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CMS-1503-FC 24 ADDENDUM D--FINAL 2011 GEOGRAPHIC ADJUSTMENT FACTORS (GAFS) ADDENDUM E--FINAL 2011****GEOGRAPHIC PRACTICE COST INDICIES (GPCIS) BY STATE AND MEDICARE LOCALITY ADDENDUM F--CY 2011 DIAGNOSTIC IMAGING SERVICES SUBJECT TO THE MULTIPLE PROCEDURE PAYMENT REDUCTION ADDENDUM G--CPT/HCPCS IMAGING CODES DEFINED BY SECTION 5102(B) OF THE DRA ADDENDUM H--CY 2011 "ALWAYS THERAPY" SERVICES* SUBJECT TO THE MULTIPLE PROCEDURE PAYMENT REDUCTION ADDENDUM I--[RESERVED] ADDENDUM J--LIST OF CPT1/HCPCS CODES USED TO DEFINE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT EFFECTIVE JANUARY 1, 2011 ADDENDUM K--CY 2011 ESRD WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS ADDENDUM L-- CY 2011 WAGE INDEX FOR RURAL AREAS BASED ON CBSA LABOR MARKET AREAS Acronyms In addition, because of the many organizations and terms to which we refer by acronym in this proposed rule, we are listing these acronyms and their corresponding terms in alphabetical order below: AA Anesthesiologist assistant AACVPR American Association of Cardiovascular and Pulmonary Rehabilitation AANA American Association of Nurse Anesthetists ABMS American Board of Medical Specialties ABN Advanced Beneficiary Notice ACA "Affordable Care Act"
CMS-1503-FC 25 ACC American College of Cardiology ACGME Accreditation Council on Graduate Medical Education ACLS Advanced cardiac life support ACP American College of Physicians ACR American College of Radiology ACS American Community Survey AED Automated external defibrillator AFROC Association of Freestanding Radiation Oncology Centers AFS Ambulance Fee Schedule AHA American Heart Association AHFS-DI American Hospital Formulary Service-Drug Information AHRQ [HHS] Agency for Healthcare Research and Quality AMA American Medical Association AMA-DE American Medical Association Drug Evaluations AACE American Association of Clinical Endocrinologists AADE American Association of Diabetes Educators AMP Average manufacturer price AO Accreditation organization AOA American Osteopathic Association APA American Psychological Association APC Administrative Procedures Act APTA American Physical Therapy Association ARRA American Recovery and Reinvestment Act (Pub. L. 111-5)
Page 1 and 2: DEPARTMENT OF HEALTH AND HUMAN SERV
Page 3 and 4: CMS-1503-FC 3 Centers for Medicare
Page 5 and 6: CMS-1503-FC 5 Elizabeth Truong, (41
Page 7 and 8: CMS-1503-FC 7 (1) The interim final
Page 9 and 10: CMS-1503-FC 9 Inputs (7) Equipment
Page 11 and 12: CMS-1503-FC 11 6. Medicare Economic
Page 13 and 14: CMS-1503-FC 13 6. Neuropsychologica
Page 15 and 16: CMS-1503-FC 15 (3) Equipment Time f
Page 17 and 18: CMS-1503-FC 17 2. Section 5501(b):
Page 19 and 20: CMS-1503-FC 19 Products (2) Final R
Page 21 and 22: CMS-1503-FC 21 a. Legislative and R
Page 23: CMS-1503-FC 23 17. Section 4103: Me
Page 27 and 28: CMS-1503-FC 27 CBP Competitive Bidd
Page 29 and 30: CMS-1503-FC 29 E/M Evaluation and m
Page 31 and 32: CMS-1503-FC 31 HITECH Health Inform
Page 33 and 34: CMS-1503-FC 33 MIEA-TRHCA Medicare
Page 35 and 36: CMS-1503-FC 35 PACE Program of All-
Page 37 and 38: CMS-1503-FC 37 RVRBS Resource-Based
Page 39 and 40: CMS-1503-FC 39 rule with comment pe
Page 41 and 42: CMS-1503-FC 41 This resource-based
Page 43 and 44: CMS-1503-FC 43 premium data collect
Page 45 and 46: CMS-1503-FC 45 CY 2011 PFS proposed
