Part IV
Federal Register: December 31, 2009 (Volume 74, Number 250)
Rules and Regulations
Page 69501-69676
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
DOCID:fr31de09-17
Page 69501
Part IV
Department of Health and Human Services
Centers for Medicare & Medicaid Services
42 CFR Parts 410, 416, and 419
Medicare Program: Changes to the Hospital Outpatient Prospective
Payment System and CY 2010 Payment Rates; Changes to the Ambulatory
Surgical Center Payment System and CY 2010 Payment Rates; Final Rule
Page 69502
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services 42 CFR Parts 410, 416, and 419
CMS-1414-CN
RIN 0938-AP41
Medicare Program: Changes to the Hospital Outpatient Prospective
Payment System and CY 2010 Payment Rates; Changes to the Ambulatory
Surgical Center Payment System and CY 2010 Payment Rates
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Correction of final rule with comment period.
SUMMARY: This document corrects technical errors that appeared in the final rule with comment period found in the Federal Register (FR) on
November 20, 2009, entitled ``Medicare Program: Changes to the Hospital
Outpatient Prospective Payment System and CY 2010 Payment Rates;
Changes to the Ambulatory Surgical Center Payment System and CY 2010
Payment Rates.''
DATES: Effective Date: This correction document is effective January 1, 2010.
FOR FURTHER INFORMATION CONTACT: Alberta Dwivedi, (410) 786-0378.
SUPPLEMENTARY INFORMATION:
-
Background
In FR Doc. E9-26499 of November 20, 2009 (74 FR 60316), the final rule with comment period entitled, ``Medicare Program: Changes to the
Hospital Outpatient Prospective Payment System and CY 2010 Payment
Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2010 Payment Rates'' (hereinafter referred to as the CY 2010 OPPS/ASC final rule), there were a few technical errors that are identified in the ``Summary of Errors'' section and corrected in the ``Correction of
Errors'' section below.
The provisions in this correction notice are effective as if they had been included in the CY 2010 OPPS/ASC final rule appearing in the
November 20, 2009 Federal Register (74 FR 60316). Accordingly, the corrections are effective January 1, 2010.
-
Summary of Errors
-
Errors in the Preamble
On page 60559, in our response to a comment regarding developing and implementing standards of participation, we erred when we referenced ``conditions for coverage'' instead of ``conditions of participation.'' Therefore, we are deleting two references to
``conditions for coverage'' and replacing them with the phrase
``conditions of participation.''
On page 60562, in our response to a comment requesting CMS to remove procedures from the CY 2010 inpatient list, we inadvertently stated that we would remove ``5'' procedure codes instead of ``4'' procedure codes. Therefore, we are replacing the reference to ``5'' with a reference to ``4.'' In the same paragraph in which the previously described error exists (paragraph one of the first response), we list the procedure codes to be removed from the CY 2010 inpatient list. However, we inadvertently included in the list the procedure described by Healthcare Common Procedure Coding System
(HCPCS) code 37215 (Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection), which should not have been listed. Therefore, we are deleting from the paragraph the language that states we are removing the procedure described by HCPCS code 37215 from the CY 2010 inpatient list. In addition, in the second paragraph in the same response, we provided the incorrect number of procedures for which the clinical and utilization data did not support the appropriateness of providing the procedures to
Medicare beneficiaries in the hospital outpatient department (HOPD).
Specifically, we incorrectly cited ``11'' procedures instead of ``12'' procedures. Therefore, in the paragraph, we are replacing both references to the number ``11'' with references to the number ``12.''
On page 60563, in the summary paragraph following the comment summaries and responses to comments, we inadvertently stated that we were removing ``five'' procedures instead of ``four'' procedures from the CY 2010 inpatient list. Therefore, we are correcting the word
``five'' to read ``four.'' In addition, in the same paragraph we listed the procedures to be removed from the CY 2010 inpatient list. However, we inadvertently included the procedure described by HCPCS code 37215, which should not have been listed. Therefore, we are deleting from the paragraph the language that states we are removing that procedure from the CY 2010 inpatient list.
