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CMS-1403-FC determination is upheld on appeal, we will initiate a recovery action. Accordingly, we proposed to add a new §424.530(a)(6) and (a)(7) to deny enrollment applications for additional Medicare billing privileges if the physician or NPP organization or individual practitioner has an active payment suspension or has an existing overpayment that has not been repaid. We proposed to allow a Medicare FFS contractor to deny enrollment applications from those authorized officials, delegated officials, owners, and individual practitioners that own a supplier or provider at the time of filing until such time as the suspension has been terminated or the Medicare overpayment has been repaid in full. Specifically, we proposed to deny enrollment to any current owner (as defined in §424.502), physician, or NPP, who is participating in the Medicare program and is under a current Medicare payment suspension. We stated that we believe that the change to our denial policy would help protect the Medicare program from unscrupulous or problematic physician and NPP organizations and individual practitioners. Moreover, we believe this change would: (1) allow Medicare FFS contractors to improve customer service to all providers and suppliers that are already enrolled in the Medicare program; (2) 284
CMS-1403-FC facilitate the enrollment of all providers and suppliers seeking to enroll in the Medicare program for the first time; and (3) expand on existing efforts to process changes in a timely manner and provide better customer service. Comment: Several commenters stated that our proposal to deny additional billing privileges to a physician or an NPP when the physician or NPP is suspended or has an outstanding overpayment is a denial of due process and is in conflict with the principle of innocent until proven guilty. Response: We believe that we have an obligation to protect the Medicare program from inappropriate payments. Conversely, physicians and NPPs have an obligation to the Medicare program to resolve payment suspensions and overpayment actions in a timely manner. Finally, as a payer of health care, we believe that additional billing privileges should not be conveyed to a physician, NPP or owners, authorized and delegated officials who have an existing payment suspension or overpayment. To grant additional billing privileges to individuals with an existing payment suspension or overpayment exposes the Medicare Trust Funds to additional risks. With Medicare’s implementation of the NPI on May 23, 2008, Medicare contractors no longer issue billing 285
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Notice: This CMS-approved document
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CMS-1403-FC 3 1. Electronically. Yo
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CMS-1403-FC 5 FOR FURTHER INFORMATI
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CMS-1403-FC 7 Trisha Brooks, (410)7
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CMS-1403-FC 9 ● The physician sel
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CMS-1403-FC 11 Schedule C. Malpract
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CMS-1403-FC 13 3. Beneficiary Signa
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CMS-1403-FC 15 A. Summary of Issues
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CMS-1403-FC 17 XIII. Waiver of Prop
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CMS-1403-FC 19 BBRA [Medicare, Medi
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CMS-1403-FC 21 E/M Evaluation and m
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CMS-1403-FC 23 MA-PD Medicare Advan
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CMS-1403-FC 25 OSCAR Online Survey
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CMS-1403-FC 27 WAMP Widely availabl
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CMS-1403-FC 29 2. Practice Expense
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CMS-1403-FC 31 extent practicable a
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CMS-1403-FC 33 AMA's Current Proced
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CMS-1403-FC 35 Payment = [(RVU work
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CMS-1403-FC 37 legislation, the PFS
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CMS-1403-FC that time, PE RVUs were
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CMS-1403-FC utilize a “bottom-up
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CMS-1403-FC ● All other expenses,
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CMS-1403-FC b. Allocation of PE to
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CMS-1403-FC combined survey data fr
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CMS-1403-FC for the global componen
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CMS-1403-FC equipment cost per minu
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CMS-1403-FC components), then the i
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CMS-1403-FC indirect PE for all PFS
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CMS-1403-FC • Physical therapy ut
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CMS-1403-FC TABLE 1: Calculation of
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CMS-1403-FC 2. PE Proposals for CY
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CMS-1403-FC The formula for estimat
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CMS-1403-FC arbitrary method for ch
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CMS-1403-FC We received no comments
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CMS-1403-FC (iv) Contractor Pricing