Page 47 and 48: CMS-1503-FC 47 appropriately reflec
Page 49 and 50: CMS-1503-FC 49 appropriate payment
Page 51 and 52: CMS-1503-FC 51 highest level initia
Page 53 and 54: CMS-1503-FC 53 PFS update of -21.2
Page 55 and 56: CMS-1503-FC 55 final rule with comm
Page 57 and 58: CMS-1503-FC 57 period (74 FR 61743
Page 59 and 60: CMS-1503-FC 59 Practice Expense Inf
Page 61 and 62: CMS-1503-FC 61 the PPIS data. In th
Page 63 and 64: CMS-1503-FC 63 implemented PFS amou
Page 65 and 66: CMS-1503-FC 65 the service to deter
Page 67 and 68: CMS-1503-FC 67 f. Alternative Data
Page 69 and 70: CMS-1503-FC 69 used in the allocati
Page 71 and 72: CMS-1503-FC 71 develop further idea
Page 73 and 74: CMS-1503-FC 73 Step 8: Calculate th
Page 75 and 76:
CMS-1503-FC 75 physician time for t
Page 77 and 78:
CMS-1503-FC 77 specialties, from th
Page 79 and 80:
CMS-1503-FC 79 minutes per year = m
Page 81 and 82:
CMS-1503-FC 81 Step Source Formula
Page 83 and 84:
CMS-1503-FC 83 expensive diagnostic
Page 85 and 86:
CMS-1503-FC 85 assumption will be a
Page 87 and 88:
CMS-1503-FC 87 3135(a) of the ACA),
Page 89 and 90:
CMS-1503-FC 89 rate assumption appl
Page 91 and 92:
CMS-1503-FC 91 CPT Code Short Descr
Page 93 and 94:
CMS-1503-FC 93 supply item as a dir
Page 95 and 96:
CMS-1503-FC 95 appear in the direct
Page 97 and 98:
CMS-1503-FC 97 inputs for CPT code
Page 99 and 100:
CMS-1503-FC 99 93786. After conside
Page 101 and 102:
CMS-1503-FC 101 (four venoms) and 9
Page 103 and 104:
CPT Code CMS-1503-FC 103 CMS Equipm
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CMS-1503-FC 105 CPT/ HCPCS Code Sho
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
CMS-1503-FC 111 database. The comme
Page 113 and 114:
CMS-1503-FC 113 of cardiac structur
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CMS-1503-FC 115 flawed. Response: A
Page 117 and 118:
CMS-1503-FC 117 51729 were assigned
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CMS-1503-FC 119 inputs, we noted th
Page 121 and 122:
CMS-1503-FC 121 requests on an ad h
Page 123 and 124:
CMS-1503-FC 123 We solicited public
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CMS-1503-FC 125 high volumes in phy
Page 127 and 128:
CMS-1503-FC 127 ongoing basis throu
Page 129 and 130:
CMS-1503-FC 129 payment to cover th
Page 131 and 132:
CMS-1503-FC 131 B. Malpractice Rela
Page 133 and 134:
CMS-1503-FC 133 where they would be
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CMS-1503-FC 135 CY 2011 New/ CY 201
Page 137 and 138:
CMS-1503-FC 137 CY 2011 New/ CY 201
Page 139 and 140:
CMS-1503-FC 139 CY 2011 New/ CY 201
Page 141 and 142:
CMS-1503-FC 141 RVUs. Services ment
Page 143 and 144:
CMS-1503-FC 143 C. Potentially Misv
Page 145 and 146:
CMS-1503-FC 145 equipment) for indi
Page 147 and 148:
CMS-1503-FC 147 Section 1848(c)(2)(
Page 149 and 150:
CMS-1503-FC 149 methodology (73 FR
Page 151 and 152:
CMS-1503-FC 151 more. Over the past
Page 153 and 154:
CMS-1503-FC 153 misvalued codes as
Page 155 and 156:
CMS-1503-FC 155 including the use o
Page 157 and 158:
CMS-1503-FC 157 overvaluation of pr
Page 159 and 160:
CMS-1503-FC 159 requiring an initia
Page 161 and 162:
CMS-1503-FC 161 payment for practit
Page 163 and 164:
CMS-1503-FC 163 CPT Code Short Desc
Page 165 and 166:
CMS-1503-FC 165 standard" to which
Page 167 and 168:
CMS-1503-FC 167 than or equal to 0.