On page 60564, in the summary paragraph at the top of the page which follows the comment summaries and responses to comments on the previous page, we made the statement that we were displaying in Table 56 the final ``eight'' procedures we are removing from the inpatient list. We should have indicated that we were displaying the final
``seven'' procedures we are removing from the CY 2010 inpatient list in
Table 56. Therefore, we are deleting from the paragraph the reference to ``eight'' and replacing it with a reference to ``seven.'' In addition, we inadvertently included a procedure in Table 56 that should not have been included. Specifically, we incorrectly included the procedure described by HCPCS code 37215 in the table. Therefore, we are deleting from Table 56 the procedure described by HCPCS code 37215 as well as all of the information associated with it in the CY 2010 long descriptor column, the Final CY 2010 APC assignment column, and the
Final CY 2010 status indicator column.
On page 60566, in our discussion to the legislative changes related to pulmonary rehabilitation, cardiac rehabilitation, and intensive cardiac rehabilitation services, we inadvertently made reference to
``section II.G.8.'' of the preamble of the CY 2010 Medicare Physician
Fee Schedule (MPFS) proposed rule (74 FR 33606) instead of ``sections
II.G.8. and II.G.9.''. We also inadvertently referenced the citation
``(74 FR 33606)'' instead of the citation ``(74 FR 33606 through 33614).'' We are correcting these errors so that the reader can easily find the appropriate sections of that proposed rule. Therefore, we are replacing the phrase ``section II.G.8.'' with the phrase ``sections
II.G.8. and II.G.9.'' and we are replacing the citation ``(74 FR 33606)'' with the citation ``(74 FR 33606 through 33614).''
On page 60598, in our response to a comment, we inadvertently reference ``section XII.E.'' of the preamble instead of ``section
XII.D.'' We are correcting this error so that the reader can easily find the appropriate section of the rule to review regarding the final
CY 2010 physician supervision requirements for hospital outpatient diagnostic and therapeutic services.
On page 60612, in our discussion of the Ambulatory Surgical Center
(ASC) treatment of surgical procedures removed from the OPPS inpatient list for CY 2010, we inadvertently made the statement that we were removing ``5'' procedures instead of ``4'' procedures from the OPPS inpatient list for CY 2010. Therefore, in section XV.C.1.d., we are replacing both references to the number ``5'' with references to the number ``4.'' In addition, we inadvertently included the procedure described by HCPCS Code 37215 in Table 69. We are correcting this error by removing this procedure code from the
Page 69503
table, as well as all of the information associated with it in the CY 2010 long descriptor column.
-
Errors in the Addendum
On page 60789, in Addendum B, we made a typographical error when we listed the letter ``T'' instead of the letter ``C'' in the payment status indicator (SI) column for HCPCS code 37215. Therefore, we are replacing the letter ``T'' with the letter ``C'' in the SI column for
HCPCS code 37215.
On page 60957, in Addendum E, we inadvertently omitted HCPCS code 37215 along with the short descriptor, comment indicator, and status indicator. Therefore, we are correcting this error by including HCPCS code 37215 as well as all of the information associated with it in the addendum.
We are republishing Addenda AA and BB, which were published on pages 60692 through 60752 and pages 60919 through 60943, respectively, to take into account updated CY 2010 MPFS information. As required under Sec. 416.171(d), the revised ASC payment system limits payment for office-based procedures and covered ancillary radiology services to the lesser of the ASC rate or the amount calculated by multiplying the nonfacility practice expense (PE) relative value units (RVUs) for the service by the conversion factor under the MPFS. However, the MPFS conversion factor and PE RVUs listed for some CPT codes in Addendum B to the CY 2010 MPFS final rule with comment period (74 FR 61738) were incorrect due to methodological errors and, consequently, have been corrected in a correction notice to that final rule (74 FR 65449).
