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CMS-1403-FC
most Evaluation and Management (E&M) visits and billing for
at least 10 percent of the total cost for a beneficiary or
an episode of care; (ii) physician billing the most
established E&M visits (chronic conditions only); (iii)
assign all cost to each physician billing for any E&M or
procedure; (iv) assign cost to each physician in proportion
to billed visits; and (v) assign cost to the physician
billing the first E&M visit (acute episodes only). In our
continued distribution of RURs through phase I, we will
continue to update and refine our attribution rules. We
are soliciting comments on this approach and the following:
● What criteria should be taken into account to
ensure equity when considering attribution rules?
Finally, although the statute authorizes the Secretary
to focus the application of the program as appropriate, on
physicians who treat a minimum number of individuals and
authorizes us to provide feedback to groups of physicians,
as determined appropriate by the Secretary, we did not
exercise these optional provisions in the Baltimore and
Boston program sites and are not finalizing these in Phase
I of the program. In addition, section 1848(n)(6) of the
Act also requires that adjustments, to the extent
practicable, take into account variations in health status
and other patient characteristics. This type of adjustment
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