Page 169 and 170:
CMS-1503-FC 169 Comment: A number o
Page 171 and 172:
CMS-1503-FC 171 In the CYs 2009 and
Page 173 and 174:
Pre- Service Time CMS-1503-FC 173 i
Page 175 and 176:
CMS-1503-FC 175 The methodology dis
Page 177 and 178:
CMS-1503-FC 177 inappropriate input
Page 179 and 180:
CMS-1503-FC 179 RUC were not consis
Page 181 and 182:
CMS-1503-FC 181 consumption of offi
Page 183 and 184:
CMS-1503-FC 183 AMA RUC for CY 2012
Page 185 and 186:
CMS-1503-FC 185 billed as an outpat
Page 187 and 188:
CMS-1503-FC 187 inpatient or outpat
Page 189 and 190:
CMS-1503-FC 189 MPPR policy, with t
Page 191 and 192:
CMS-1503-FC 191 expanding the exist
Page 193 and 194:
CMS-1503-FC 193 under the PFS) for
Page 195 and 196:
CMS-1503-FC 195 MPPR policy in CY 2
Page 197 and 198:
CMS-1503-FC 197 appropriately valui
Page 199 and 200:
CMS-1503-FC 199 ultrasound. Another
Page 201 and 202:
CMS-1503-FC 201 furnished with more
Page 203 and 204:
CMS-1503-FC 203 acknowledge that th
Page 205 and 206:
CMS-1503-FC 205 under the PFS. We b
Page 207 and 208:
CMS-1503-FC 207 TABLE 17: CPT Code
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CMS-1503-FC 209 "always therapy" se
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CMS-1503-FC 211 Based on CY 2009 PF
Page 213 and 214:
CMS-1503-FC 213 TABLE 19: Examples
Page 215 and 216:
CMS-1503-FC 215 and position patien
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CMS-1503-FC 217 TABLE 20: Sample Pa
Page 219 and 220:
CMS-1503-FC 219 respectively, notab
Page 221 and 222:
CMS-1503-FC 221 Response: We apprec
Page 223 and 224:
CMS-1503-FC 223 were systematically
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CMS-1503-FC 225 CY 2011 if there we
Page 227 and 228:
CMS-1503-FC 227 However, we believe
Page 229 and 230:
CMS-1503-FC 229 of therapy services
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CMS-1503-FC 231 and speech-language
Page 233 and 234:
CMS-1503-FC 233 because SLP service
Page 235 and 236:
CMS-1503-FC 235 Response: Through t
Page 237 and 238:
CMS-1503-FC 237 commenters on the C
Page 239 and 240:
CMS-1503-FC 239 service by the same
Page 241 and 242:
CMS-1503-FC 241 under the PFS. Most
Page 243 and 244:
CMS-1503-FC 243 prices for the 65 s
Page 245 and 246:
CMS-1503-FC 245 because company pol
Page 247 and 248:
CMS-1503-FC 247 CMS Supply Code Sup
Page 249 and 250:
CMS-1503-FC 249 CMS Supply Code Sup
Page 251 and 252:
CMS-1503-FC 251 on the GSA schedule
Page 253 and 254:
CMS-1503-FC 253 that the periodicit
Page 255 and 256:
CMS-1503-FC 255 is reasonable to us
Page 257 and 258:
CMS-1503-FC 257 solely because larg
Page 259 and 260:
CMS-1503-FC 259 more appropriately
Page 261 and 262:
CMS-1503-FC 261 included the direct
Page 263 and 264:
CMS-1503-FC 263 Prior to implementi
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CMS-1503-FC 265 individual high-cos
Page 267 and 268:
CMS-1503-FC 267 D. Geographic Pract
Page 269 and 270:
CMS-1503-FC 269 complete an analysi
Page 271 and 272:
CMS-1503-FC 271 PE GPCI calculated
