pro
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Page 407 and 408:
CMS-1403-FC finalize this condition
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Page 409 and 410:
CMS-1403-FC and “quality maintena
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Page 411 and 412:
CMS-1403-FC date. We seek comments
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Page 413 and 414:
CMS-1403-FC existing exceptions to
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Page 415 and 416:
CMS-1403-FC our general rulemaking
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Page 417 and 418:
CMS-1403-FC these approaches. We pr
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Page 419 and 420:
CMS-1403-FC building in which the b
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Page 421 and 422:
CMS-1403-FC were concerned that thi
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Page 423 and 424:
CMS-1403-FC supplier will be subjec
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Page 425 and 426:
CMS-1403-FC numerical test for the
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Page 427 and 428:
CMS-1403-FC space in which the orde
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Page 429 and 430:
CMS-1403-FC disadvantage nonproblem
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Page 431 and 432:
CMS-1403-FC would be simpler to not
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Page 433 and 434:
CMS-1403-FC IDTF standards in §410
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Page 435 and 436:
CMS-1403-FC that rule, the Governme
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Page 437 and 438:
CMS-1403-FC with comment period, th
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Page 439 and 440:
CMS-1403-FC 1842(n)(1) of the Act,
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Page 441 and 442:
CMS-1403-FC anti-markup provisions
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Page 443 and 444:
CMS-1403-FC her group practice woul
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Page 445 and 446:
CMS-1403-FC A commenter representin
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Page 447 and 448:
CMS-1403-FC tenens arrangements cou
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CMS-1403-FC other supplier. We are
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Page 451 and 452:
CMS-1403-FC on pathology reports or
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Page 453 and 454:
CMS-1403-FC patients. According to
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Page 455 and 456:
CMS-1403-FC from sharing a practice
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Page 457 and 458:
CMS-1403-FC Group A orders the TC a
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Page 459 and 460:
CMS-1403-FC physicians the flexibil
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Page 461 and 462:
CMS-1403-FC Response: We recognize
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CMS-1403-FC Response: Because the d
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Page 465 and 466:
CMS-1403-FC limited by the proposed
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Page 467 and 468:
CMS-1403-FC Response: With respect
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Page 469 and 470:
CMS-1403-FC to focus on the medical
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Page 471 and 472:
CMS-1403-FC service” approach bec
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Page 473 and 474:
CMS-1403-FC have the right to recei
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Page 475 and 476:
CMS-1403-FC 2 approach finalized he
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Page 477 and 478:
CMS-1403-FC the ordering physician
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Page 479 and 480:
CMS-1403-FC ensure an adequate nexu
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Page 481 and 482:
CMS-1403-FC entity” should be def
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Page 483 and 484:
CMS-1403-FC between the performing
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Page 485 and 486:
CMS-1403-FC supplier” to encompas
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Page 487 and 488:
CMS-1403-FC to continue to provide
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Page 489 and 490:
CMS-1403-FC requirements of the Alt
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Page 491 and 492:
CMS-1403-FC supervised in the offic
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Page 493 and 494:
CMS-1403-FC reducing access to care
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Page 495 and 496:
CMS-1403-FC commenter supported ado
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Page 497 and 498:
CMS-1403-FC “outside supplier,”
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CMS-1403-FC group could recover onl
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Page 501 and 502:
CMS-1403-FC incurred, thereby compe
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Page 503 and 504:
CMS-1403-FC needed to provide the t
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Page 505 and 506:
CMS-1403-FC performing supplier for
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Page 507 and 508:
CMS-1403-FC providers, the services
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Page 509 and 510:
CMS-1403-FC commenter also expresse
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Page 511 and 512:
CMS-1403-FC overutilization of in-o
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Page 513 and 514:
CMS-1403-FC provisions for single-s
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Page 515 and 516:
CMS-1403-FC we did not propose such
