Medicare: Physician fee schedule (CY 2007); payment policies and relative value units Correction,
[Federal Register: December 8, 2006 (Volume 71, Number 236)]
[Rules and Regulations]
[Page 71062-71072]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr08de06-12]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 405, 410, 411, 414, 415, and 424
CMS-1321-CN RIN 0938-AN84
Medicare Program; Revisions to Payment Policies, Five-Year Review of Work Relative Value Units, and Changes to the Practice Expense Methodology Under the Physician Fee Schedule, and Other Changes to Payment Under Part B; Corrections
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Correction.
SUMMARY: This correction document corrects a limited number of technical and typographical errors in the final rule with comment period that appeared in the December 1, 2006 Federal Register (71 FR 69624). The final rule with comment period addressed Medicare Part B payment policy, including the physician fee schedule (PFS) that is applicable for calendar year (CY) 2007, finalized the CY 2006 interim relative value units (RVUs), and established interim RVUs for new and revised procedure codes for CY 2007.
EFFECTIVE DATE: This correction notice is effective January 1, 2007.
FOR FURTHER INFORMATION CONTACT: Diane Milstead, (410) 786-3355.
SUPPLEMENTARY INFORMATION:
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Background
In FR Doc. 06-9086 (71 FR 69624), the final rule with comment period entitled ``Medicare Program; Revisions to Payment Policies, Five-Year Review of Work Relative Value Units, and Changes to the Practice Expense Methodology Under the Physician Fee Schedule, and Other Changes to Payment Under Part B; Revisions to the Payment Policies of Ambulance Services Under the Fee Schedule for Ambulance Services; Ambulance Inflation Factor Update for CY 2007'' (hereinafter referred to as the CY 2007 final rule with comment period), there were technical and typographical errors that are identified and corrected in this correction notice. The provisions of this correction notice are effective January 1, 2007.
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Summary of Errors
-
Preamble
In the preamble of the CY 2007 final rule with comment period, there were a number of technical errors and omissions.
On page 69634, in step 8 of the Practice Expense (PE) methodology calculation, we erroneously stated in the parenthetical note that unadjusted work RVUs are used to calculate the service level allocators for indirect practice expenses (PEs) in this final rule.
On pages 69636 and 69637, in Table 1, ``Calculation of PE RVUs under Methodology For Selected Codes'', we found numerous errors that include amounts and row headings.
On page 69640, under the discussion titled, ``(4) Indirect PE RVUs Methodology'' in the last sentence of the first response concerning the use of budget-neutralized work RVUs, we erroneously stated that we did not use the budget-neutralized work RVUs to calculate indirect PE.
On page 69646, clarifying language was inadvertently omitted from the response.
On page 69654, in Table 6, ``Practice Expense Equipment Item Additions for CY 2007'', one of the equipment items is misspelled.
On page 69692, the word ``a'' was inadvertently omitted from a response.
On page 69694, the word ``receiving'' was erroneously omitted from a response.
On pages 69741 through 69743, in Table 15, ``AMA RUC and HCPAC recommendations and CMS' Decisions for New and Revised 2007 CPT Codes,'' the title of the last column ``2006 work RVUs'' is incorrect.
On page 69744, in Table 16, ``AMA RUC Anesthesia Recommendations and CMS Decisions for New and Revised CPT codes'', the RUC-recommended base value for CPT code 00626 is incorrect.
On page 69744, under section E. ``Discussion of Codes for Which There Were No RUC recommendations or For Which the RUC Recommendations Were Not Accepted'', we inadvertently omitted the discussion related to CPT code 15830.
On page 69747, we incorrectly stated that pricing information for an item was not provided.
On page 69760, in section B ``Anesthesia Fee Schedule Conversion Factor,'' the discussion concerning the adjustment factor in Table 32 did not address all the included adjustments. In addition, Table 32 did not reflect the additional adjustment.
On page 69768, in Table 35, a footnote was inadvertently omitted.
On page 69770, in Table 36, a footnote was inadvertently omitted.
These corrections are reflected in section III.A. of this correction notice.
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Addenda
The following errors in Addenda B and C are revised under this correction notice. These addenda will not appear in the Code of Federal Regulations.
In Addendum B, pages 69796 through 70011, we are making the following corrections:
(1) An indicator ``+'' denoting that the published RVUs are not used was omitted from the following Physicians' Current Procedural Terminology (CPT) or alphanumeric Healthcare Procedure Coding System (HCPCS) codes:
11000: 11975, 11977;
15000: 15850;
37000: 37216;
38000: 38204, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215;
43000: 43842;
58000: 58300;
61000: 61630, 61635, 61640, 61641, 61642;
72000: 72159, 72159-TC, 72159-26;
73000: 73225, 73225-TC, 73225-26;
76000: 76390, 76390-TC, 76390-26;
78000: 78350, 78350-TC, 78350-26, 78351, 78890, 78890-TC, 78890-26, 78891, 78891-TC, 78891-26;
90000: 90875, 90876, 90885, 90887, 90918, 90919, 90920, 90921, 90922, 90923, 90924, 90925;
[[Page 71063]]
92000: 92015, 92310, 92314, 92340, 92341, 92342, 92352, 92353, 92354, 92355, 92358, 92370, 92371, 92551;
93000: 93668, 93740, 93740-TC, 93740-26, 93770, 93770-TC, 93770-26;
94000: 94005, 94150, 94150-TC, 94150-26;
96000: 96040, 96155, 96902;
97000: 97010, 97014, 97810, 97811, 97813, 97814;
98000: 98943, 98960, 98961, 98962;
99000: 99091, 99173, 99339, 99340, 99358, 99359, 99360, 99363, 99364, 99374, 99375, 99377, 99378, 99379, 99380, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420;
G codes: G0122, G0122-TC, G0122-26, G0252-26, G0337.
