Notice: This CMS-approved document has been submitted - Philips ...

CMS-1403-FC 30
Practice Expert Panel (CPEP) data; and the AMA's
Socioeconomic Monitoring System (SMS) data. The CPEP data
were collected from panels of physicians, practice
administrators, and nonphysicians (for example, registered
nurses (RNs)) nominated by physician specialty societies
and other groups. The CPEP panels identified the direct
inputs required for each physician’s service in both the
office setting and out-of-office setting. We have since
refined and revised these inputs based on recommendations
from the RUC. The AMA’s SMS data provided aggregate
specialty-specific information on hours worked and PEs.
Separate PE RVUs are established for procedures that
can be performed in both a nonfacility setting, such as a
physician's office, and a facility setting, such as a
hospital outpatient department. The difference between the
facility and nonfacility RVUs reflects the fact that a
facility typically receives separate payment from Medicare
for its costs of providing the service, apart from payment
under the PFS. The nonfacility RVUs reflect all of the
direct and indirect PEs of providing a particular service.
Section 212 of the Balanced Budget Refinement Act of
1999 (BBRA) (Pub. L. 106-113) directed the Secretary of
Health and Human Services (the Secretary) to establish a
process under which we accept and use, to the maximum