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Page 517 and 518:
CMS-1403-FC and PCs supervised or p
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Page 519 and 520:
CMS-1403-FC provisions will not app
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Page 521 and 522:
CMS-1403-FC (Pub. L. 110-173) (MMSE
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Page 523 and 524:
CMS-1403-FC reporting data on quali
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Page 525 and 526:
CMS-1403-FC PQRI and a more detaile
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Page 527 and 528:
CMS-1403-FC and our responses to th
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Page 529 and 530:
CMS-1403-FC provisions of the Priva
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Page 531 and 532:
CMS-1403-FC reducing eligible profe
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Page 533 and 534:
CMS-1403-FC administrative or judic
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Page 535 and 536:
CMS-1403-FC professionals who did n
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Page 537 and 538:
CMS-1403-FC base the incentive paym
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Page 539 and 540:
CMS-1403-FC A few commenters noted
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Page 541 and 542:
CMS-1403-FC administrative burden t
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Page 543 and 544:
CMS-1403-FC requested that more det
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Page 545 and 546:
CMS-1403-FC incentive payments for
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Page 547 and 548:
CMS-1403-FC December 31, 2009 and J
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Page 549 and 550:
CMS-1403-FC the reporting period fo
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Page 551 and 552:
CMS-1403-FC proposed to carry forwa
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Page 553 and 554:
CMS-1403-FC measures group is appli
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Page 555 and 556:
CMS-1403-FC measures results and nu
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Page 557 and 558:
CMS-1403-FC (Delmarva Foundation fo
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Page 559 and 560:
CMS-1403-FC registries to report on
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Page 561 and 562:
CMS-1403-FC reporting options for r
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Page 563 and 564:
CMS-1403-FC incentive payment for P
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Page 565 and 566:
CMS-1403-FC to report 2009 PQRI qua
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Page 567 and 568:
CMS-1403-FC Comment: We received nu
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Page 569 and 570:
CMS-1403-FC Comment: One comment su
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Page 571 and 572:
CMS-1403-FC quality measures result
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Page 573 and 574:
CMS-1403-FC requirements listed on
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Page 575 and 576:
CMS-1403-FC a data submission vendo
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Page 577 and 578:
CMS-1403-FC As we stated in the CY
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Page 579 and 580:
CMS-1403-FC whether eligible profes
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Page 581 and 582:
CMS-1403-FC ● Agree that the regi
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Page 583 and 584:
CMS-1403-FC soon thereafter as is t
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Page 585 and 586:
CMS-1403-FC Comment: We received ma
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Page 587 and 588:
CMS-1403-FC Comment: One commenter
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Page 589 and 590:
CMS-1403-FC additional 2.0 percent
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Page 591 and 592:
CMS-1403-FC EHRs in 2009. The measu
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Page 593 and 594:
CMS-1403-FC i. Overview and Summary
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Page 595 and 596:
CMS-1403-FC voluntary consensus sta
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Page 597 and 598:
CMS-1403-FC Comment: Several commen
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Page 599 and 600:
CMS-1403-FC the AMA-PCPI should be
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Page 601 and 602:
CMS-1403-FC are appropriate and do
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Page 603 and 604:
CMS-1403-FC to make any changes to
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Page 605 and 606:
CMS-1403-FC post the measures for p
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Page 607 and 608:
CMS-1403-FC beneficiaries. We now h
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Page 609 and 610:
CMS-1403-FC identified in Tables 15
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Page 611 and 612:
CMS-1403-FC important difference in
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Page 613 and 614:
CMS-1403-FC not use Measures #73 Ca
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Page 615 and 616:
CMS-1403-FC measures, but which are
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Page 617 and 618:
CMS-1403-FC with comment period. Ho
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Page 619 and 620:
CMS-1403-FC ● Measure #41 Osteopo
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Page 621 and 622:
CMS-1403-FC professional to simply
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Page 623 and 624:
CMS-1403-FC measures. We consider t
