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

CMS-1403-FC
• Physical therapy utilization: Crosswalk the
utilization associated with all physical therapy services to
the specialty of physical therapy.
• Identify professional and technical services not
identified under the usual TC and 26 modifiers: Flag the
services that are PC and TC services, but do not use TC and
26 modifiers (for example, electrocardiograms). This flag
associates the PC and TC with the associated global code
for use in creating the indirect PE RVU. For example, the
professional service code 93010 is associated with the
global code 93000.
• Payment modifiers: Payment modifiers are accounted
for in the creation of the file. For example, services
billed with the assistant at surgery modifier are paid
16 percent of the PFS amount for that service; therefore,
the utilization file is modified to only account for
16 percent of any service that contains the assistant at
surgery modifier.
● Work RVUs: The setup file contains the work RVUs
from this final rule.
(vi) Equipment cost per minute
The equipment cost per minute is calculated as:
57