Page 273 and 274:
CMS-1503-FC 273 ACA) requires that
Page 275 and 276:
CMS-1503-FC 275 We proposed to assi
Page 277 and 278:
CMS-1503-FC 277 CY 2011 PFS propose
Page 279 and 280:
CMS-1503-FC 279 physicians' service
Page 281 and 282:
CMS-1503-FC 281 that items such as
Page 283 and 284:
CMS-1503-FC 283 GPCIs at least ever
Page 285 and 286:
CMS-1503-FC 285 changes to the work
Page 287 and 288:
CMS-1503-FC 287 Comment: Many comme
Page 289 and 290:
CMS-1503-FC 289 files that are not
Page 291 and 292:
Page 293 and 294:
CMS-1503-FC 293 the results on the
Page 295 and 296:
CMS-1503-FC 295 In light of the com
Page 297 and 298:
CMS-1503-FC 297 Medicare PFS. Comme
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CMS-1503-FC 299 than 48.3 percent (
Page 301 and 302:
CMS-1503-FC 301 various studies reg
Page 303 and 304:
CMS-1503-FC 303 this section. Confi
Page 305 and 306:
CMS-1503-FC 305 summarizing or resp
Page 307 and 308:
CMS-1503-FC 307 that the cost weigh
Page 309 and 310:
CMS-1503-FC 309 both non-physician
Page 311 and 312:
CMS-1503-FC 311 (7) Consumer Price
Page 313 and 314:
CMS-1503-FC 313 We proposed to use
Page 315 and 316:
CMS-1503-FC 315 categories, as well
Page 317 and 318:
CMS-1503-FC 317 well as photocopier
Page 319 and 320:
CMS-1503-FC 319 The proposed weight
Page 321 and 322:
CMS-1503-FC 321 captured in the que
Page 323 and 324:
CMS-1503-FC 323 judgments about rel
Page 325 and 326:
CMS-1503-FC 325 TABLE 30: CMS Compo
Page 327 and 328:
CMS-1503-FC 327 (11) Fixed Capital
Page 329 and 330:
CMS-1503-FC 329 purchase, as well a
Page 331 and 332:
CMS-1503-FC 331 was within 0.3 perc
Page 333 and 334:
CMS-1503-FC 333 2006 Cost Categorie
Page 335 and 336:
CMS-1503-FC 335 should move forward
Page 337 and 338:
CMS-1503-FC 337 that the estimates
Page 339 and 340:
CMS-1503-FC 339 • The Chemicals a
Page 341 and 342:
CMS-1503-FC 341 Expense categories,
Page 343 and 344:
CMS-1503-FC 343 Comment: One commen
Page 345 and 346:
CMS-1503-FC 345 technology. Respons
Page 347 and 348:
CMS-1503-FC 347 the MEI only increa
Page 349 and 350:
CMS-1503-FC 349 by CMS. Suggested m
Page 351 and 352:
CMS-1503-FC 351 price (ASP) and, si
Page 353 and 354:
CMS-1503-FC 353 CY 1999 and CY 2004
Page 355 and 356:
CMS-1503-FC 355 heavily weighted to
Page 357 and 358:
CMS-1503-FC 357 adjustment to the w
Page 359 and 360:
CMS-1503-FC 359 F. Allowed Expendit
Page 361 and 362:
CMS-1503-FC 361 "physicians' servic
Page 363 and 364:
CMS-1503-FC 363 ● Physician work
Page 365 and 366:
CMS-1503-FC 365 TABLE 37: CY 2009 S
Page 367 and 368:
CMS-1503-FC 367 We estimate that th
Page 369 and 370:
CMS-1503-FC 369 This factor was cal
Page 371 and 372:
CMS-1503-FC 371 (3) Factor 3--Estim
Page 373 and 374:
CMS-1503-FC 373 the SGR of 1.6 perc
Page 375 and 376:
CMS-1503-FC 375 + Computing the dif
Page 377 and 378:
CMS-1503-FC 377 Consistent with sec
Page 379 and 380:
CMS-1503-FC 379 specified that the
Page 381 and 382:
CMS-1503-FC 381 period, we are resc
Page 383 and 384:
CMS-1503-FC 383 acts to extend it.
