Notice: This CMS-approved document has been submitted - Philips ...
Notice: This CMS-approved document has been submitted - Philips ... Notice: This CMS-approved document has been submitted - Philips ...
CMS-1403-FC 26 PT Physical therapy ResDAC Research Data Assistance Center RFA Regulatory Flexibility Act RIA Regulatory impact analysis RN Registered nurse RNAC Reasonable net acquisition cost RRT Registered respiratory therapist RUC [AMA's Specialty Society] Relative (Value) Update Committee RVU Relative value unit SBA Small Business Administration SGR Sustainable growth rate SLP Speech-language pathology SMS [AMA’s] Socioeconomic Monitoring System SNF Skilled nursing facility SOR System of record SRS Stereotactic radiosurgery TC Technical Component TIN Tax identification number TRHCA Tax Relief and Health Care Act of 2006 (Pub. L. 109-432) UPMC University of Pittsburgh Medical Center USDE United States Department of Education VBP Value-based purchasing
CMS-1403-FC 27 WAMP Widely available market price I. Background Since January 1, 1992, Medicare has paid for physicians' services under section 1848 of the Social Security Act (the Act), "Payment for Physicians' Services." The Act requires that payments under the physician fee schedule (PFS) be based on national uniform relative value units (RVUs) based on the relative resources used in furnishing a service. Section 1848(c) of the Act requires that national RVUs be established for physician work, practice expense (PE), and malpractice expense. Before the establishment of the resource-based relative value system, Medicare payment for physicians’ services was based on reasonable charges. A. Development of the Relative Value System 1. Work RVUs The concepts and methodology underlying the PFS were enacted as part of the Omnibus Budget Reconciliation Act (OBRA) of 1989 (Pub. L. 101-239), and OBRA 1990, (Pub. L. 101-508). The final rule, published on November 25, 1991 (56 FR 59502), set forth the fee schedule for payment for physicians’ services beginning January 1, 1992. Initially, only the physician work RVUs
- Page 1 and 2: Notice: This CMS-approved document
- Page 3 and 4: CMS-1403-FC 3 1. Electronically. Yo
- Page 5 and 6: CMS-1403-FC 5 FOR FURTHER INFORMATI
- Page 7 and 8: CMS-1403-FC 7 Trisha Brooks, (410)7
- Page 9 and 10: CMS-1403-FC 9 ● The physician sel
- Page 11 and 12: CMS-1403-FC 11 Schedule C. Malpract
- Page 13 and 14: CMS-1403-FC 13 3. Beneficiary Signa
- Page 15 and 16: CMS-1403-FC 15 A. Summary of Issues
- Page 17 and 18: CMS-1403-FC 17 XIII. Waiver of Prop
- Page 19 and 20: CMS-1403-FC 19 BBRA [Medicare, Medi
- Page 21 and 22: CMS-1403-FC 21 E/M Evaluation and m
- Page 23 and 24: CMS-1403-FC 23 MA-PD Medicare Advan
- Page 25: CMS-1403-FC 25 OSCAR Online Survey
- Page 29 and 30: CMS-1403-FC 29 2. Practice Expense
- Page 31 and 32: CMS-1403-FC 31 extent practicable a
- Page 33 and 34: CMS-1403-FC 33 AMA's Current Proced
- Page 35 and 36: CMS-1403-FC 35 Payment = [(RVU work
- Page 37 and 38: CMS-1403-FC 37 legislation, the PFS
- Page 39 and 40: CMS-1403-FC that time, PE RVUs were
- Page 41 and 42: CMS-1403-FC utilize a “bottom-up
- Page 43 and 44: CMS-1403-FC ● All other expenses,
- Page 45 and 46: CMS-1403-FC b. Allocation of PE to
- Page 47 and 48: CMS-1403-FC combined survey data fr
- Page 49 and 50: CMS-1403-FC for the global componen
- Page 51 and 52: CMS-1403-FC equipment cost per minu
- Page 53 and 54: CMS-1403-FC components), then the i
- Page 55 and 56: CMS-1403-FC indirect PE for all PFS
- Page 57 and 58: CMS-1403-FC • Physical therapy ut
- Page 59 and 60: CMS-1403-FC TABLE 1: Calculation of
- Page 61 and 62: CMS-1403-FC 2. PE Proposals for CY
- Page 63 and 64: CMS-1403-FC The formula for estimat
- Page 65 and 66: CMS-1403-FC arbitrary method for ch
- Page 67 and 68: CMS-1403-FC We received no comments
- Page 69 and 70: CMS-1403-FC (iv) Contractor Pricing
- Page 71 and 72: CMS-1403-FC Response: We will ask t
- Page 73 and 74: Code CMS-1403-FC 2008/9 Description
- Page 75 and 76: CMS-1403-FC TABLE 4: Practice Expen
<strong>CMS</strong>-1403-FC 26<br />
PT Physical therapy<br />
ResDAC Research Data Assistance Center<br />
RFA Regulatory Flexibility Act<br />
RIA Regulatory impact analysis<br />
RN Registered nurse<br />
RNAC Reasonable net acquisition cost<br />
RRT Registered respiratory therapist<br />
RUC [AMA's Specialty Society] Relative (Value) Update<br />
Committee<br />
RVU Relative value unit<br />
SBA Small Business Administration<br />
SGR Sustainable growth rate<br />
SLP Speech-language pathology<br />
SMS [AMA’s] Socioeconomic Monitoring System<br />
SNF Skilled nursing facility<br />
SOR System of record<br />
SRS Stereotactic radiosurgery<br />
TC Technical Component<br />
TIN Tax identification number<br />
TRHCA Tax Relief and Health Care Act of 2006<br />
(Pub. L. 109-432)<br />
UPMC University of Pittsburgh Medical Center<br />
USDE United States Department of Education<br />
VBP Value-based purc<strong>has</strong>ing
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