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Page 625 and 626:
CMS-1403-FC Measure Number and Titl
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Page 627 and 628:
CMS-1403-FC Measure Number and Titl
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Page 629 and 630:
CMS-1403-FC ● Measure #120 CKD: A
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Page 631 and 632:
CMS-1403-FC For the 2009 PQRI quali
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Page 633 and 634:
CMS-1403-FC rule indicated that the
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Page 635 and 636:
CMS-1403-FC Response: As suggested
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Page 637 and 638:
CMS-1403-FC required for the measur
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Page 639 and 640:
CMS-1403-FC ● Achievement of NQF
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Page 641 and 642:
CMS-1403-FC These additional measur
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Page 643 and 644:
CMS-1403-FC We did not include this
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Page 645 and 646:
CMS-1403-FC Comment: Many commenter
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Page 647 and 648:
CMS-1403-FC groups must have a part
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Page 649 and 650:
CMS-1403-FC selected for inclusion
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Page 651 and 652:
CMS-1403-FC Measure Title Measure S
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Page 653 and 654:
CMS-1403-FC proposed HIV/AIDS measu
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CMS-1403-FC set of denominator spec
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CMS-1403-FC results, for this purpo
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CMS-1403-FC informed decision-makin
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CMS-1403-FC Comment: Several commen
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CMS-1403-FC prior commitments that
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CMS-1403-FC groups who successfully
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CMS-1403-FC ● Eligible profession
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CMS-1403-FC patients, families, and
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CMS-1403-FC that have satisfactoril
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CMS-1403-FC e-prescribing quality m
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Page 675 and 676:
CMS-1403-FC Douglas S. and Friedman
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CMS-1403-FC subsequent year, if the
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CMS-1403-FC eligible professional f
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CMS-1403-FC and is included in the
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Page 683 and 684:
CMS-1403-FC The measure becomes app
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Page 685 and 686:
CMS-1403-FC is, Measure #125) appli
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Page 687 and 688:
CMS-1403-FC outpatient setting. Whi
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Page 689 and 690:
CMS-1403-FC ability of an electroni
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Page 691 and 692:
CMS-1403-FC October 2005 (hereinaft
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Page 693 and 694:
CMS-1403-FC We are aware that there
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Page 695 and 696:
CMS-1403-FC provided during the enc
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Page 697 and 698:
CMS-1403-FC denominator of a measur
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Page 699 and 700:
CMS-1403-FC cases. If the is determ
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Page 701 and 702:
CMS-1403-FC during 2009; and (3) wh
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Page 703 and 704:
CMS-1403-FC on this quality measure
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Page 705 and 706:
CMS-1403-FC become effective until
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Page 707 and 708:
CMS-1403-FC and CY 2007 PFS final r
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Page 709 and 710:
CMS-1403-FC directly affected by th
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Page 711 and 712:
CMS-1403-FC requires advanced pract
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Page 713 and 714:
CMS-1403-FC applaud CMS for recogni
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Page 715 and 716:
CMS-1403-FC standardization of DNP
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Page 717 and 718:
CMS-1403-FC for the most part, been
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Page 719 and 720:
CMS-1403-FC that the requirement fo
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CMS-1403-FC degree in radiologic te
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CMS-1403-FC the physicians that fur
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CMS-1403-FC is associated with a te
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CMS-1403-FC facility in which a tec
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CMS-1403-FC by the Medicare program
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Page 731 and 732:
CMS-1403-FC pressure (CPAP)” and
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CMS-1403-FC for example chronic obs
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Page 735 and 736:
CMS-1403-FC thus they believe leadi
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Page 737 and 738:
CMS-1403-FC Excepting attended faci
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Page 739 and 740:
CMS-1403-FC supplier separately. Ho
