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CMS-1403-FC
and CY 2007 PFS final rules with comment period, we would
make adjustments to the chiropractor fees under the
Medicare PFS to recover aggregate payments under the
demonstration in excess of the amount estimated to yield
BN. We will assess BN by determining the change in costs
based on a pre- and post-comparison of aggregate payments
and the rate of change for specific diagnoses that were
treated by chiropractors and physicians in the
demonstration sites and control sites. Because the
aggregate payments under the expanded chiropractor services
may have an impact on other Medicare expenditures, we will
not limit our analysis to reviewing only chiropractor
claims.
Any needed reduction to chiropractor fees under the
PFS would be made in the CY 2010 and CY 2011 physician fee
schedules as it will take approximately 2 years after the
demonstration ends to complete the claims analysis. If we
determine that the adjustment for BN is greater than
2 percent of spending for the chiropractor fee schedule
codes (comprised of the 3 currently covered CPT codes
98940, 98941, and 98942), we would implement the adjustment
over a 2-year period. However, if the adjustment is less
than 2 percent of spending under the chiropractor fee
schedule codes, we would implement the adjustment over a
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