(2) Incorrect RVUs were listed for the following CPT codes: 38207, 38210, 38211, 38212, 38213, 38214, and 38215.
(3) Incorrect practice expense RVUs were listed for the following CPT and HCPCS codes: 73223, 73323-TC, 76775, 76775-TC, 76775-26, 95060, 95065, G0389, G0389-TC, G0389-26, G0392, and G0393.
(4) Incorrect status indicators and RVUs were listed for CPT codes 93235, 93624, and 93624-TC.
In Addendum C, page 70015, an indicator ``+'' denoting that the published RVUs are not used was omitted from the following Physicians' Current Procedural Terminology (CPT) or alphanumeric Healthcare Procedure Coding System (HCPCS) codes:
90000: 94005, 96040, 99363, and 99364.
These corrections are reflected in section III.B. of this correction notice.
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-
Correction of Errors
-
Correction of Errors in the Preamble
1. On page 69634, in the 2nd column, in the 8th full paragraph, lines 11 through 13, in step 8 of the PE methodology calculation, the sentence ``In this final rule, unadjusted work RVUs are used'' is removed.
2. On pages 69636 through 69637, in Table 1: Calculation of PE RVUs under Methodology for Selected Codes, the table is corrected to read as follows: BILLING CODE 4120-01-P
[[Page 71064]]
[GRAPHIC] [TIFF OMITTED] TR08DE06.002
[[Page 71065]]
[GRAPHIC] [TIFF OMITTED] TR08DE06.003
BILLING CODE 4120-01-C
[[Page 71066]]
3. On page 69640, in the 2nd column, the 1st full paragraph, the response beginning with the phrase ``As discussed in section III.D.3. of this final rule with comment period * * *'' and ending with the phrase ``* * * budget-neutralized work RVUs to calculate indirect PE'' is corrected to read as follows:
``As discussed elsewhere in this rule, we do not believe it would be appropriate to allow the increases in work RVUs for certain services as a result of the 5-Year Review to reduce aggregate payments for PEs and professional liability under the Medicare PFS. Our final policy to use the budget-neutralized work RVUs in the calculation of indirect PEs appropriately maintains the current relationships between the work, PE, and professional liability (malpractice insurance expense) components of the PFS. We also believe it is important to apply the revised, budget-neutralized work RVUs consistently within the PFS framework. It would not be consistent to apply one set of work RVUs for work payments, but a different set for purposes of calculating indirect PEs. Therefore, we will base the calculation of both the work payments and the indirect PEs on the revised, budget-neutralized work RVUs adopted as part of this final rule, and maintain the overall current relationships between work, PE, and professional liability. The PE RVUs in Addendum B and throughout the rest of this rule reflect this policy.''
4. On page 69646, in the 2nd column, the 4th full paragraph, the response ``We will implement these changes for CY 2007'' is corrected to read as follows: ``We are implementing these changes for CY 2007. Because we are implementing the bottom-up methodology, which utilizes the direct inputs to determine the PE RVUs for CY 2007, a separate payment for the contrast media used in various imaging procedures will be available. In addition to the CPT code representing the imaging procedure, providers are instructed to use the appropriate HCPCS Q- code, Q9942 through Q9964, to separately bill for the contrast medium utilized in performing the service.''
5. On page 69654, in Table 6, Practice Expense Equipment Item Additions for CY 2007, column 2, line 16, the word ``Acerine'' is corrected to read ``Aerocrine.''
6. On page 69692, in the 3rd column, 1st paragraph, line 10, the phrase ``verified in large trial'' is corrected to read as ``verified in a large trial.''
7. On page 69694, in the 3rd column, 3rd paragraph, lines 8 through 9, the phrase ``may also be FDA-approved'' is corrected to read ``may also be receiving FDA-approved.''
8. On pages 69741 through 69743, in Table 15, ``AMA RUC and HCPAC recommendations and CMS'' Decisions for New and Revised 2007 CPT Codes'', last column, the column heading, ``2006 work RVU'' is corrected to read ``2007 work RVU''.
9. On page 69744, in Table 16: AMA RUC Anesthesia Recommendations and CMS Decisions for New and Revised CPT Codes, column 3 (RUC- recommendation), line 2 (CPT code 00626), the value ``13.00'' is corrected to read ``15.00.''