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Page 741 and 742:
CMS-1403-FC final rule’s provisio
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CMS-1403-FC as a DME supplier and p
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CMS-1403-FC Moreover, given our gen
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CMS-1403-FC resources and infrastru
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Page 749 and 750:
CMS-1403-FC Comment: Several commen
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CMS-1403-FC organization through a
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CMS-1403-FC After reviewing the pub
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CMS-1403-FC the nonparticipating ho
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CMS-1403-FC be costly and burdensom
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CMS-1403-FC adopting our proposal t
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CMS-1403-FC We are not persuaded to
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CMS-1403-FC §424.36(b)(6)(ii)(C)(2
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Page 765 and 766:
CMS-1403-FC be made to obtain the s
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Page 767 and 768:
CMS-1403-FC willing to sign at the
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CMS-1403-FC and not suppliers, may
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Page 771 and 772:
CMS-1403-FC crew member would have
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Page 773 and 774:
CMS-1403-FC In order to determine f
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Page 775 and 776:
CMS-1403-FC retrieval of the variou
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Page 777 and 778:
CMS-1403-FC plan that demonstrates
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Page 779 and 780:
CMS-1403-FC conviction, license sus
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Page 781 and 782:
CMS-1403-FC The following is a summ
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CMS-1403-FC faith reduces the time
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Page 785 and 786:
CMS-1403-FC suspension or revocatio
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Page 787 and 788:
CMS-1403-FC 9 percent per year. 2 I
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Page 789 and 790:
CMS-1403-FC magnetic resonance imag
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Page 791 and 792:
CMS-1403-FC Committee for Quality A
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Page 793 and 794:
CMS-1403-FC measures in CMS’ VBP
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Page 795 and 796:
CMS-1403-FC the Boston program site
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Page 797 and 798:
CMS-1403-FC conditions that are hig
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Page 799 and 800:
CMS-1403-FC reports? ● Do physici
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Page 801 and 802:
CMS-1403-FC most Evaluation and Man
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Page 803 and 804:
CMS-1403-FC III. Medicare Improveme
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Page 805 and 806:
CMS-1403-FC Specifically, section 1
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Page 807 and 808:
CMS-1403-FC period. The public will
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Page 809 and 810:
CMS-1403-FC Section 101(b) of the M
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Page 811 and 812:
CMS-1403-FC 1 year after the effect
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Page 813 and 814:
CMS-1403-FC applies to both adult m
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Page 815 and 816:
CMS-1403-FC period is limited to th
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Page 817 and 818:
CMS-1403-FC 2007 through 2010. In a
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Page 819 and 820:
CMS-1403-FC Section 1848(m)(3)(D) o
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Page 821 and 822:
CMS-1403-FC In addition to the prov
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Page 823 and 824:
CMS-1403-FC during the 2009 and 201
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Page 825 and 826:
CMS-1403-FC prescribers for 2009 ar
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Page 827 and 828:
CMS-1403-FC requirement by making a
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Page 829 and 830:
CMS-1403-FC continue to bill the Me
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Page 831 and 832:
CMS-1403-FC therapy and speech-lang
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Page 833 and 834:
CMS-1403-FC ● Section 1835(a) of
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Page 835 and 836:
CMS-1403-FC The amendments made by
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Page 837 and 838:
CMS-1403-FC national associations a
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Page 839 and 840:
CMS-1403-FC On November 9, 2006, we
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Page 841 and 842:
CMS-1403-FC our regulations states
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Page 843 and 844:
CMS-1403-FC rental period. The supp
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Page 845 and 846:
CMS-1403-FC reasonable useful lifet
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Page 847 and 848:
CMS-1403-FC to use the equipment be
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Page 849 and 850:
CMS-1403-FC oxygen contents after t
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Page 851 and 852:
CMS-1403-FC the oxygen contents and
