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CMS-1403-FC
charge for the service or the amount of the fee schedule.
The beneficiary would be responsible for the remaining 20
percent as coinsurance. We will specifically identify the
type of service and the accompanying payment levels in our
implementing instructions that will be issued
contemporaneously with each NCD.
2. Revisions to Initial Preventive Physical Examination
(IPPE)
Section 101(b) of the MIPPA also amended section
1861(ww)(1) of the Act which establishes an IPPE for
individuals who are newly enrolled in the voluntary Part B
program. This benefit was originally effective on
January 1, 2005, and is implemented at §410.16. Section
101(b) of the MIPPA revises the benefit by the following:
(1) Adding the measurement of an individual’s body
mass index as part of the IPPE;
(2) Upon the individual’s consent, adding end-of-life
planning to the IPPE services; and
(3) Removing the electrocardiogram from the list of
mandated services that must be included in the IPPE
benefit, and making it an educational, counseling, and
referral service to be discussed with the individual and
ordered by the physician, if necessary.
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