10. On page 69744, in the 1st column, after the 2nd full paragraph following the table, after the sentence ``This summary refers only to work RVUs'' and before the sentence beginning ``For CPT code 22857 * * * '' the following paragraph is added to read as follows:
``For CPT code 15830, Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy, the RUC recommended 15.60 work RVUs. We reviewed the summary of recommendations for an add-on procedure to CPT code 15830, CPT code 15847, Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen (eg, abdominoplasty) (includes umbilical transposition and fascial pilcation (List separately in addition to code for primary procedure), in which the RUC and the specialty society recommended that this code be carrier-priced to reduce the potential for abuse. In order to reduce the potential for abuse, we believe that, payment for CPT code 15830 should be similarly restricted and medical necessity should be established prior to payment. Therefore, we have assigned a status indicator of ``R'' (Restricted) to this code.''
11. On page 69747, in the 3rd column, 1st paragraph, lines 2 through 5, the sentence ``We were not able to include a price for the pedigree software equipment as it was not provided with the PE inputs'' is corrected to read as ``We included a price of $950 for the pedigree software desktop version as the typical equipment used in a physician office.''
12. On page 69760,
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In the 3rd column, 1st full paragraph, lines 10 through 12, the sentence ``The adjustment factor in Table 32 includes the combined effect of the PE adjustment and the BN adjustment'' is corrected to read ``The adjustment factor in Table 32 includes the combined effect of the PE adjustment, the BN adjustment and the adjustment to anesthesia work to account for the increase in the work of the E/M codes.''
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In the 3rd column, Table 32 is corrected as follows:
Table 32
2006 Anesthesia Conversion Factor........ $17.7663 2007 Update.............................. -5.0 percent (0.94953) 2007 Combined Adjustment PE and BN....... 0.9110 2007 Anesthesia Conversion Factor........ $15.3682
13. On page 69768, Table 35 is corrected by adding a footnote to read as follows:
``**Components may not sum due to rounding error.''
14. On page 69770, Table 36 is corrected by adding a footnote to read as follows:
``Note: When applying the 0.8994 work adjuster to the work relative values printed in Addendum B, you must round the product to two decimal places.''
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Addenda
1. On pages 69796 through 70011, in Addendum B: Relative Value Units (RVUs) And Related Information the following entries are corrected to read as follows:
[[Page 71067]]
Addendum B.--Relative Value Units (RVUs) and Related Information--Corrections
Fully
Fully Physician implemented Year 2007 Fully Year 2007
implemented Year 2007 Fully Year 2007 CPT \1\/ Mod Status Description work RVUs non- transitional implemented transitional Malpractice non- transitional implemented transitional Global HCPCS \2\
\3\ facility PE non-facility facility PE facility PE RVUs facility non-facility facility facility RVUs
PE RVUs
RVUs
RVUs
total
total
total
total
11975....... ........ N
Insert
1.48+
1.52
1.45
0.34
0.51
0.17
3.17
3.10
1.99
2.16 XXX contraceptive cap. 11977....... ........ N
Removal/reinsert 3.30+
1.97
2.20
0.76
1.14
0.37
5.64
5.87
4.43
4.81 XXX contra cap. 15850....... ........ B
Removal of
0.78+
1.19
1.47
0.18
0.27
0.05
2.02
2.30
1.01
1.10 XXX sutures. 37216....... ........ N
Transcath stent, 18.85+
NA
NA
5.75
