[Federal Register Volume 71, Number 236 (Friday, December 8, 2006)]
[Rules and Regulations]
[Pages 71062-71072]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-9550]
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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.
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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:
I. 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.
II. Summary of Errors
A. 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.
B. 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.
III. Correction of Errors
A. 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,
a. 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.''
b. 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.''
B. 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]]
IV. 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