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CMS-1403-FC
involving the level 4/5 new or established office or other
outpatient visit codes being reported with the IPPE. If
there are consistent data that demonstrate high usage of
level 4/5 E/M codes in conjunction with the IPPE, we will
reevaluate the policy.
Additionally, since section 101(b) of the MIPPA
provides that the Medicare Part B deductible will not apply
for the IPPE performed on or after January 1, 2009 (as
defined in section 1861(ww)(1) of the Act), we are revising
§410.160(b) to include an exception from the Medicare Part
B deductible for the IPPE as described in §410.16 (Initial
preventive physical examination: Conditions for and
limitations on coverage). The co-insurance continues to
apply.
B. Section 131: Physician Payment, Efficiency, and
Quality Improvements
Section 131 of the MIPPA includes a number of
provisions that impact the quality reporting system defined
in section 1848(k) of the Act. For ease of reference, we
have named this quality reporting system, the “Physician
Quality Reporting Initiative” (PQRI). Although the new
MIPPA amendments that pertain to the PQRI, including those
provisions that pertain to PQRI beyond 2009, are generally
described below, the scope of this final rule with comment
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