8.05
1.04
NA
NA
25.64
27.94 090 cca w/o eps. 38204....... ........ B
Bl donor search 2.00+
0.91
0.91
0.91
0.91
0.06
2.97
2.97
2.97
2.97 XXX management. 38207....... ........ I
Cryopreserve
0.89+
0.41
0.41
0.41
0.41
0.01
1.31
1.31
1.31
1.31 XXX stem cells. 38208....... ........ I
Thaw preserved
0.56+
0.25
0.25
0.25
0.25
0.02
0.83
0.83
0.83
0.83 XXX stem cells. 38209....... ........ I
Wash harvest
0.24+
0.11
0.11
0.11
0.11
0.01
0.36
0.36
0.36
0.36 XXX stem cells. 38210....... ........ I
T-cell depletion 1.57+
0.72
0.72
0.72
0.72
0.03
2.32
2.32
2.32
2.32 XXX of harvest. 38211....... ........ I
Tumor cell
1.42+
0.65
0.65
0.65
0.65
0.02
2.09
2.09
2.09
2.09 XXX deplete of harvst. 38212....... ........ I
Rbc depletion of 0.94+
0.43
0.43
0.43
0.43
0.02
1.39
1.39
1.39
1.39 XXX harvest. 38213....... ........ I
Platelet deplete 0.24+
0.11
0.11
0.11
0.11
0.01
0.36
0.36
0.36
0.36 XXX of harvest. 38214....... ........ I
Volume deplete
0.81+
0.37
0.37
0.37
0.37
0.01
1.19
1.19
1.19
1.19 XXX of harvest. 38215....... ........ I
Harvest stem
0.94+
0.43
0.43
0.43
0.43
0.02
1.39
1.39
1.39
1.39 XXX cell concentrte. 43842....... ........ N
V-band
20.90+
NA
NA
6.75
7.53
2.45
NA
NA
30.10
30.88 090 gastroplasty. 58300....... ........ N
Insert
1.01+
0.62
1.22
0.23
0.34
0.12
1.75
2.35
1.36
1.47 XXX intrauterine device. 61630....... ........ N
Intracranial
22.07+
NA
NA
6.44
10.98
2.02
NA
NA
30.53
35.07 090 angioplasty. 61635....... ........ N
Intracran
24.28+
NA
NA
6.95
11.89
2.21
NA
NA
33.44
38.38 090 angioplsty w/ stent. 61640....... ........ N
Dilate ic
12.32+
NA
NA
2.85
2.85
0.71
NA
NA
15.88
15.88 000 vasospasm, init. 61641....... ........ N
Dilate ic
4.33+
NA
NA
1.00
1.00
0.25
NA
NA
5.58
5.58 ZZZ vasospasm add- on. 61642....... ........ N
Dilate ic
8.66+
NA
NA
2.00
2.00
0.50
NA
NA
11.16
11.16 ZZZ vasospasm add- on. 72159....... ........ N
Mr angio spine w/ 1.80+ 14.49
13.31
NA
NA
0.74
17.03
15.85
NA
NA XXX o&w/dye. 72159....... TC...... N
Mr angio spine w/ 0.00+ 14.07
12.69
NA
NA
0.64
14.71
13.33
NA
NA XXX o&w/dye. 72159....... 26...... N
Mr angio spine w/ 1.80+
0.42
0.62
0.42
0.62
0.10
2.32
2.52
2.32
2.52 XXX o&w/dye. 73223....... ........ A
Mri joint upr
2.15 16.74
23.38
NA
NA
0.94
19.83
26.47
NA
NA XXX extr w/o&w/dye. 73223....... 26...... A
Mri joint upr
2.15
0.61
0.69
0.61
0.69
0.10
2.86
2.94
2.86
2.94 XXX extr w/o&w/dye. 73225....... ........ N
Mr angio upr
1.73+ 14.47
12.38
NA
NA
0.69
16.89
14.80
NA
NA XXX extr w/o&w/dye. 73225....... TC...... N
Mr angio upr
0.00+ 14.07
11.78
NA
NA
0.59
14.66
12.37
NA
NA XXX extr w/o&w/dye. 73225....... 26...... N
Mr angio upr
1.73+
0.40
0.60
0.40
0.60
0.10
2.23
2.43
2.23
2.43 XXX extr w/o&w/dye. 76390....... ........ N
Mr spectroscopy. 1.40+
9.31
10.94
NA
NA
0.66
11.37
13.00
NA
NA XXX 76390....... TC...... N
Mr spectroscopy. 0.00+
8.99
10.51
NA
NA
0.59
9.58
11.10
NA
NA XXX 76390....... 26...... N
Mr spectroscopy. 1.40+
0.32
0.43
0.32
0.43
0.07
1.79
1.90
1.79
1.90 XXX 76775....... ........ A
Us exam abdo
0.58
2.23
1.77
NA
NA
0.11
2.92
2.46
NA
NA XXX back wall, lim. 76775....... TC...... A
Us exam abdo
0.00
2.06
1.58
NA
NA
0.08
2.14
1.66
NA
NA XXX back wall, lim. 76775....... 26...... A
Us exam abdo
0.58
0.17
0.19
0.17
0.19
0.03
0.78
0.80
0.78
0.80 XXX back wall, lim. 78350....... ........ N
Bone mineral,
0.22+
0.00
0.82
NA
NA
0.06
0.28
1.10
NA
NA XXX single photon. 78350....... TC...... N
Bone mineral,
0.00+
0.00
0.75
NA
NA
0.05
0.05
0.80
NA
NA XXX single photon. 78350....... 26...... N
Bone mineral,
0.22+
0.00
0.07
0.00
0.07
0.01
0.23
0.30
0.23
0.30 XXX single photon. 78351....... ........ N
Bone mineral,
0.30+
NA
NA
0.07
0.11
0.01
NA
NA
0.38
0.42 XXX dual photon. 78890....... ........ B