Since the ASC payment amounts for office-based procedures and covered ancillary services are determined using the amounts in the MPFS final rule, we must correct the CY 2010 payment amounts for ASC procedures and services using the corrected MPFS amounts. The revised rates continue to reflect the negative update to the MPFS for CY 2010 authorized under current law. The corrected payment amounts are reflected in Addenda AA and BB to this correction notice and also are posted on the CMS Web site at: http://www.cms.hhs.gov/ASCPayment.
-
-
Correction of Errors 1. On page 60559, in column 1, in the first response to comment, in lines 5 and 10 of the response, the statement ``conditions for coverage'' is corrected to read, ``conditions of participation''. 2. On page 60562--
-
In column 1, in the first response to comment, in line 10, the number ``5'' is corrected to read number ``4''.
-
In column 1, in the first response to comment, in lines 15 through 18, the statement ``37215 (Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection);'' is deleted.
-
In column 1, in the last paragraph of the response to comment, in lines 2 and 7, the number ``11'' is corrected to read, ``12''. 3. On page 60563--
-
In column 3, in the last paragraph, in line 6, the word ``five'' is corrected to read ``four''.
-
In column 3, in the last paragraph, in lines 12 through 15, the statement ``37215 (Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection);'' is deleted. 4. On page 60564--
-
In column 3, in line 1 at the top of the page before the chart, the word ``eight'' is corrected to read ``seven''.
-
In Table 56, in row 4, the HCPCS Code ``37215'' and all associated information is deleted. 5. On page 60566--
-
In column 2, in line 30 from the top of the page, the reference to ``section II.G.8.'' is corrected to read ``sections II.G.8. and
II.G.9.''
-
In column 2, in line 31 from the top of the page, the reference to ``(74 FR 33606)'' is corrected to read ``(74 FR 33606 through 33614)''. 6. On page 60598, in column 3, in line 4 from the top of the page, the reference to ``section XII.E.'' is corrected to read ``section
XII.D.'' 7. On page 60612--
-
In column 1, in line 5 from the top of the page before the table, the number ``5'' is corrected to read number ``4''.
-
In column 2, in line 4 from the top of the page before the table, the number ``5'' is corrected to read number ``4''.
-
In Table 69, in row 4, the HCPCS Code ``37215'' and all associated information is deleted.
Corrections to Addenda
Addendum B.--OPPS Payment by HCPCS Code for CY 2010
On page 60789, for HCPCS code 37215, in line 36 of the second chart, in column 4, the status indicator ``T'' is corrected to read
``C''.
Addendum E.--HCPCS Codes That Are Paid Only as Inpatient Procedures for
CY 2010
On page 60957, in the second chart, insert between HCPCS Codes 37182 and 37616 the final OPPS CY 2010 entry for HCPCS Code 37215 to read as follows:
HCPCS Code
Short descriptor
SI
CI
37215........... Transcath stent, cca w/ C
............. eps.
Addendum AA.--Final ASC Covered Surgical Procedures for CY 2010
(Including Surgical Procedures for Which Payment Is Packaged)
We are republishing Addendum AA in its entirety. See attached chart.
Addendum BB.--Final ASC Covered Ancillary Services Integral to Covered
Surgical Procedures for CY 2010 (Including Ancillary Services for Which
Payment Is Packaged)
We are republishing Addendum BB in its entirety. See attached chart.