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CMS-1403-FC Response: We will ask t
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Code CMS-1403-FC 2008/9 Description
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CMS-1403-FC TABLE 4: Practice Expen
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CMS-1403-FC B. Geographic Practice
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CMS-1403-FC services, and are adjus
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CMS-1403-FC by at least 5 percent,
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CMS-1403-FC we decided not to proce
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CMS-1403-FC so as part of the CY 20
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CMS-1403-FC In the CY 2008 PFS fina
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CMS-1403-FC are available, we would
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CMS-1403-FC is no duplication of co
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CMS-1403-FC practitioner) at the di
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CMS-1403-FC PFS final rule with com
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CMS-1403-FC individual MNT (or any
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CMS-1403-FC Group DSMT (which compr
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CMS-1403-FC The acuity of a critica
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CMS-1403-FC needed regarding a crit
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CMS-1403-FC errors; enhanced patien
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CMS-1403-FC 99233). For CY 2006, we
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CMS-1403-FC follow-up inpatient con
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CMS-1403-FC As noted previously, CP
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CMS-1403-FC face-to-face encounter
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CMS-1403-FC visits requested by the
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CMS-1403-FC Follow-up inpatient tel
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CMS-1403-FC that were appropriate t
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CMS-1403-FC HCPCS codes 96150 throu
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CMS-1403-FC G0332). The Medicare pa
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CMS-1403-FC code G0332. For CY 2009
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CMS-1403-FC Response: The separate
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CMS-1403-FC preadministration-relat
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CMS-1403-FC pricing of IVIG and Med
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CMS-1403-FC CPT Code Short Descript
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CMS-1403-FC percent for the subsequ
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CMS-1403-FC in the same session, on
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CMS-1403-FC jeopardizes beneficiary
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CMS-1403-FC As discussed in the pro
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CMS-1403-FC Note: Under the PFS, CP
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CMS-1403-FC The methodology for dev
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CMS-1403-FC drugs furnished through
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CMS-1403-FC Response: We disagree w
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CMS-1403-FC available to support a
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CMS-1403-FC that there are complica
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CMS-1403-FC administered to a benef
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CMS-1403-FC as we assess potential
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CMS-1403-FC add a modifier to their
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CMS-1403-FC application of the AQ m
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CMS-1403-FC 0.7000. ● A reduction
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CMS-1403-FC so the CY 2009 base com
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CMS-1403-FC patient utilization gro
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CMS-1403-FC make those estimates. A
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CMS-1403-FC After removing the enro
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CMS-1403-FC For CY 2009, we propose
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CMS-1403-FC plain language over pol
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CMS-1403-FC four quarters of ASP pr
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CMS-1403-FC composite rates. The wa
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CMS-1403-FC from the figure in the
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CMS-1403-FC that our goal is the ev
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CMS-1403-FC the average wage index
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CMS-1403-FC Labor Statistics, to de
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CMS-1403-FC been previously deemed
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CMS-1403-FC CBSA where the campuses
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CMS-1403-FC composite rates during
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CMS-1403-FC target amount of compos
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CMS-1403-FC admission. That is, the