Nuclear medicine 0.05+
0.38
1.10
NA
NA
0.07
0.50
1.22
NA
NA XXX data proc. 78890....... TC...... B
Nuclear medicine 0.00+
0.37
1.08
NA
NA
0.06
0.43
1.14
NA
NA XXX data proc. 78890....... 26...... B
Nuclear medicine 0.05+
0.01
0.02
0.01
0.02
0.01
0.07
0.08
0.07
0.08 XXX data proc. 78891....... ........ B
Nuclear med data 0.10+
0.86
2.22
NA
NA
0.14
1.10
2.46
NA
NA XXX proc. 78891....... TC...... B
Nuclear med data 0.00+
0.84
2.18
NA
NA
0.13
0.97
2.31
NA
NA XXX proc. 78891....... 26...... B
Nuclear med data 0.10+
0.02
0.04
0.02
0.04
0.01
0.13
0.15
0.13
0.15 XXX proc. 90875....... ........ N
Psychophysiologi 1.20+
0.52
0.81
0.28
0.42
0.04
1.76
2.05
1.52
1.66 XXX cal therapy. 90876....... ........ N
Psychophysiologi 1.90+
0.67
1.04
0.44
0.66
0.05
2.62
2.99
2.39
2.61 XXX cal therapy. 90885....... ........ B
Psy evaluation
0.97+
0.22
0.33
0.22
0.33
0.02
1.21
1.32
1.21
1.32 XXX of records. 90887....... ........ B
Consultation
1.48+
0.61
0.77
0.34
0.51
0.04
2.13
2.29
1.86
2.03 XXX with family. 90918....... ........ I
ESRD related
11.16+
4.68
5.75
3.74
5.52
0.36
16.20
17.27
15.26
17.04 XXX services, month. 90919....... ........ I
ESRD related
8.53+
3.02
3.76
2.55
3.64
0.29
11.84
12.58
11.37
12.46 XXX services, month. 90920....... ........ I
ESRD related
7.26+
2.73
3.50
2.27
3.38
0.23
10.22
10.99
9.76
10.87 XXX services, month. 90921....... ........ I
ESRD related
4.46+
1.70
2.26
1.61
2.23
0.14
6.30
6.86
6.21
6.83 XXX services, month. 90922....... ........ I
ESRD related
0.37+
0.16
0.20
0.12
0.19
0.01
0.54
0.58
0.50
0.57 XXX services, day. 90923....... ........ I
Esrd related
0.28+
0.10
0.12
0.08
0.12
0.01
0.39
0.41
0.37
0.41 XXX services, day. 90924....... ........ I
Esrd related
0.24+
0.09
0.11
0.08
0.11
0.01
0.34
0.36
0.33
0.36 XXX services, day.
[[Page 71068]]
90925....... ........ I
Esrd related
0.15+
0.05
0.07
0.05
0.07
0.01
0.21
0.23
0.21
0.23 XXX services, day. 92015....... ........ N
Refraction...... 0.38+
0.10
1.14
0.09
0.14
0.01
0.49
1.53
0.48
0.53 XXX 92310....... ........ N
Contact lens
1.17+
1.05
1.10
0.27
0.41
0.04
2.26
2.31
1.48
1.62 XXX fitting. 92314....... ........ N
Prescription of 0.69+
1.13
0.99
0.16
0.24
0.01
1.83
1.69
0.86
0.94 XXX contact lens. 92340....... ........ N
Fitting of
0.37+
0.44
0.64
0.08
0.13
0.01
0.82
1.02
0.46
0.51 XXX spectacles. 92341....... ........ N
Fitting of
0.47+
0.46
0.67
0.11
0.16
0.01
0.94
1.15
0.59
0.64 XXX spectacles. 92342....... ........ N
Fitting of
0.53+
0.48
0.69
0.12
0.19
0.01
1.02
1.23
0.66
0.73 XXX spectacles. 92352....... ........ B
Special
0.37+
0.56
0.65
0.08
0.13
0.01
0.94
1.03
0.46
0.51 XXX spectacles fitting. 92353....... ........ B
Special
0.50+
0.59
0.70
0.12
0.17
0.02
1.11
1.22
0.64
0.69 XXX spectacles fitting. 92354....... ........ B
Special
0.00+
0.28
6.72
NA
NA
0.10
0.38
6.82
NA
NA XXX spectacles fitting. 92355....... ........ B
Special
0.00+
0.44
3.36
NA
NA
0.01
0.45
3.37
NA
NA XXX spectacles fitting. 92358....... ........ B
Eye prosthesis
0.00+
0.23
0.79
NA
NA
0.05
0.28
0.84
NA
NA XXX service. 92370....... ........ N
Repair & adjust 0.32+
0.39
0.51
0.07
0.12
0.02
0.73
0.85
0.41
0.46 XXX spectacles. 92371....... ........ B
Repair & adjust 0.00+
0.24
0.53
NA
NA
0.02
0.26
0.55
NA
NA XXX spectacles. 92551....... ........ N
Pure tone
0.00+
0.25
0.25
NA
NA
0.01
0.26
0.26
NA
NA XXX hearing test, air. 93235....... ........ C
ECG monitor/
0.00
0.00
0.00
NA
NA
0.00
0.00
0.00
NA
NA XXX report, 24 hrs. 93624....... ........ C
Electrophysiolog 0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00 000 ic evaluation. 93624....... TC...... C
Electrophysiolog 0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00 000 ic evaluation. 93668....... ........ N