-
-
Waiver of Proposed Rulemaking and Delay in Effective Date
We ordinarily publish a notice of proposed rulemaking in the
Federal Register to provide a period for public comment before the provisions of a notice such as this take effect, in accordance with section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). We also ordinarily provide a 30-day delay in the effective date of the provisions of a notice in accordance with section 553(d) of the APA (5 U.S.C. 553(d)). However, we can waive both the notice and comment procedure and the 30-day delay in effective date if the
Secretary finds, for good cause, that it is impracticable, unnecessary or contrary to the public interest to follow the notice and comment procedure or to comply with the 30-day delay in the effective date, and incorporates a statement of the finding and the reasons therefore in the notice. The policies and payment methodologies finalized in the CY 2010 OPPS/ASC final rule with comment period have previously been subjected to notice and comment procedures. This correction notice merely provides technical corrections to the CY 2010 OPPS/ASC final rule with comment period that was promulgated through notice and comment rulemaking, and does not make substantive changes to the policies or payment methodologies that were finalized in the final rule with comment period. For example, in order to conform the document to the final policies of the CY 2010 OPPS/ASC final rule with comment period, this notice makes changes to revise inaccurate tabular information. Therefore, we find it unnecessary to undertake further notice and comment procedures with
Page 69504
respect to this correction notice. In addition, we believe it is important for the public to have the correct information as soon as possible and find no reason to delay the dissemination of it. For the reasons stated above, we find that both notice and comment and the 30- day delay in effective date for this correction notice are unnecessary.
Therefore, we find there is good cause to waive notice and comment procedures and the 30-day delay in effective date for this correction notice.
(Catalog of Federal Domestic Assistance Program No. 93.774,
Medicare-- Supplementary Medical Insurance Program)
Dated: December 24, 2009.
Dawn L. Smalls,
Executive Secretary to the Department.
BILLING CODE 4120-01-P
Page 69505
GRAPHIC
TIFF OMITTED TR31DE09.000
Page 69506
GRAPHIC
TIFF OMITTED TR31DE09.001
Page 69507
GRAPHIC
TIFF OMITTED TR31DE09.002
Page 69508
GRAPHIC
TIFF OMITTED TR31DE09.003
Page 69509
GRAPHIC
TIFF OMITTED TR31DE09.004
Page 69510
GRAPHIC
TIFF OMITTED TR31DE09.005
Page 69511
GRAPHIC
TIFF OMITTED TR31DE09.006
Page 69512
GRAPHIC
TIFF OMITTED TR31DE09.007
Page 69513
GRAPHIC
TIFF OMITTED TR31DE09.008