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CMS-1403-FC that CMS consider issue
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CMS-1403-FC hold the provider in wh
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CMS-1403-FC Comment: Commenters rai
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CMS-1403-FC who have enrolled in th
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CMS-1403-FC ● Posting IDTF standa
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CMS-1403-FC other diagnostic testin
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CMS-1403-FC entities furnishing mob
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CMS-1403-FC state Radioactive Mater
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CMS-1403-FC equipment and provide t
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CMS-1403-FC Response: We understand
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CMS-1403-FC believe that requiring
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CMS-1403-FC these claims will ensur
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CMS-1403-FC and NPP organizations,
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CMS-1403-FC prior to their enrollin
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CMS-1403-FC The date of approval is
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CMS-1403-FC organizations, and indi
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CMS-1403-FC To assist physician and
Page 233 and 234: CMS-1403-FC Comment: Several commen
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Page 237 and 238: CMS-1403-FC services are complying
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Page 243 and 244: CMS-1403-FC Comment: The suggestion
Page 245 and 246: CMS-1403-FC Response: We thank the
Page 247 and 248: CMS-1403-FC provider enrollment giv
Page 249 and 250: CMS-1403-FC instead, it will force
Page 251 and 252: CMS-1403-FC Response: As stated abo
Page 253 and 254: CMS-1403-FC Comment: One commenter
Page 255 and 256: CMS-1403-FC In an attempt to ensure
Page 257 and 258: CMS-1403-FC rule, rather than limit
Page 259 and 260: CMS-1403-FC changes have occurred,
Page 261 and 262: CMS-1403-FC Response: While we moni
Page 263 and 264: CMS-1403-FC records faster and more
Page 265 and 266: CMS-1403-FC In §424.521(a)(1), we
Page 267 and 268: CMS-1403-FC practitioners with the
Page 269 and 270: CMS-1403-FC In June 2002 and Novemb
Page 271 and 272: CMS-1403-FC full implementation sch
Page 273 and 274: CMS-1403-FC with billing agents, cl
Page 275 and 276: CMS-1403-FC 2. Medicare Billing Pri
Page 277 and 278: CMS-1403-FC The FPLP is a collectio
Page 279 and 280: CMS-1403-FC continued enrollment to
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Page 283: CMS-1403-FC Consistent with existin
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Page 289 and 290: CMS-1403-FC individual practitioner
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Page 293 and 294: CMS-1403-FC Management Manual (IOM
Page 295 and 296: CMS-1403-FC Response: Based on thes
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Page 301 and 302: CMS-1403-FC Response: We disagree w
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Page 305 and 306: CMS-1403-FC Response: We disagree w
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Page 311 and 312: CMS-1403-FC §424.535(a)(10) that w
Page 313 and 314: CMS-1403-FC documentation for 7 yea
Page 315 and 316: CMS-1403-FC pharmacies to follow re
Page 317 and 318: CMS-1403-FC Comment: One commenter
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Page 323 and 324: CMS-1403-FC provider and supplier e
Page 325 and 326: CMS-1403-FC K. Amendment to the Exe
Page 327 and 328: CMS-1403-FC Prescription Fill Statu
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Page 331 and 332: CMS-1403-FC Following the publicati
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CMS-1403-FC facsimiles in all insta
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CMS-1403-FC Similarly, other commen
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CMS-1403-FC proposed rule's publica
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CMS-1403-FC elimination of the comp
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CMS-1403-FC exemption originally cr
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CMS-1403-FC dispensers are not requ
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CMS-1403-FC products, or, where upg
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CMS-1403-FC take time to develop, a
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CMS-1403-FC integrated this technol
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CMS-1403-FC Version 10.2 or higher)
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CMS-1403-FC proposed January 2009 c
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CMS-1403-FC L. Comprehensive Outpat
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CMS-1403-FC examination. In order t
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CMS-1403-FC qualifications for HHAs
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CMS-1403-FC distinction in the lice
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CMS-1403-FC (2) Have successfully c
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CMS-1403-FC risk-taking behaviors,
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CMS-1403-FC Therefore, we proposed
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CMS-1403-FC commenter stated that o
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CMS-1403-FC psychological services