Peripheral
0.00+
0.40
0.40
NA
NA
0.01
0.41
0.41
NA
NA XXX vascular rehab. 93740....... ........ B
Temperature
0.16+
0.04
0.15
NA
NA
0.02
0.22
0.33
NA
NA XXX gradient studies. 93740....... TC...... B
Temperature
0.00+
0.00
0.11
NA
NA
0.01
0.01
0.12
NA
NA XXX gradient studies. 93740....... 26...... B
Temperature
0.16+
0.04
0.04
0.04
0.04
0.01
0.21
0.21
0.21
0.21 XXX gradient studies. 93770....... ........ B
Measure venous
0.16+
0.04
0.07
NA
NA
0.02
0.22
0.25
NA
NA XXX pressure. 93770....... TC...... B
Measure venous
0.00+
0.00
0.02
NA
NA
0.01
0.01
0.03
NA
NA XXX pressure. 93770....... 26...... B
Measure venous
0.16+
0.04
0.05
0.04
0.05
0.01
0.21
0.22
0.21
0.22 XXX pressure. 94005....... ........ B
Home vent mgmt
1.50+
0.69
0.69
NA
NA
0.06
2.25
2.25
NA
NA XXX supervision. 94150....... ........ B
Vital capacity
0.07+
0.48
0.48
NA
NA
0.02
0.57
0.57
NA
NA XXX test. 94150....... TC...... B
Vital capacity
0.00+
0.46
0.45
NA
NA
0.01
0.47
0.46
NA
NA XXX test. 94150....... 26...... B
Vital capacity
0.07+
0.02
0.03
0.02
0.03
0.01
0.10
0.11
0.10
0.11 XXX test. 95060....... ........ A
Eye allergy
0.00
0.72
0.44
0.72
0.44
0.02
0.74
0.46
0.74
0.46 XXX tests. 95065....... ........ A
Nose allergy
0.00
0.65
0.31
0.65
0.31
0.01
0.66
0.32
0.66
0.32 XXX test. 96040....... ........ B
Genetic
0.00+
0.97
0.97
NA
NA
0.01
0.98
0.98
NA
NA XXX counseling, 30 min. 96155....... ........ N
Interv hlth/
0.44+
0.10
0.16
0.10
0.15
0.02
0.56
0.62
0.56
0.61 XXX behav fam no pt. 96902....... ........ B
Trichogram...... 0.41+
0.11
0.16
0.10
0.15
0.01
0.53
0.58
0.52
0.57 XXX 97010....... ........ B
Hot or cold
0.06+
0.07
0.06
NA
NA
0.01
0.14
0.13
NA
NA XXX packs therapy. 97014....... ........ I
Electric
0.18+
0.18
0.19
NA
NA
0.01
0.37
0.38
NA
NA XXX stimulation therapy. 97810....... ........ N
Acupunct w/o
0.60+
0.26
0.35
0.14
0.21
0.03
0.89
0.98
0.77
0.84 XXX stimul 15 min. 97811....... ........ N
Acupunct w/o
0.50+
0.15
0.23
0.12
0.17
0.03
0.68
0.76
0.65
0.70 ZZZ stimul addl 15m. 97813....... ........ N
Acupunct w/
0.65+
0.27
0.37
0.15
0.23
0.03
0.95
1.05
0.83
0.91 XXX stimul 15 min. 97814....... ........ N
Acupunct w/
0.55+
0.19
0.27
0.13
0.19
0.03
0.77
0.85
0.71
0.77 ZZZ stimul addl 15m. 98943....... ........ N
Chiropractic
0.40+
0.17
0.22
0.09
0.14
0.01
0.58
0.63
0.50
0.55 XXX manipulation. 98960....... ........ B
Self-mgmt educ & 0.00+
0.48
0.48
0.00
0.00
0.01
0.49
0.49
0.01
0.01 XXX train, 1 pt. 98961....... ........ B
Self-mgmt educ/ 0.00+
0.23
0.23
0.00
0.00
0.01
0.24
0.24
0.01
0.01 XXX train, 2-4 pt. 98962....... ........ B
Self-mgmt educ/ 0.00+
0.17
0.17
0.00
0.00
0.01
0.18
0.18
0.01
0.01 XXX train, 5-8 pt. 99091....... ........ B
Collect/review
1.10+
0.25
0.25
NA
NA
0.04
1.39
1.39
NA
NA XXX data from pt. 99173....... ........ N
Visual acuity
0.00+
0.06
0.06
NA
NA
0.01
0.07
0.07
NA
NA XXX screen. 99339....... ........ B
Domicil/r-home
1.25+
0.58
0.58
NA
NA
0.06
1.89
1.89
NA
NA XXX care supervis. 99340....... ........ B
Domicil/r-home
1.80+
0.76
0.76
NA
NA
0.07
2.63
2.63
NA
NA XXX care supervis. 99358....... ........ B
Prolonged serv, 2.10+
0.51
0.51
0.51
0.51
0.09
2.70
2.70
2.70
2.70 ZZZ w/o contact. 99359....... ........ B
Prolonged serv, 1.00+
0.26
0.26
0.26
0.26
0.04
1.30
1.30
1.30
1.30 ZZZ w/o contact. 99360....... ........ X
Physician
1.20+
0.00
0.00
0.00
0.00
0.05
1.25
1.25
1.25
1.25 XXX standby services. 99363....... ........ B
Anticoag mgmt,
1.65+
1.29
1.29
0.38
0.38
0.07
3.01
3.01
2.10
2.10 XXX init. 99364....... ........ B
Anticoag mgmt,
0.63+
0.38
0.38
0.15
0.15
0.04
1.05
1.05
0.82
0.82 XXX subseq. 99374....... ........ B
Home health care 1.10+
0.54
0.66
0.25
0.38
0.05
1.69
1.81
1.40
1.53 XXX supervision. 99375....... ........ I
Home health care 1.73+
0.75
1.35
0.40
1.26
0.07
2.55
3.15
2.20