Page 69514
GRAPHIC
TIFF OMITTED TR31DE09.009
Page 69515
GRAPHIC
TIFF OMITTED TR31DE09.010
Page 69516
GRAPHIC
TIFF OMITTED TR31DE09.011
Page 69517
GRAPHIC
TIFF OMITTED TR31DE09.012
Page 69518
GRAPHIC
TIFF OMITTED TR31DE09.013
Page 69519
GRAPHIC
TIFF OMITTED TR31DE09.014
Page 69520
GRAPHIC
TIFF OMITTED TR31DE09.015
Page 69521
GRAPHIC
TIFF OMITTED TR31DE09.016
Page 69522
GRAPHIC
TIFF OMITTED TR31DE09.017
Page 69523
GRAPHIC
TIFF OMITTED TR31DE09.018
Page 69524
GRAPHIC
TIFF OMITTED TR31DE09.019
Page 69525
GRAPHIC
TIFF OMITTED TR31DE09.020
Page 69526
GRAPHIC
TIFF OMITTED TR31DE09.021
Page 69527
GRAPHIC
TIFF OMITTED TR31DE09.022
Page 69528
GRAPHIC
TIFF OMITTED TR31DE09.023
Page 69529
GRAPHIC
TIFF OMITTED TR31DE09.024
Page 69530
GRAPHIC
TIFF OMITTED TR31DE09.025
Page 69531
GRAPHIC
TIFF OMITTED TR31DE09.026
Page 69532
GRAPHIC
TIFF OMITTED TR31DE09.027
Page 69533
GRAPHIC
TIFF OMITTED TR31DE09.028
Page 69534
GRAPHIC
TIFF OMITTED TR31DE09.029
Page 69535
GRAPHIC
TIFF OMITTED TR31DE09.030
Page 69536
GRAPHIC
TIFF OMITTED TR31DE09.031
Page 69537
GRAPHIC
TIFF OMITTED TR31DE09.032
Page 69538
GRAPHIC
TIFF OMITTED TR31DE09.033
Page 69539
GRAPHIC
TIFF OMITTED TR31DE09.034
Page 69540
GRAPHIC
TIFF OMITTED TR31DE09.035
Page 69541
GRAPHIC
TIFF OMITTED TR31DE09.036
Page 69542
GRAPHIC
TIFF OMITTED TR31DE09.037
Page 69543
GRAPHIC
TIFF OMITTED TR31DE09.038
Page 69544
GRAPHIC
TIFF OMITTED TR31DE09.039
Page 69545
GRAPHIC
TIFF OMITTED TR31DE09.040
Page 69546
GRAPHIC
TIFF OMITTED TR31DE09.041
Page 69547
GRAPHIC
TIFF OMITTED TR31DE09.042
Page 69548
GRAPHIC
TIFF OMITTED TR31DE09.043
Page 69549
GRAPHIC
TIFF OMITTED TR31DE09.044
Page 69550
GRAPHIC
TIFF OMITTED TR31DE09.045
Continued on page 69551
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
]
pp. 69551-69600
Medicare Program: Changes to the Hospital Outpatient Prospective
Payment System and CY 2010 Payment Rates; Changes to the Ambulatory
Surgical Center Payment System and CY 2010 Payment Rates
Continued from page 69550
Page 69551
GRAPHIC
TIFF OMITTED TR31DE09.046
Page 69552
GRAPHIC
TIFF OMITTED TR31DE09.047
Page 69553
GRAPHIC
TIFF OMITTED TR31DE09.048
Page 69554
GRAPHIC
TIFF OMITTED TR31DE09.049
Page 69555
GRAPHIC
TIFF OMITTED TR31DE09.050
Page 69556
GRAPHIC
TIFF OMITTED TR31DE09.051
Page 69557
GRAPHIC
TIFF OMITTED TR31DE09.052
Page 69558
GRAPHIC
TIFF OMITTED TR31DE09.053
Page 69559
GRAPHIC
TIFF OMITTED TR31DE09.054
Page 69560
GRAPHIC
TIFF OMITTED TR31DE09.055
Page 69561
GRAPHIC
TIFF OMITTED TR31DE09.056
Page 69562
GRAPHIC
TIFF OMITTED TR31DE09.057
Page 69563
GRAPHIC
TIFF OMITTED TR31DE09.058
Page 69564
GRAPHIC
TIFF OMITTED TR31DE09.059
Page 69565
GRAPHIC
TIFF OMITTED TR31DE09.060
Page 69566
GRAPHIC
TIFF OMITTED TR31DE09.061
Page 69567
GRAPHIC
TIFF OMITTED TR31DE09.062
Page 69568
GRAPHIC