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CMS-1403-FC 3. CORF Conditions of P
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CMS-1403-FC The following is a summ
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CMS-1403-FC We are not making any c
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CMS-1403-FC N. Physician Self-Refer
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CMS-1403-FC arrangements, and the l
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CMS-1403-FC below are related to ea
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CMS-1403-FC clinical practice. With
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CMS-1403-FC In the CY 2009 PFS prop
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CMS-1403-FC would be outside the sc
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CMS-1403-FC reflect objective quali
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CMS-1403-FC quality resulting from
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CMS-1403-FC payments should be reas
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CMS-1403-FC changes in referral pat
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CMS-1403-FC the alternative, we pro
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CMS-1403-FC finalize this condition
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CMS-1403-FC and “quality maintena
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CMS-1403-FC date. We seek comments
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CMS-1403-FC existing exceptions to
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CMS-1403-FC our general rulemaking
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CMS-1403-FC these approaches. We pr
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CMS-1403-FC building in which the b
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CMS-1403-FC were concerned that thi
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CMS-1403-FC supplier will be subjec
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CMS-1403-FC numerical test for the
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CMS-1403-FC space in which the orde
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CMS-1403-FC disadvantage nonproblem
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CMS-1403-FC would be simpler to not
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CMS-1403-FC IDTF standards in §410
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CMS-1403-FC that rule, the Governme
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CMS-1403-FC with comment period, th
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CMS-1403-FC 1842(n)(1) of the Act,
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CMS-1403-FC anti-markup provisions
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CMS-1403-FC her group practice woul
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CMS-1403-FC A commenter representin
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CMS-1403-FC tenens arrangements cou
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CMS-1403-FC other supplier. We are
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CMS-1403-FC on pathology reports or
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CMS-1403-FC patients. According to
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CMS-1403-FC from sharing a practice
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CMS-1403-FC Group A orders the TC a
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CMS-1403-FC physicians the flexibil
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CMS-1403-FC Response: We recognize
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CMS-1403-FC Response: Because the d
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CMS-1403-FC limited by the proposed
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CMS-1403-FC Response: With respect
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CMS-1403-FC to focus on the medical
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CMS-1403-FC service” approach bec
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CMS-1403-FC have the right to recei
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CMS-1403-FC 2 approach finalized he
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CMS-1403-FC the ordering physician
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CMS-1403-FC ensure an adequate nexu
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CMS-1403-FC entity” should be def
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CMS-1403-FC between the performing
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CMS-1403-FC supplier” to encompas
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CMS-1403-FC to continue to provide
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CMS-1403-FC requirements of the Alt
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CMS-1403-FC supervised in the offic
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CMS-1403-FC reducing access to care
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CMS-1403-FC commenter supported ado
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CMS-1403-FC “outside supplier,”
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CMS-1403-FC group could recover onl
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CMS-1403-FC incurred, thereby compe
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CMS-1403-FC needed to provide the t
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CMS-1403-FC performing supplier for