3.06 XXX supervision. 99377....... ........ B
Hospice care
1.10+
0.54
0.66
0.25
0.38
0.05
1.69
1.81
1.40
1.53 XXX supervision.
[[Page 71069]]
99378....... ........ I
Hospice care
1.73+
0.75
1.64
0.40
1.56
0.07
2.55
3.44
2.20
3.36 XXX supervision. 99379....... ........ B
Nursing fac care 1.10+
0.54
0.66
0.25
0.38
0.04
1.68
1.80
1.39
1.52 XXX supervision. 99380....... ........ B
Nursing fac care 1.73+
0.75
0.93
0.40
0.60
0.06
2.54
2.72
2.19
2.39 XXX supervision. 99381....... ........ N
Init pm e/m, new 1.19+
0.99
1.37
0.27
0.41
0.05
2.23
2.61
1.51
1.65 XXX pat, inf. 99382....... ........ N
Init pm e/m, new 1.36+
1.03
1.41
0.31
0.47
0.05
2.44
2.82
1.72
1.88 XXX pat 1-4 yrs. 99383....... ........ N
Prev visit, new, 1.36+
1.02
1.37
0.31
0.47
0.05
2.43
2.78
1.72
1.88 XXX age 5-11. 99384....... ........ N
Prev visit, new, 1.53+
1.06
1.43
0.35
0.53
0.06
2.65
3.02
1.94
2.12 XXX age 12-17. 99385....... ........ N
Prev visit, new, 1.53+
1.06
1.43
0.35
0.53
0.06
2.65
3.02
1.94
2.12 XXX age 18-39. 99386....... ........ N
Prev visit, new, 1.88+
1.14
1.59
0.43
0.65
0.07
3.09
3.54
2.38
2.60 XXX age 40-64. 99387....... ........ N
Init pm e/m, new 2.06+
1.27
1.72
0.48
0.71
0.07
3.40
3.85
2.61
2.84 XXX pat 65+ yrs. 99391....... ........ N
Per pm reeval,
1.02+
0.86
0.98
0.24
0.35
0.04
1.92
2.04
1.30
1.41 XXX est pat, inf. 99392....... ........ N
Prev visit, est, 1.19+
0.89
1.04
0.27
0.41
0.05
2.13
2.28
1.51
1.65 XXX age 1-4. 99393....... ........ N
Prev visit, est, 1.19+
0.89
1.02
0.27
0.41
0.05
2.13
2.26
1.51
1.65 XXX age 5-11. 99394....... ........ N
Prev visit, est, 1.36+
0.93
1.08
0.31
0.47
0.05
2.34
2.49
1.72
1.88 XXX age 12-17. 99395....... ........ N
Prev visit, est, 1.36+
0.93
1.10
0.31
0.47
0.05
2.34
2.51
1.72
1.88 XXX age 18-39. 99396....... ........ N
Prev visit, est, 1.53+
0.97
1.18
0.35
0.53
0.06
2.56
2.77
1.94
2.12 XXX age 40-64. 99397....... ........ N
Per pm reeval
1.71+
1.11
1.30
0.40
0.60
0.06
2.88
3.07
2.17
2.37 XXX est pat 65+ yr. 99401....... ........ N
Preventive
0.48+
0.36
0.56
0.11
0.17
0.01
0.85
1.05
0.60
0.66 XXX counseling, indiv. 99402....... ........ N
Preventive
0.98+
0.47
0.77
0.23
0.34
0.02
1.47
1.77
1.23
1.34 XXX counseling, indiv. 99403....... ........ N
Preventive
1.46+
0.58
0.96
0.34
0.51
0.04
2.08
2.46
1.84
2.01 XXX counseling, indiv. 99404....... ........ N
Preventive
1.95+
0.70
1.17
0.45
0.68
0.05
2.70
3.17
2.45
2.68 XXX counseling, indiv. 99411....... ........ N
Preventive
0.15+
0.22
0.19
0.03
0.05
0.01
0.38
0.35
0.19
0.21 XXX counseling, group. 99412....... ........ N
Preventive
0.25+
0.24
0.25
0.06
0.09
0.01
0.50
0.51
0.32
0.35 XXX counseling, group. 99420....... ........ N
Health risk
0.00+
0.22
0.22
NA
NA
0.01
0.23
0.23
NA
NA XXX assessment test. G0122....... ........ N
Colon ca scrn;
0.99+
5.58
3.32
NA
NA
0.18
6.75
4.49
NA
NA XXX barium enema. G0122....... TC...... N
Colon ca scrn;
0.00+
5.35
2.98
NA
NA
0.13
5.48
3.11
NA
NA XXX barium enema. G0122....... 26...... N
Colon ca scrn;
0.99+
0.23
0.34
0.23
0.34
0.05
1.27
1.38
1.27
1.38 XXX barium enema. G0252....... 26...... N
PET imaging
1.50+
0.00
0.60
0.00
0.60
0.04
1.54
2.14
1.54
2.14 XXX initial dx. G0337....... ........ X
Hospice
1.34+
0.31
0.46
0.31
0.46
0.09
1.74
1.89
1.74
1.89 XXX evaluation preelecti. G0389....... ........ A
Ultrasound exam
0.58
2.23
1.77
NA
NA
0.11
2.92
2.46
NA
NA XXX AAA screen. G0389....... TC...... A
Ultrasound exam
0.00
2.06
1.58
NA
NA
0.08
2.14
1.66
NA
NA XXX AAA screen. G0389....... 26...... A
Ultrasound exam
0.58
0.17
0.19
0.17
0.19
0.03
0.78
0.80
0.78
0.80 XXX AAA screen. G0392....... ........ A
AV fistula or
9.48 47.48
53.95
3.25
3.48
0.62
57.58
64.05
13.35
13.58 000 graft arterial. G0393....... ........ A
AV fistula or
6.03 35.61
42.45
1.97
2.26
0.34
41.98
48.82
8.34
8.63 000 graft venous.