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Page 853 and 854:
CMS-1403-FC Section 414.210(e)(2) a
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Page 855 and 856:
CMS-1403-FC reported to us that, ba
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Page 857 and 858:
CMS-1403-FC non-routine maintenance
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Page 859 and 860:
CMS-1403-FC As a result, we will ma
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Page 861 and 862:
CMS-1403-FC 31, 2009 amounts for gr
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Page 863 and 864:
CMS-1403-FC under section 332(a)(1)
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Page 865 and 866:
CMS-1403-FC furnishing services via
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Page 867 and 868:
CMS-1403-FC required to furnish dir
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Page 869 and 870:
CMS-1403-FC mental health services
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Page 871 and 872:
CMS-1403-FC Skilled Nursing Facilit
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Page 873 and 874:
CMS-1403-FC where the SNF resident
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Page 875 and 876:
CMS-1403-FC describes the methodolo
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Page 877 and 878:
CMS-1403-FC The RUC has created the
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Page 879 and 880:
CMS-1403-FC Response: Although we r
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Page 881 and 882:
CMS-1403-FC occurring code pairs. T
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Page 883 and 884:
CMS-1403-FC a standing panel of exp
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Page 885 and 886:
CMS-1403-FC extraction of the assoc
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Page 887 and 888:
CMS-1403-FC TABLE 26: AMA RUC Recom
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Page 889 and 890:
CMS-1403-FC AMA RUC Rec Site of Ser
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Page 891 and 892:
CMS-1403-FC AMA RUC Rec Site of Ser
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Page 893 and 894:
CMS-1403-FC AMA RUC Rec Site of Ser
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Page 895 and 896:
CMS-1403-FC Note: The RUC reviewed
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Page 897 and 898:
CMS-1403-FC C. Interim 2008 Codes 1
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Page 899 and 900:
CMS-1403-FC national noncoverage de
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Page 901 and 902:
CMS-1403-FC CPT codes for 2008. In
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Page 903 and 904:
CMS-1403-FC associated work RVUs, t
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Page 905 and 906:
CMS-1403-FC CPT 1 AMA RUC Work RVU
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Page 907 and 908:
CMS-1403-FC # New CPT code. 1 All C
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Page 909 and 910:
CMS-1403-FC ● 27218, Open treatme
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Page 911 and 912:
CMS-1403-FC RVUs for G0412; 15.73 w
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Page 913 and 914:
CMS-1403-FC Therefore, we disagree
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Page 915 and 916:
CMS-1403-FC generally contractor pr
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Page 917 and 918:
CMS-1403-FC In addition, we believe
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Page 919 and 920:
CMS-1403-FC RVU for CPT code 93289
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Page 921 and 922:
CMS-1403-FC time to better understa
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Page 923 and 924:
CMS-1403-FC ● 93306, Echocardiogr
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Page 925 and 926:
CMS-1403-FC Although not discussed
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Page 927 and 928:
CMS-1403-FC for New and Revised 200
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Page 929 and 930:
CMS-1403-FC item. In addition, the
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Page 931 and 932:
CMS-1403-FC 90956, 90957, 90958, 90
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Page 933 and 934:
CMS-1403-FC place of these two new
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Page 935 and 936:
CMS-1403-FC beneficiary or any othe
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Page 937 and 938:
CMS-1403-FC ● Adding the followin
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Page 939 and 940:
CMS-1403-FC Tables 29 and 30 also i
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Page 941 and 942:
CMS-1403-FC RADIOLOGY AND CERTAIN O
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Page 943 and 944:
CMS-1403-FC 93320 Doppler echo exam
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Page 945 and 946:
CMS-1403-FC index data, that the hi
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Page 947 and 948:
CMS-1403-FC TABLE 32: Increase in t
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Page 949 and 950:
CMS-1403-FC C. The Update Adjustmen
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Page 951 and 952:
CMS-1403-FC end of the prior year a
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Page 953 and 954:
CMS-1403-FC CY 2009, the statute re
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Page 955 and 956:
CMS-1403-FC Actual08 = Estimated Ac
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Page 957 and 958:
CMS-1403-FC 1848(f)(3)(C)(i) of the
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Page 959 and 960:
CMS-1403-FC ● Screening mammograp
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Page 961 and 962:
CMS-1403-FC payments while promotin
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Page 963 and 964:
CMS-1403-FC E. Final Sustainable Gr
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Page 965 and 966:
CMS-1403-FC included in the SGR (us
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Page 967 and 968:
CMS-1403-FC that this figure will c
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Page 969 and 970:
CMS-1403-FC physicians' services in
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Page 971 and 972:
CMS-1403-FC imaging services, the M
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Page 973 and 974:
CMS-1403-FC CY 2007. Table 42 illus
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Page 975 and 976:
CMS-1403-FC year to the entire year
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Page 977 and 978:
CMS-1403-FC the CF. Therefore, this
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Page 979 and 980:
CMS-1403-FC estimate that CY 2009 R
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Page 981 and 982:
CMS-1403-FC Table 44: Calculation o
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Page 983 and 984:
CMS-1403-FC XI. Payment for Certain
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Page 985 and 986:
CMS-1403-FC In the Competitive Acqu
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Page 987 and 988:
CMS-1403-FC glasses, hand magnifier
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Page 989 and 990:
CMS-1403-FC Our interpretation of t
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Page 991 and 992:
CMS-1403-FC Response: We understand
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Page 993 and 994:
CMS-1403-FC defines “eyeglass”
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Page 995 and 996:
CMS-1403-FC this statutory exclusio
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Page 997 and 998:
CMS-1403-FC advances in the use of
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Page 999 and 1000:
CMS-1403-FC is paid for his or her
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Page 1001 and 1002:
CMS-1403-FC XII. Provisions of the
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Page 1003 and 1004:
CMS-1403-FC these RUC recommendatio
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Page 1005 and 1006:
CMS-1403-FC services. We believe a
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Page 1007 and 1008:
CMS-1403-FC Section 144(b) of the M
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Page 1009 and 1010:
CMS-1403-FC rulemaking with respect
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Page 1011 and 1012:
CMS-1403-FC (respectively) of this
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Page 1013 and 1014:
CMS-1403-FC completing and submitti
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Page 1015 and 1016:
CMS-1403-FC §424.516(d)(1). Additi
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Page 1017 and 1018:
CMS-1403-FC to several associated i
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Page 1019 and 1020:
CMS-1403-FC incentive payment for 2
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Page 1021 and 1022:
CMS-1403-FC year of PQRI reporting)
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Page 1023 and 1024:
CMS-1403-FC Based on the assumption
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Page 1025 and 1026:
CMS-1403-FC these activities for th
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Page 1027 and 1028:
CMS-1403-FC per hour, we estimate t
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Page 1029 and 1030:
CMS-1403-FC Because of the large nu
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Page 1031 and 1032:
CMS-1403-FC threshold, and hence al
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Page 1033 and 1034:
CMS-1403-FC shoes, the regulation i
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Page 1035 and 1036:
CMS-1403-FC with comment period for
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Page 1037 and 1038:
CMS-1403-FC substance of State laws
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Page 1039 and 1040:
CMS-1403-FC $20 million from what e
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Page 1041 and 1042:
CMS-1403-FC ● Impact of Work RVU
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Page 1043 and 1044:
CMS-1403-FC imaging services from t
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Page 1045 and 1046:
CMS-1403-FC ● Impact of section 1
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Page 1047 and 1048:
CMS-1403-FC management, could have
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Page 1049 and 1050:
CMS-1403-FC Table 50 illustrates, f
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Page 1051 and 1052:
CMS-1403-FC CPT/ HCPCS Mod Descript
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Page 1053 and 1054:
CMS-1403-FC impact associated with
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Page 1055 and 1056:
CMS-1403-FC The fourth column shows
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Page 1057 and 1058:
CMS-1403-FC the CY 2007 claims. The
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Page 1059 and 1060:
CMS-1403-FC 1059 4/This column show
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Page 1061 and 1062:
CMS-1403-FC requirements is to allo
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Page 1063 and 1064:
CMS-1403-FC This amendment of the e
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Page 1065 and 1066:
CMS-1403-FC 4 minutes per call, lab
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Page 1067 and 1068:
CMS-1403-FC e-prescribing and who m
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Page 1069 and 1070:
CMS-1403-FC anti-markup provisions
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Page 1071 and 1072:
CMS-1403-FC approximately $50 per h
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Page 1073 and 1074:
CMS-1403-FC e-prescribing measure i
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Page 1075 and 1076:
CMS-1403-FC we estimate that each e
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Page 1077 and 1078:
CMS-1403-FC P. Prohibition Concerni
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Page 1079 and 1080:
CMS-1403-FC that provides a calcula
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Page 1081 and 1082:
CMS-1403-FC treatment) that occur a
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Page 1083 and 1084:
CMS-1403-FC locality (+5.37 percent
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Page 1085 and 1086:
CMS-1403-FC additional rental payme
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Page 1087 and 1088:
CMS-1403-FC T. Competitive Acquisit
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Page 1089 and 1090:
CMS-1403-FC Program; II.T. Electron
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Page 1091 and 1092:
CMS-1403-FC which means that in 200
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Page 1093 and 1094:
CMS-1403-FC List of Subjects 42 CFR
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Page 1095 and 1096:
CMS-1403-FC For the reasons set for
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Page 1097 and 1098:
CMS-1403-FC (1) Except as specified
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Page 1099 and 1100:
CMS-1403-FC pressure, a visual acui
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Page 1101 and 1102:
CMS-1403-FC (ii) A speech-language
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Page 1103 and 1104:
CMS-1403-FC during the hours that t
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Page 1105 and 1106:
CMS-1403-FC (i) Be certified as a n
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Page 1107 and 1108:
CMS-1403-FC 14. Section 410.155 is
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Page 1109 and 1110:
CMS-1403-FC prostate cancer screeni
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Page 1111 and 1112:
CMS-1403-FC B. Amending the definit
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Page 1113 and 1114:
CMS-1403-FC The revisions and addit
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Page 1115 and 1116:
CMS-1403-FC or institution other th
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Page 1117 and 1118:
CMS-1403-FC substantially all (whic
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Page 1119 and 1120:
CMS-1403-FC psychiatric diagnostic
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Page 1121 and 1122:
CMS-1403-FC repairing, maintaining,
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Page 1123 and 1124:
CMS-1403-FC B. Deleting paragraph (
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Page 1125 and 1126:
CMS-1403-FC during any period of me
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Page 1127 and 1128:
CMS-1403-FC (c)(1). A. Revising the
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Page 1129 and 1130:
CMS-1403-FC * * * * * (b) * * * (2)
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Page 1131 and 1132:
CMS-1403-FC assigned to such drug p
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Page 1133 and 1134:
CMS-1403-FC 33. In §415.130(d), th
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Page 1135 and 1136:
CMS-1403-FC (6) An ambulance provid
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Page 1137 and 1138:
CMS-1403-FC §424.57 Special paymen
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Page 1139 and 1140:
CMS-1403-FC Final adverse action me
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Page 1141 and 1142:
CMS-1403-FC (b) Reporting requireme
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Page 1143 and 1144:
CMS-1403-FC of Medicare billing pri
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Page 1145 and 1146:
CMS-1403-FC (a) Physicians, nonphys
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Page 1147 and 1148:
CMS-1403-FC * * * * * (g) Effective
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Page 1149 and 1150:
CMS-1403-FC that meet the qualifica
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Page 1151 and 1152:
CMS-1403-FC (3) Have equivalent tra
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Page 1153 and 1154:
CMS-1403-FC §485.711 Condition of
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Page 1155 and 1156:
CMS-1403-FC Subpart C--Conditions f
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Page 1157 and 1158:
CMS-1403-FC Authority: Catalog of F
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Page 1159 and 1160:
CMS-1403-FC Addendum B means that C
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Page 1161 and 1162:
CMS-1403-FC which they are incident
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Page 1163 and 1164:
CMS-1403-FC T = There are RVUs for
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Page 1165 and 1166:
CMS-1403-FC ADDENDUM B: Relative Va
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Page 1167 and 1168:
CMS-1403-FC Physi- cian Work Fully
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Page 1169 and 1170:
CMS-1403-FC Physi- cian Work Fully
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Page 1171 and 1172:
CMS-1403-FC Physi- cian Work Fully
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Page 1173 and 1174:
CMS-1403-FC Physi- cian Work Fully
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Page 1175 and 1176:
CMS-1403-FC Physi- cian Work Fully
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Page 1177 and 1178:
CMS-1403-FC Physi- cian Work Fully
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Page 1179 and 1180:
CMS-1403-FC Physi- cian Work Fully
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Page 1181 and 1182:
CMS-1403-FC Physi- cian Work Fully
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Page 1183 and 1184:
CMS-1403-FC Physi- cian Work Fully
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Page 1185 and 1186:
CMS-1403-FC Physi- cian Work Fully
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Page 1187 and 1188:
CMS-1403-FC Physi- cian Work Fully
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Page 1189 and 1190:
CMS-1403-FC Physi- cian Work Fully
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Page 1191 and 1192:
CMS-1403-FC Physi- cian Work Fully
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Page 1193 and 1194:
CMS-1403-FC Physi- cian Work Fully
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Page 1195 and 1196:
CMS-1403-FC Physi- cian Work Fully
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Page 1197 and 1198:
CMS-1403-FC Physi- cian Work Fully
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Page 1199 and 1200:
CMS-1403-FC Physi- cian Work Fully
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Page 1201 and 1202:
CMS-1403-FC Physi- cian Work Fully
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Page 1203 and 1204:
CMS-1403-FC Physi- cian Work Fully
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Page 1205 and 1206:
CMS-1403-FC Physi- cian Work Fully
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Page 1207 and 1208:
CMS-1403-FC Physi- cian Work Fully
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Page 1209 and 1210:
CMS-1403-FC Physi- cian Work Fully
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Page 1211 and 1212:
CMS-1403-FC Physi- cian Work Fully
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Page 1213 and 1214:
CMS-1403-FC Physi- cian Work Fully
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Page 1215 and 1216:
CMS-1403-FC Physi- cian Work Fully
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Page 1217 and 1218:
CMS-1403-FC Physi- cian Work Fully
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Page 1219 and 1220:
CMS-1403-FC Physi- cian Work Fully
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Page 1221 and 1222:
CMS-1403-FC Physi- cian Work Fully
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Page 1223 and 1224:
CMS-1403-FC Physi- cian Work Fully
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Page 1225 and 1226:
CMS-1403-FC Physi- cian Work Fully
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Page 1227 and 1228:
CMS-1403-FC Physi- cian Work Fully
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Page 1229 and 1230:
CMS-1403-FC Physi- cian Work Fully
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Page 1231 and 1232:
CMS-1403-FC Physi- cian Work Fully
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Page 1233 and 1234:
CMS-1403-FC Physi- cian Work Fully
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Page 1235 and 1236:
CMS-1403-FC Physi- cian Work Fully
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Page 1237 and 1238:
CMS-1403-FC Physi- cian Work Fully
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Page 1239 and 1240:
CMS-1403-FC Physi- cian Work Fully
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Page 1241 and 1242:
CMS-1403-FC Physi- cian Work Fully
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Page 1243 and 1244:
CMS-1403-FC Physi- cian Work Fully
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Page 1245 and 1246:
CMS-1403-FC Physi- cian Work Fully
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Page 1247 and 1248:
CMS-1403-FC Physi- cian Work Fully
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Page 1249 and 1250:
CMS-1403-FC Physi- cian Work Fully
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Page 1251 and 1252:
CMS-1403-FC Physi- cian Work Fully
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Page 1253 and 1254:
CMS-1403-FC Physi- cian Work Fully
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Page 1255 and 1256:
CMS-1403-FC Physi- cian Work Fully
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Page 1257 and 1258:
CMS-1403-FC Physi- cian Work Fully
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Page 1259 and 1260:
CMS-1403-FC Physi- cian Work Fully
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Page 1261 and 1262:
CMS-1403-FC Physi- cian Work Fully
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Page 1263 and 1264:
CMS-1403-FC Physi- cian Work Fully
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Page 1265 and 1266:
CMS-1403-FC Physi- cian Work Fully
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Page 1267 and 1268:
CMS-1403-FC Physi- cian Work Fully
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Page 1269 and 1270:
CMS-1403-FC Physi- cian Work Fully
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Page 1271 and 1272:
CMS-1403-FC Physi- cian Work Fully
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Page 1273 and 1274:
CMS-1403-FC Physi- cian Work Fully
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Page 1275 and 1276:
CMS-1403-FC Physi- cian Work Fully
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Page 1277 and 1278:
CMS-1403-FC Physi- cian Work Fully
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Page 1279 and 1280:
CMS-1403-FC Physi- cian Work Fully
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Page 1281 and 1282:
CMS-1403-FC Physi- cian Work Fully
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