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CMS-1403-FC providers, the services
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CMS-1403-FC commenter also expresse
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CMS-1403-FC overutilization of in-o
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CMS-1403-FC provisions for single-s
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CMS-1403-FC we did not propose such
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CMS-1403-FC and PCs supervised or p
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CMS-1403-FC provisions will not app
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CMS-1403-FC (Pub. L. 110-173) (MMSE
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CMS-1403-FC reporting data on quali
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CMS-1403-FC PQRI and a more detaile
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CMS-1403-FC and our responses to th
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CMS-1403-FC provisions of the Priva
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CMS-1403-FC reducing eligible profe
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CMS-1403-FC administrative or judic
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CMS-1403-FC professionals who did n
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CMS-1403-FC base the incentive paym
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CMS-1403-FC A few commenters noted
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CMS-1403-FC administrative burden t
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CMS-1403-FC requested that more det
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CMS-1403-FC incentive payments for
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CMS-1403-FC December 31, 2009 and J
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CMS-1403-FC the reporting period fo
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CMS-1403-FC proposed to carry forwa
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CMS-1403-FC measures group is appli
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CMS-1403-FC measures results and nu
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CMS-1403-FC (Delmarva Foundation fo
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CMS-1403-FC registries to report on
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CMS-1403-FC reporting options for r
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CMS-1403-FC incentive payment for P
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CMS-1403-FC to report 2009 PQRI qua
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CMS-1403-FC Comment: We received nu
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CMS-1403-FC Comment: One comment su
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CMS-1403-FC quality measures result
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CMS-1403-FC requirements listed on
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CMS-1403-FC a data submission vendo
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CMS-1403-FC As we stated in the CY
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CMS-1403-FC whether eligible profes
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CMS-1403-FC ● Agree that the regi
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CMS-1403-FC soon thereafter as is t
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CMS-1403-FC Comment: We received ma
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CMS-1403-FC Comment: One commenter
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CMS-1403-FC additional 2.0 percent
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CMS-1403-FC EHRs in 2009. The measu
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CMS-1403-FC i. Overview and Summary
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CMS-1403-FC voluntary consensus sta
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CMS-1403-FC Comment: Several commen
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CMS-1403-FC the AMA-PCPI should be
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CMS-1403-FC are appropriate and do
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CMS-1403-FC to make any changes to
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CMS-1403-FC post the measures for p
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CMS-1403-FC beneficiaries. We now h
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CMS-1403-FC identified in Tables 15
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CMS-1403-FC important difference in
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CMS-1403-FC not use Measures #73 Ca
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CMS-1403-FC measures, but which are
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CMS-1403-FC with comment period. Ho
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CMS-1403-FC ● Measure #41 Osteopo
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CMS-1403-FC professional to simply
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CMS-1403-FC measures. We consider t
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CMS-1403-FC Measure Number and Titl
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CMS-1403-FC Measure Number and Titl
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CMS-1403-FC ● Measure #120 CKD: A
Page 631 and 632:
CMS-1403-FC For the 2009 PQRI quali
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CMS-1403-FC rule indicated that the
Page 635 and 636:
CMS-1403-FC Response: As suggested