\1\ CPT codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. \2\ Copyright 2006 American Dental Association. All rights reserved. \3\ + Indicates RVUs are not used for Medicare payment.
[[Page 71070]]
0 2. On page 70015, in Addendum C: Codes with Interim RVUs the following entries are corrected to read as follows:
[[Page 71071]]
Addendum C.-- Codes With Interim RVUs--Corrections
Fully
Fully Physician implemented Year 2007 Fully Year 2007
implemented Year 2007 Fully Year 2007 CPT \1\/ Mod Status Description work
non- transitional implemented transitional Malpractice non- transitional implemented transitional Global HCPCS \2\
RVUs\3\ facility PE non-facility facility PE facility PE RVUs facility non-facility facility facility RVUs
PE RVUs
RVUs
RVUs
total
total
total
total
94005...... ....... B
Home vent mgmt 1.50+
0.69
0.69
NA
NA
0.06
2.25
2.25
NA
NA
XXX supervision. 96040...... ....... B
Genetic
0.00+
0.97
0.97
NA
NA
0.01
0.98
0.98
NA
NA
XXX counseling, 30 min. 99363...... ....... B
Anticoag mgmt, 1.65+
1.29
1.29
0.38
0.38
0.07
3.01
3.01
2.10
2.10
XXX init. 99364...... ....... B
Anticoag mgmt, 0.63+
0.38
0.38
0.15
0.15
0.04
1.05
1.05
0.82
0.82
XXX subseq.
\1\ CPT codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. \2\ Copyright 2006 American Dental Association. All rights reserved. \3\ + Indicates RVUs are not used for Medicare payment.
[[Page 71072]]
-
-
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 rule take effect in accordance with section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive the notice and comment procedures if the Secretary finds, for good cause, that the notice and comment process is impracticable, unnecessary or contrary to the public interest, and incorporates a statement of the finding and the reasons therefore in the rule.
Section 553(d) for the APA ordinarily requires a 30-day delay in effective date of final rules after the date of their publication. This 30-day delay in effective date can be waived, however, if an agency finds for good cause that the delay is impracticable, unnecessary, or contrary to the public interest, and the agency incorporates a statement of the findings and its reasons in the rule issued.
This correction notice addresses technical errors and omissions made in FR Doc. 06-9086, entitled ``Medicare Program; Revisions to Payment Policies, Five-Year Review of Work Relative Value Units, and changes to the Practice Expense Methodology Under the Physician Fee Schedule, and Other Changes to Payment Under Part B; Revisions to the Payment Policies of Ambulance Services Under the Fee Schedule for Ambulance Services; Ambulance Inflation Factor Update for CY 2007,'' which appeared in the December 1, 2006 Federal Register (71 FR 69624), and is effective January 1, 2007. The provisions of this final rule with comment period have been previously subjected to notice and comment procedures. These corrections are consistent with the discussion and text of the final rule with comment period, and do not make substantive changes to the CY 2007 published rule. As such, this correction notice is intended to ensure the CY 2007 final rule with comment period accurately reflects the policies adopted in that rule. Therefore, we find that undertaking further notice and comment procedures to incorporate these corrections into the final rule with comment is unnecessary and contrary to the public interest.
For the same reasons, we are also waiving the 30-day delay in effective date for this correction notice. We believe that it is in the public interest to ensure that the CY 2007 final rule with comment period accurately states our policies relating to the PFS and other Part B payment policies. Therefore, delaying the effective date of these corrections beyond the January 1, 2007 effective date of the final rule with comment period would be contrary to the public interest. In so doing, we find good cause to waive the 30-day delay in the effective date.
(Catalog of Federal Domestic Assistance Program No. 93.774, Medicare--Supplementary Medical Insurance Program)
Dated: November 30, 2006. Ann C. Agnew, Executive Secretary to the Department.
[FR Doc. 06-9550 Filed 12-4-06; 9:46 am]
BILLING CODE 4120-01-M