TIFF OMITTED TR31DE09.063
Page 69569
GRAPHIC
TIFF OMITTED TR31DE09.064
Page 69570
GRAPHIC
TIFF OMITTED TR31DE09.065
Page 69571
GRAPHIC
TIFF OMITTED TR31DE09.066
Page 69572
GRAPHIC
TIFF OMITTED TR31DE09.067
Page 69573
GRAPHIC
TIFF OMITTED TR31DE09.068
Page 69574
GRAPHIC
TIFF OMITTED TR31DE09.069
Page 69575
GRAPHIC
TIFF OMITTED TR31DE09.070
Page 69576
GRAPHIC
TIFF OMITTED TR31DE09.071
Page 69577
GRAPHIC
TIFF OMITTED TR31DE09.072
Page 69578
GRAPHIC
TIFF OMITTED TR31DE09.073
Page 69579
GRAPHIC
TIFF OMITTED TR31DE09.074
Page 69580
GRAPHIC
TIFF OMITTED TR31DE09.075
Page 69581
GRAPHIC
TIFF OMITTED TR31DE09.076
Page 69582
GRAPHIC
TIFF OMITTED TR31DE09.077
Page 69583
GRAPHIC
TIFF OMITTED TR31DE09.078
Page 69584
GRAPHIC
TIFF OMITTED TR31DE09.079
Page 69585
GRAPHIC
TIFF OMITTED TR31DE09.080
Page 69586
GRAPHIC
TIFF OMITTED TR31DE09.081
Page 69587
GRAPHIC
TIFF OMITTED TR31DE09.082
Page 69588
GRAPHIC
TIFF OMITTED TR31DE09.083
Page 69589
GRAPHIC
TIFF OMITTED TR31DE09.084
Page 69590
GRAPHIC
TIFF OMITTED TR31DE09.085
Page 69591
GRAPHIC
TIFF OMITTED TR31DE09.086
Page 69592
GRAPHIC
TIFF OMITTED TR31DE09.087
Page 69593
GRAPHIC
TIFF OMITTED TR31DE09.088
Page 69594
GRAPHIC
TIFF OMITTED TR31DE09.089
Page 69595
GRAPHIC
TIFF OMITTED TR31DE09.090
Page 69596
GRAPHIC
TIFF OMITTED TR31DE09.091
Page 69597
GRAPHIC
TIFF OMITTED TR31DE09.092
Page 69598
GRAPHIC
TIFF OMITTED TR31DE09.093
Page 69599
GRAPHIC
TIFF OMITTED TR31DE09.094
Page 69600
GRAPHIC
TIFF OMITTED TR31DE09.095
Continued on page 69601
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
]
pp. 69601-69650
Medicare Program: Changes to the Hospital Outpatient Prospective
Payment System and CY 2010 Payment Rates; Changes to the Ambulatory
Surgical Center Payment System and CY 2010 Payment Rates
Continued from page 69600
Page 69601
GRAPHIC
TIFF OMITTED TR31DE09.096
Page 69602
GRAPHIC
TIFF OMITTED TR31DE09.097
Page 69603
GRAPHIC
TIFF OMITTED TR31DE09.098
Page 69604
GRAPHIC
TIFF OMITTED TR31DE09.099
Page 69605
GRAPHIC
TIFF OMITTED TR31DE09.100
Page 69606
GRAPHIC
TIFF OMITTED TR31DE09.101
Page 69607
GRAPHIC
TIFF OMITTED TR31DE09.102
Page 69608
GRAPHIC
TIFF OMITTED TR31DE09.103
Page 69609
GRAPHIC
TIFF OMITTED TR31DE09.104
Page 69610
GRAPHIC
TIFF OMITTED TR31DE09.105
Page 69611
GRAPHIC
TIFF OMITTED TR31DE09.106
Page 69612
GRAPHIC
TIFF OMITTED TR31DE09.107
Page 69613
GRAPHIC
TIFF OMITTED TR31DE09.108
Page 69614
GRAPHIC
TIFF OMITTED TR31DE09.109
Page 69615
GRAPHIC
TIFF OMITTED TR31DE09.110
Page 69616
GRAPHIC
TIFF OMITTED TR31DE09.111
Page 69617
GRAPHIC
TIFF OMITTED TR31DE09.112
Page 69618
GRAPHIC
TIFF OMITTED TR31DE09.113
Page 69619
GRAPHIC
TIFF OMITTED TR31DE09.114
Page 69620
GRAPHIC
TIFF OMITTED TR31DE09.115
Page 69621
GRAPHIC
TIFF OMITTED TR31DE09.116
Page 69622
GRAPHIC
TIFF OMITTED TR31DE09.117