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CMS-1403-FC required for the measur
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CMS-1403-FC ● Achievement of NQF
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CMS-1403-FC These additional measur
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CMS-1403-FC We did not include this
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CMS-1403-FC Comment: Many commenter
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CMS-1403-FC groups must have a part
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CMS-1403-FC selected for inclusion
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CMS-1403-FC Measure Title Measure S
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 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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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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CMS-1403-FC The measure becomes app
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CMS-1403-FC is, Measure #125) appli
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CMS-1403-FC outpatient setting. Whi
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CMS-1403-FC ability of an electroni
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CMS-1403-FC October 2005 (hereinaft
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CMS-1403-FC We are aware that there
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CMS-1403-FC provided during the enc
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CMS-1403-FC denominator of a measur
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CMS-1403-FC cases. If the is determ
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CMS-1403-FC during 2009; and (3) wh
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CMS-1403-FC on this quality measure
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CMS-1403-FC become effective until
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CMS-1403-FC and CY 2007 PFS final r
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CMS-1403-FC directly affected by th
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CMS-1403-FC requires advanced pract
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CMS-1403-FC applaud CMS for recogni
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CMS-1403-FC standardization of DNP
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CMS-1403-FC for the most part, been
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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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CMS-1403-FC pressure (CPAP)” and
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CMS-1403-FC for example chronic obs
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CMS-1403-FC thus they believe leadi
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CMS-1403-FC Excepting attended faci
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CMS-1403-FC supplier separately. Ho
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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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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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CMS-1403-FC be made to obtain the s
Page 767 and 768:
CMS-1403-FC willing to sign at the
Page 769 and 770:
CMS-1403-FC and not suppliers, may
Page 771 and 772:
CMS-1403-FC crew member would have
Page 773 and 774:
CMS-1403-FC In order to determine f
Page 775 and 776:
CMS-1403-FC retrieval of the variou
Page 777 and 778:
CMS-1403-FC plan that demonstrates
Page 779 and 780:
CMS-1403-FC conviction, license sus
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CMS-1403-FC The following is a summ
Page 783 and 784:
CMS-1403-FC faith reduces the time
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CMS-1403-FC suspension or revocatio
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CMS-1403-FC 9 percent per year. 2 I
Page 789 and 790:
CMS-1403-FC magnetic resonance imag
Page 791 and 792:
CMS-1403-FC Committee for Quality A
Page 793 and 794:
CMS-1403-FC measures in CMS’ VBP
Page 795 and 796:
CMS-1403-FC the Boston program site
Page 797 and 798:
CMS-1403-FC conditions that are hig
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CMS-1403-FC reports? ● Do physici
Page 801 and 802:
CMS-1403-FC most Evaluation and Man
Page 803 and 804:
CMS-1403-FC III. Medicare Improveme
Page 805 and 806:
CMS-1403-FC Specifically, section 1
Page 807 and 808:
CMS-1403-FC period. The public will
Page 809 and 810:
CMS-1403-FC Section 101(b) of the M
Page 811 and 812:
CMS-1403-FC 1 year after the effect
Page 813 and 814:
CMS-1403-FC applies to both adult m
Page 815 and 816:
CMS-1403-FC period is limited to th
Page 817 and 818:
CMS-1403-FC 2007 through 2010. In a
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CMS-1403-FC Section 1848(m)(3)(D) o
Page 821 and 822:
CMS-1403-FC In addition to the prov
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CMS-1403-FC during the 2009 and 201
Page 825 and 826:
CMS-1403-FC prescribers for 2009 ar
Page 827 and 828:
CMS-1403-FC requirement by making a
Page 829 and 830:
CMS-1403-FC continue to bill the Me
Page 831 and 832:
CMS-1403-FC therapy and speech-lang
Page 833 and 834:
CMS-1403-FC ● Section 1835(a) of
Page 835 and 836:
CMS-1403-FC The amendments made by
Page 837 and 838:
CMS-1403-FC national associations a
Page 839 and 840:
CMS-1403-FC On November 9, 2006, we
Page 841 and 842:
CMS-1403-FC our regulations states
Page 843 and 844:
CMS-1403-FC rental period. The supp
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CMS-1403-FC reasonable useful lifet