Page 385 and 386:
CMS-1503-FC 385 expected effects of
Page 387 and 388:
CMS-1503-FC 387 the feasibility of
Page 389 and 390:
CMS-1503-FC 389 (75 FR 40097 throug
Page 391 and 392:
CMS-1503-FC 391 information about p
Page 393 and 394:
CMS-1503-FC 393 dedicated professio
Page 395 and 396:
CMS-1503-FC 395 are not medically r
Page 397 and 398:
CMS-1503-FC 397 documentation in th
Page 399 and 400:
CMS-1503-FC 399 similarly for effic
Page 401 and 402:
CMS-1503-FC 401 feasibility of usin
Page 403 and 404:
CMS-1503-FC 403 being furnished are
Page 405 and 406:
CMS-1503-FC 405 commenters agreed t
Page 407 and 408:
CMS-1503-FC 407 To that end, some c
Page 409 and 410:
CMS-1503-FC 409 the efficiencies th
Page 411 and 412:
CMS-1503-FC 411 valuation of therap
Page 413 and 414:
CMS-1503-FC 413 commenters recommen
Page 415 and 416:
CMS-1503-FC 415 intervention are in
Page 417 and 418:
CMS-1503-FC 417 However, there are
Page 419 and 420:
CMS-1503-FC 419 be important in mak
Page 421 and 422:
CMS-1503-FC 421 B. Diabetes Self-Ma
Page 423 and 424:
CMS-1503-FC 423 • That HCPCS G010
Page 425 and 426:
CMS-1503-FC 425 HCPCS codes for KDE
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CMS-1503-FC 427 http://www.cms.gov/
Page 429 and 430:
CMS-1503-FC 429 not show up for the
Page 431 and 432:
CMS-1503-FC 431 requests, we refer
Page 433 and 434:
CMS-1503-FC 433 process. After cons
Page 435 and 436:
CMS-1503-FC 435 (End-stage renal di
Page 437 and 438:
CMS-1503-FC 437 recommendations as
Page 439 and 440:
CMS-1503-FC 439 code would clearly
Page 441 and 442:
CMS-1503-FC 441 CY 2011 proposal to
Page 443 and 444:
CMS-1503-FC 443 duration of acute e
Page 445 and 446:
CMS-1503-FC 445 separate HCPCS code
Page 447 and 448:
CMS-1503-FC 447 arms, legs; each ad
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CMS-1503-FC 449 sq cm or less) and
Page 451 and 452:
CMS-1503-FC 451 application of skin
Page 453 and 454:
CMS-1503-FC 453 fair and balanced t
Page 455 and 456:
CMS-1503-FC 455 definitions would a
Page 457 and 458:
CMS-1503-FC 457 application would b
Page 459 and 460:
CMS-1503-FC 459 HCPCS code G0440 is
Page 461 and 462:
CMS-1503-FC 461 and 15341 to HCPCS
Page 463 and 464:
CMS-1503-FC 463 our crosswalk propo
Page 465 and 466:
CMS-1503-FC 465 file. H. Intranasal
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CMS-1503-FC 467 Response: We would
Page 469 and 470:
CMS-1503-FC 469 our CY 2011 proposa
Page 471 and 472:
CMS-1503-FC 471 clarification. Spec
Page 473 and 474:
CMS-1503-FC 473 the resources neede
Page 475 and 476:
CMS-1503-FC 475 In the CY 2011 PFS
Page 477 and 478:
CMS-1503-FC 477 Independent Diagnos
Page 479 and 480:
CMS-1503-FC 479 for cardiac and oth
Page 481 and 482:
CMS-1503-FC 481 data applied to all
Page 483 and 484:
CMS-1503-FC 483 submission of $21,5
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CMS-1503-FC 485 as transparent and
Page 487 and 488:
CMS-1503-FC 487 consultations, offi
Page 489 and 490:
CMS-1503-FC 489 ● Offices of a ph
Page 491 and 492:
CMS-1503-FC 491 Section 1834(m)(2)(
Page 493 and 494:
CMS-1503-FC 493 Requestors should s
Page 495 and 496:
CMS-1503-FC 495 diagnosis, medical
Page 497 and 498:
CMS-1503-FC 497 rulemaking, we had
Page 499 and 500:
CMS-1503-FC 499 furnished to the el
Page 501 and 502:
CMS-1503-FC 501 individual as indiv
Page 503 and 504:
CMS-1503-FC 503 services, and that