Page 69623
GRAPHIC
TIFF OMITTED TR31DE09.118
Page 69624
GRAPHIC
TIFF OMITTED TR31DE09.119
Page 69625
GRAPHIC
TIFF OMITTED TR31DE09.120
Page 69626
GRAPHIC
TIFF OMITTED TR31DE09.121
Page 69627
GRAPHIC
TIFF OMITTED TR31DE09.122
Page 69628
GRAPHIC
TIFF OMITTED TR31DE09.123
Page 69629
GRAPHIC
TIFF OMITTED TR31DE09.124
Page 69630
GRAPHIC
TIFF OMITTED TR31DE09.125
Page 69631
GRAPHIC
TIFF OMITTED TR31DE09.126
Page 69632
GRAPHIC
TIFF OMITTED TR31DE09.127
Page 69633
GRAPHIC
TIFF OMITTED TR31DE09.128
Page 69634
GRAPHIC
TIFF OMITTED TR31DE09.129
Page 69635
GRAPHIC
TIFF OMITTED TR31DE09.130
Page 69636
GRAPHIC
TIFF OMITTED TR31DE09.131
Page 69637
GRAPHIC
TIFF OMITTED TR31DE09.132
Page 69638
GRAPHIC
TIFF OMITTED TR31DE09.133
Page 69639
GRAPHIC
TIFF OMITTED TR31DE09.134
Page 69640
GRAPHIC
TIFF OMITTED TR31DE09.135
Page 69641
GRAPHIC
TIFF OMITTED TR31DE09.136
Page 69642
GRAPHIC
TIFF OMITTED TR31DE09.137
Page 69643
GRAPHIC
TIFF OMITTED TR31DE09.138
Page 69644
GRAPHIC
TIFF OMITTED TR31DE09.139
Page 69645
GRAPHIC
TIFF OMITTED TR31DE09.140
Page 69646
GRAPHIC
TIFF OMITTED TR31DE09.141
Page 69647
GRAPHIC
TIFF OMITTED TR31DE09.142
Page 69648
GRAPHIC
TIFF OMITTED TR31DE09.143
Page 69649
GRAPHIC
TIFF OMITTED TR31DE09.144
Page 69650
GRAPHIC
TIFF OMITTED TR31DE09.145
Continued on page 69651
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
]
pp. 69651-69676
Medicare Program: Changes to the Hospital Outpatient Prospective
Payment System and CY 2010 Payment Rates; Changes to the Ambulatory
Surgical Center Payment System and CY 2010 Payment Rates
Continued from page 69650
Page 69651
GRAPHIC
TIFF OMITTED TR31DE09.146
Page 69652
GRAPHIC
TIFF OMITTED TR31DE09.147
Page 69653
GRAPHIC
TIFF OMITTED TR31DE09.148
Page 69654
GRAPHIC
TIFF OMITTED TR31DE09.149
Page 69655
GRAPHIC
TIFF OMITTED TR31DE09.150
Page 69656
GRAPHIC
TIFF OMITTED TR31DE09.151
Page 69657
GRAPHIC
TIFF OMITTED TR31DE09.152
Page 69658
GRAPHIC
TIFF OMITTED TR31DE09.153
Page 69659
GRAPHIC
TIFF OMITTED TR31DE09.154
Page 69660
GRAPHIC
TIFF OMITTED TR31DE09.155
Page 69661
GRAPHIC
TIFF OMITTED TR31DE09.156
Page 69662
GRAPHIC
TIFF OMITTED TR31DE09.157
Page 69663
GRAPHIC
TIFF OMITTED TR31DE09.158
Page 69664
GRAPHIC
TIFF OMITTED TR31DE09.159
Page 69665
GRAPHIC
TIFF OMITTED TR31DE09.160
Page 69666
GRAPHIC
TIFF OMITTED TR31DE09.161
Page 69667
GRAPHIC
TIFF OMITTED TR31DE09.162
Page 69668
GRAPHIC
TIFF OMITTED TR31DE09.163
Page 69669
GRAPHIC
TIFF OMITTED TR31DE09.164
Page 69670
GRAPHIC
TIFF OMITTED TR31DE09.165
Page 69671
GRAPHIC
TIFF OMITTED TR31DE09.166
Page 69672
GRAPHIC
TIFF OMITTED TR31DE09.167
Page 69673
GRAPHIC
TIFF OMITTED TR31DE09.168
Page 69674
GRAPHIC
TIFF OMITTED TR31DE09.169
Page 69675
GRAPHIC
TIFF OMITTED TR31DE09.170
Page 69676
FR Doc. E9-30967 Filed 12-28-09; 11:15 am
BILLING CODE 4120-01-C