Page 847 and 848:
CMS-1403-FC to use the equipment be
Page 849 and 850:
CMS-1403-FC oxygen contents after t
Page 851 and 852:
CMS-1403-FC the oxygen contents and
Page 853 and 854:
CMS-1403-FC Section 414.210(e)(2) a
Page 855 and 856:
CMS-1403-FC reported to us that, ba
Page 857 and 858:
CMS-1403-FC non-routine maintenance
Page 859 and 860:
CMS-1403-FC As a result, we will ma
Page 861 and 862:
CMS-1403-FC 31, 2009 amounts for gr
Page 863 and 864:
CMS-1403-FC under section 332(a)(1)
Page 865 and 866:
CMS-1403-FC furnishing services via
Page 867 and 868:
CMS-1403-FC required to furnish dir
Page 869 and 870:
CMS-1403-FC mental health services
Page 871 and 872:
CMS-1403-FC Skilled Nursing Facilit
Page 873 and 874:
CMS-1403-FC where the SNF resident
Page 875 and 876:
CMS-1403-FC describes the methodolo
Page 877 and 878:
CMS-1403-FC The RUC has created the
Page 879 and 880:
CMS-1403-FC Response: Although we r
Page 881 and 882:
CMS-1403-FC occurring code pairs. T
Page 883 and 884:
CMS-1403-FC a standing panel of exp
Page 885 and 886:
CMS-1403-FC extraction of the assoc
Page 887 and 888:
CMS-1403-FC TABLE 26: AMA RUC Recom
Page 889 and 890:
CMS-1403-FC AMA RUC Rec Site of Ser
Page 891 and 892:
Page 893 and 894:
Page 895 and 896:
CMS-1403-FC Note: The RUC reviewed
Page 897 and 898:
CMS-1403-FC C. Interim 2008 Codes 1
Page 899 and 900:
CMS-1403-FC national noncoverage de
Page 901 and 902:
CMS-1403-FC CPT codes for 2008. In
Page 903 and 904:
CMS-1403-FC associated work RVUs, t
Page 905 and 906:
CMS-1403-FC CPT 1 AMA RUC Work RVU
Page 907 and 908:
CMS-1403-FC # New CPT code. 1 All C
Page 909 and 910:
CMS-1403-FC ● 27218, Open treatme
Page 911 and 912:
CMS-1403-FC RVUs for G0412; 15.73 w
Page 913 and 914:
CMS-1403-FC Therefore, we disagree
Page 915 and 916:
CMS-1403-FC generally contractor pr
Page 917 and 918:
CMS-1403-FC In addition, we believe
Page 919 and 920:
CMS-1403-FC RVU for CPT code 93289
Page 921 and 922:
CMS-1403-FC time to better understa
Page 923 and 924:
CMS-1403-FC ● 93306, Echocardiogr
Page 925 and 926:
CMS-1403-FC Although not discussed
Page 927 and 928:
CMS-1403-FC for New and Revised 200
Page 929 and 930:
CMS-1403-FC item. In addition, the
Page 931 and 932:
CMS-1403-FC 90956, 90957, 90958, 90
Page 933 and 934:
CMS-1403-FC place of these two new
Page 935 and 936:
CMS-1403-FC beneficiary or any othe
Page 937 and 938:
CMS-1403-FC ● Adding the followin
Page 939 and 940:
CMS-1403-FC Tables 29 and 30 also i
Page 941 and 942:
CMS-1403-FC RADIOLOGY AND CERTAIN O
Page 943 and 944:
CMS-1403-FC 93320 Doppler echo exam
Page 945 and 946:
CMS-1403-FC index data, that the hi
Page 947 and 948:
CMS-1403-FC TABLE 32: Increase in t
Page 949 and 950:
CMS-1403-FC C. The Update Adjustmen
Page 951 and 952:
CMS-1403-FC end of the prior year a
Page 953 and 954:
CMS-1403-FC CY 2009, the statute re
Page 955 and 956:
CMS-1403-FC Actual08 = Estimated Ac
Page 957 and 958:
CMS-1403-FC 1848(f)(3)(C)(i) of the
Page 959 and 960:
CMS-1403-FC ● Screening mammograp
Page 961 and 962:
CMS-1403-FC payments while promotin
Page 963 and 964:
CMS-1403-FC E. Final Sustainable Gr
Page 965 and 966:
CMS-1403-FC included in the SGR (us
Page 967 and 968:
CMS-1403-FC that this figure will c
Page 969 and 970:
CMS-1403-FC physicians' services in
Page 971 and 972:
CMS-1403-FC imaging services, the M
Page 973 and 974:
CMS-1403-FC CY 2007. Table 42 illus
Page 975 and 976:
CMS-1403-FC year to the entire year
Page 977 and 978:
CMS-1403-FC the CF. Therefore, this
Page 979 and 980:
CMS-1403-FC estimate that CY 2009 R
Page 981 and 982:
CMS-1403-FC Table 44: Calculation o
Page 983 and 984:
CMS-1403-FC XI. Payment for Certain
Page 985 and 986:
CMS-1403-FC In the Competitive Acqu
Page 987 and 988:
CMS-1403-FC glasses, hand magnifier
Page 989 and 990:
CMS-1403-FC Our interpretation of t
Page 991 and 992:
CMS-1403-FC Response: We understand
Page 993 and 994:
CMS-1403-FC defines “eyeglass”
Page 995 and 996:
CMS-1403-FC this statutory exclusio
Page 997 and 998:
CMS-1403-FC advances in the use of
Page 999 and 1000:
CMS-1403-FC is paid for his or her
Page 1001 and 1002:
CMS-1403-FC XII. Provisions of the
Page 1003 and 1004:
CMS-1403-FC these RUC recommendatio
Page 1005 and 1006:
CMS-1403-FC services. We believe a
Page 1007 and 1008:
CMS-1403-FC Section 144(b) of the M
Page 1009 and 1010:
CMS-1403-FC rulemaking with respect
Page 1011 and 1012:
CMS-1403-FC (respectively) of this
Page 1013 and 1014:
CMS-1403-FC completing and submitti
Page 1015 and 1016:
CMS-1403-FC §424.516(d)(1). Additi
Page 1017 and 1018:
CMS-1403-FC to several associated i
Page 1019 and 1020:
CMS-1403-FC incentive payment for 2
Page 1021 and 1022:
CMS-1403-FC year of PQRI reporting)
Page 1023 and 1024:
CMS-1403-FC Based on the assumption
Page 1025 and 1026:
CMS-1403-FC these activities for th
Page 1027 and 1028:
CMS-1403-FC per hour, we estimate t
Page 1029 and 1030:
CMS-1403-FC Because of the large nu
Page 1031 and 1032:
CMS-1403-FC threshold, and hence al
Page 1033 and 1034:
CMS-1403-FC shoes, the regulation i
Page 1035 and 1036:
CMS-1403-FC with comment period for
Page 1037 and 1038:
CMS-1403-FC substance of State laws
Page 1039 and 1040:
CMS-1403-FC $20 million from what e
Page 1041 and 1042:
CMS-1403-FC ● Impact of Work RVU
Page 1043 and 1044:
CMS-1403-FC imaging services from t
Page 1045 and 1046:
CMS-1403-FC ● Impact of section 1
Page 1047 and 1048:
CMS-1403-FC management, could have
Page 1049 and 1050:
CMS-1403-FC Table 50 illustrates, f
Page 1051 and 1052:
CMS-1403-FC CPT/ HCPCS Mod Descript
Page 1053 and 1054:
CMS-1403-FC impact associated with
Page 1055 and 1056:
CMS-1403-FC The fourth column shows
Page 1057 and 1058:
CMS-1403-FC the CY 2007 claims. The
