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(22) (23) (24) (25) (26) CMS-1403-FC Indirect Allocator (1st+2nd) Step 8 =(19)+(21) 1.48 36.70 0.76 0.54 0.22 0.49 0.32 0.17 Indirect Adjustment (Ind Adj) Steps 9-11 See footnote** 0.337 0.337 0.337 0.337 0.337 0.337 0.337 0.337 Adjusted Indirect Allocator Steps 9-11 Ind.Practice Cost Index =Ind Alloc * Ind Adj 0.50 12.37 0.26 0.18 0.07 0.16 0.11 0.06 (PCI) Steps 12- 16 See Steps 12-16 0.973 0.976 1.087 1.087 1.087 1.237 1.237 1.237 Adjusted = Adj. Ind Indirect Step 17 Alloc*PCI =(24)*(25) 0.49 12.07 0.28 0.20 0.08 0.20 0.13 0.07 (27) PE RVU Steps 18- 19 =(Adj Dir+Adj Ind) *budn =((14)+(26)) *budn 0.77 13.44 0.57 0.49 0.08 0.33 0.26 0.07 60
CMS-1403-FC 2. PE Proposals for CY 2009 a. RUC Recommendations for Direct PE Inputs In the CY 2009 PFS proposed rule, we agreed with the AMA RUC PE recommendations for 23 codes except for the inclusion of the clinical staff for quality-related activities for 8 immunization injection services (73 FR 38512). The AMA RUC recommendations and other PE issues are addressed below. Immunization Services We did not accept the AMA RUC-recommended inclusion of 4 minutes of clinical staff time related to quality activities (QA) for the 4 immunization codes for the initial injection: CPT codes 90465, 90467, 90471, and 90473; nor did we accept the recommended 1 minute of QA time for the 4 “each additional” subsequent injection for CPT codes 90466, 90468, 90472 and 90474. As we explained, unlike the clinical staff time related to quality activities that is included for mammography services as required by the Mammography Quality Standards Act of 1992 (Pub. L. 102-539) (MSQA), there is no statutory requirement for quality-related clinical staff time inputs for these services. Comment: We received comments from individuals and group practice physicians, specialty societies, the AMA 61
- Page 9 and 10: CMS-1403-FC 9 ● The physician sel
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- Page 15 and 16: CMS-1403-FC 15 A. Summary of Issues
- Page 17 and 18: CMS-1403-FC 17 XIII. Waiver of Prop
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- Page 27 and 28: CMS-1403-FC 27 WAMP Widely availabl
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- Page 43 and 44: CMS-1403-FC ● All other expenses,
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- Page 57 and 58: CMS-1403-FC • Physical therapy ut
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- Page 67 and 68: CMS-1403-FC We received no comments
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- Page 73 and 74: Code CMS-1403-FC 2008/9 Description
- Page 75 and 76: CMS-1403-FC TABLE 4: Practice Expen
- Page 77 and 78: CMS-1403-FC B. Geographic Practice
- Page 79 and 80: CMS-1403-FC services, and are adjus
- Page 81 and 82: CMS-1403-FC by at least 5 percent,
- Page 83 and 84: CMS-1403-FC we decided not to proce
- Page 85 and 86: CMS-1403-FC so as part of the CY 20
- Page 87 and 88: CMS-1403-FC In the CY 2008 PFS fina
- Page 89 and 90: CMS-1403-FC are available, we would
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- Page 107 and 108: CMS-1403-FC 99233). For CY 2006, we
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(22)<br />
(23)<br />
(24)<br />
(25)<br />
(26)<br />
<strong>CMS</strong>-1403-FC<br />
Indirect<br />
Allocator<br />
(1st+2nd) Step 8 =(19)+(21) 1.48 36.70 0.76 0.54 0.22 0.49 0.32 0.17<br />
Indirect<br />
Adjustment<br />
(Ind Adj) Steps 9-11 See footnote** 0.337 0.337 0.337 0.337 0.337 0.337 0.337 0.337<br />
Adjusted<br />
Indirect<br />
Allocator Steps 9-11<br />
Ind.Practice<br />
Cost Index<br />
=Ind Alloc * Ind<br />
Adj 0.50 12.37 0.26 0.18 0.07 0.16 0.11 0.06<br />
(PCI)<br />
Steps 12-<br />
16 See Steps 12-16 0.973 0.976 1.087 1.087 1.087 1.237 1.237 1.237<br />
Adjusted<br />
= Adj. Ind<br />
Indirect Step 17 Alloc*PCI =(24)*(25) 0.49 12.07 0.28 0.20 0.08 0.20 0.13 0.07<br />
(27) PE RVU<br />
Steps 18-<br />
19<br />
=(Adj Dir+Adj<br />
Ind) *budn<br />
=((14)+(26))<br />
*budn 0.77 13.44 0.57 0.49 0.08 0.33 0.26 0.07<br />
60
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