Page 1059 and 1060:
CMS-1403-FC 1059 4/This column show
Page 1061 and 1062:
CMS-1403-FC requirements is to allo
Page 1063 and 1064:
CMS-1403-FC This amendment of the e
Page 1065 and 1066:
CMS-1403-FC 4 minutes per call, lab
Page 1067 and 1068:
CMS-1403-FC e-prescribing and who m
Page 1069 and 1070:
CMS-1403-FC anti-markup provisions
Page 1071 and 1072:
CMS-1403-FC approximately $50 per h
Page 1073 and 1074:
CMS-1403-FC e-prescribing measure i
Page 1075 and 1076:
CMS-1403-FC we estimate that each e
Page 1077 and 1078:
CMS-1403-FC P. Prohibition Concerni
Page 1079 and 1080:
CMS-1403-FC that provides a calcula
Page 1081 and 1082:
CMS-1403-FC treatment) that occur a
Page 1083 and 1084:
CMS-1403-FC locality (+5.37 percent
Page 1085 and 1086:
CMS-1403-FC additional rental payme
Page 1087 and 1088:
CMS-1403-FC T. Competitive Acquisit
Page 1089 and 1090:
CMS-1403-FC Program; II.T. Electron
Page 1091 and 1092:
CMS-1403-FC which means that in 200
Page 1093 and 1094:
CMS-1403-FC List of Subjects 42 CFR
Page 1095 and 1096:
CMS-1403-FC For the reasons set for
Page 1097 and 1098:
CMS-1403-FC (1) Except as specified
Page 1099 and 1100:
CMS-1403-FC pressure, a visual acui
Page 1101 and 1102:
CMS-1403-FC (ii) A speech-language
Page 1103 and 1104:
CMS-1403-FC during the hours that t
Page 1105 and 1106:
CMS-1403-FC (i) Be certified as a n
Page 1107 and 1108:
CMS-1403-FC 14. Section 410.155 is
Page 1109 and 1110:
CMS-1403-FC prostate cancer screeni
Page 1111 and 1112:
CMS-1403-FC B. Amending the definit
Page 1113 and 1114:
CMS-1403-FC The revisions and addit
Page 1115 and 1116:
CMS-1403-FC or institution other th
Page 1117 and 1118:
CMS-1403-FC substantially all (whic
Page 1119 and 1120:
CMS-1403-FC psychiatric diagnostic
Page 1121 and 1122:
CMS-1403-FC repairing, maintaining,
Page 1123 and 1124:
CMS-1403-FC B. Deleting paragraph (
Page 1125 and 1126:
CMS-1403-FC during any period of me
Page 1127 and 1128:
CMS-1403-FC (c)(1). A. Revising the
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CMS-1403-FC * * * * * (b) * * * (2)
Page 1131 and 1132:
CMS-1403-FC assigned to such drug p
Page 1133 and 1134:
CMS-1403-FC 33. In §415.130(d), th
Page 1135 and 1136:
CMS-1403-FC (6) An ambulance provid
Page 1137 and 1138:
CMS-1403-FC §424.57 Special paymen
Page 1139 and 1140:
CMS-1403-FC Final adverse action me
Page 1141 and 1142:
CMS-1403-FC (b) Reporting requireme
Page 1143 and 1144:
CMS-1403-FC of Medicare billing pri
Page 1145 and 1146:
CMS-1403-FC (a) Physicians, nonphys
Page 1147 and 1148:
CMS-1403-FC * * * * * (g) Effective
Page 1149 and 1150:
CMS-1403-FC that meet the qualifica
Page 1151 and 1152:
CMS-1403-FC (3) Have equivalent tra
Page 1153 and 1154:
CMS-1403-FC §485.711 Condition of
Page 1155 and 1156:
CMS-1403-FC Subpart C--Conditions f
Page 1157 and 1158:
CMS-1403-FC Authority: Catalog of F
Page 1159 and 1160:
CMS-1403-FC Addendum B means that C
Page 1161 and 1162:
CMS-1403-FC which they are incident
Page 1163 and 1164:
CMS-1403-FC T = There are RVUs for
Page 1165 and 1166:
CMS-1403-FC ADDENDUM B: Relative Va
Page 1167 and 1168:
CMS-1403-FC Physi- cian Work Fully
Page 1169 and 1170:
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Page 1173 and 1174:
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CMS-1403-FC CPT 1 / HCPCS Mod Statu
Page 1371 and 1372:
CMS-1403-FC CPT 1 / HCPCS Mod Statu
Page 1373 and 1374:
Page 1375 and 1376:
CMS-1403-FC Contractor Locality Loc
Page 1377 and 1378:
CMS-1403-FC ADDENDUM E: 2009 Geogra
Page 1379 and 1380:
CMS-1403-FC Work** PE MP Contractor
Page 1381 and 1382:
CMS-1403-FC 70492 Ct soft tissue ne
Page 1383 and 1384:
CMS-1403-FC 73201 Ct upper extremit
Page 1385 and 1386:
CMS-1403-FC 10780 10900 11020 11100
Page 1387 and 1388:
CMS-1403-FC 12420 12540 12580 12620
Page 1389 and 1390:
CMS-1403-FC 14060 14260 14484 14500
Page 1391 and 1392:
CMS-1403-FC 16820 16860 16940 16974
Page 1393 and 1394:
CMS-1403-FC 17980 18020 18140 18580
Page 1395 and 1396:
CMS-1403-FC 19804 20020 20100 20220
Page 1397 and 1398:
CMS-1403-FC 22500 22520 22540 22660
Page 1399 and 1400:
CMS-1403-FC 25020 25060 25180 25260
Page 1401 and 1402:
CMS-1403-FC 26980 27060 27100 27140
Page 1403 and 1404:
CMS-1403-FC 28700 28740 28940 29020
Page 1405 and 1406:
CMS-1403-FC 30860 30980 31020 31084
Page 1407 and 1408:
CMS-1403-FC 33140 33260 33340 33460
Page 1409 and 1410:
CMS-1403-FC 35300 35380 35644 35660
Page 1411 and 1412:
CMS-1403-FC 37340 37380 37460 37620
Page 1413 and 1414:
CMS-1403-FC 39300 39340 39380 39460
Page 1415 and 1416:
CMS-1403-FC 40580 40660 40900 40980
Page 1417 and 1418:
CMS-1403-FC 41940 41980 Sabana Gran
Page 1419 and 1420:
CMS-1403-FC 43340 43580 43620 43780
Page 1421 and 1422:
CMS-1403-FC 45940 46060 46140 46220
Page 1423 and 1424:
CMS-1403-FC 47940 48140 48260 48300
Page 1425 and 1426:
CMS-1403-FC 1425
Page 1427 and 1428:
CMS-1403-FC CBSA Code Nonurban Area
Page 1429 and 1430:
CMS-1403-FC HCPCS Descriptor 71260
Page 1431 and 1432:
Page 1433 and 1434:
Page 1435 and 1436:
Page 1437 and 1438:
CMS-1403-FC 78122 Blood volume 7813
Page 1439 and 1440:
CMS-1403-FC 96125 Cognitive test by
Page 1441 and 1442:
CMS-1403-FC 70240 X-ray exam, pitui
Page 1443 and 1444:
CMS-1403-FC 72120 X-ray exam of low
Page 1445 and 1446:
CMS-1403-FC 73720 Mri lwr extremity
Page 1447 and 1448:
CMS-1403-FC 76856 Us exam, pelvic,
Page 1449 and 1450:
CMS-1403-FC 78456 Acute venous thro
Page 1451 and 1452:
CMS-1403-FC 93320 Doppler echo exam
Page 1453 and 1454:
CMS-1403-FC A9571 Indium In-111 aut
Page 1455 and 1456:
CMS-1403-FC 77333 Radiation treatme
Page 1457 and 1458:
CMS-1403-FC C2638 Brachytx, strande
Page 1459:
CMS-1403-FC P3000 Screen pap by tec
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