Page 505 and 506:
CMS-1503-FC 505 commenters' shared
Page 507 and 508:
CMS-1503-FC 507 psychiatric hospita
Page 509 and 510:
CMS-1503-FC 509 telehealth consulta
Page 511 and 512:
CMS-1503-FC 511 comprehensive, coor
Page 513 and 514:
CMS-1503-FC 513 services. One comme
Page 515 and 516:
CMS-1503-FC 515 proposed rule (74 F
Page 517 and 518:
CMS-1503-FC 517 discussion of subse
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CMS-1503-FC 519 commenter agreed wi
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CMS-1503-FC 521 not believe that th
Page 523 and 524:
CMS-1503-FC 523 any proposals regar
Page 525 and 526:
CMS-1503-FC 525 ● Individual and
Page 527 and 528:
CMS-1503-FC 527 V. Addressing Inter
Page 529 and 530:
CMS-1503-FC 529 misvalued codes and
Page 531 and 532:
CMS-1503-FC 531 experience which in
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CMS-1503-FC 533 2. CY 2010 Interim
Page 535 and 536:
CMS-1503-FC 535 c. Myocardial Perfu
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CMS-1503-FC 537 included in the myo
Page 539 and 540:
CMS-1503-FC 539 noted that when thi
Page 541 and 542:
CMS-1503-FC 541 RVUs we established
Page 543 and 544:
CMS-1503-FC 543 endorsed CMS' decis
Page 545 and 546:
CMS-1503-FC 545 public notice and t
Page 547 and 548:
CMS-1503-FC 547 Comment: Several co
Page 549 and 550:
Page 551 and 552:
CMS-1503-FC 551 have replaced petro
Page 553 and 554:
CMS-1503-FC 553 (or nerves innervat
Page 555 and 556:
CMS-1503-FC 555 service since the o
Page 557 and 558:
CMS-1503-FC 557 displayed in Table
Page 559 and 560:
CMS-1503-FC 559 physical effort, an
Page 561 and 562:
CMS-1503-FC 561 recommending the me
Page 563 and 564:
CMS-1503-FC 563 recommended that th
Page 565 and 566:
CMS-1503-FC 565 basis for CY 2011.
Page 567 and 568:
CMS-1503-FC 567 perform this servic
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CMS-1503-FC 569 which is a value be
Page 571 and 572:
CMS-1503-FC 571 and complex than CP
Page 573 and 574:
CMS-1503-FC 573 with comment period
Page 575 and 576:
CMS-1503-FC 575 generator and repla
Page 577 and 578:
CMS-1503-FC 577 of 18 minutes. The
Page 579 and 580:
CMS-1503-FC 579 for CPT code 90461
Page 581 and 582:
CMS-1503-FC 581 Therefore we are as
Page 583 and 584:
CMS-1503-FC 583 patient), and recom
Page 585 and 586:
CPT Code 37220 37221 37222 37223 37
Page 587 and 588:
CMS-1503-FC 587 The AMA RUC used a
Page 589 and 590:
CMS-1503-FC 589 we are requesting t
Page 591 and 592:
CMS-1503-FC 591 When the AMA RUC re
Page 593 and 594:
CMS-1503-FC 593 and add new codes t
Page 595 and 596:
CMS-1503-FC 595 work RVUs that are
Page 597 and 598:
CMS-1503-FC 597 the CMS decision in
Page 599 and 600:
CMS-1503-FC 599 52332. Therefore, w
Page 601 and 602:
CMS-1503-FC 601 21.47 work RVUs to
Page 603 and 604:
CMS-1503-FC 603 misvalued codes in
Page 605 and 606:
CMS-1503-FC 605 maintain the curren
Page 607 and 608:
CMS-1503-FC 607 code 99213, a more
Page 609 and 610:
Page 611 and 612:
Page 613 and 614:
Page 615 and 616:
Page 617 and 618:
CMS-1503-FC 617 Many of the refinem
Page 619 and 620:
CMS-1503-FC 619 For add-on codes, o
Page 621 and 622:
CMS-1503-FC 621 equipment items in
Page 623 and 624:
CMS-1503-FC 623 reflect the actual
Page 625 and 626:
Page 627 and 628:
Page 629 and 630:
Page 631 and 632:
CMS-1503-FC 631 CPT Code 11042 1104
Page 633 and 634:
Page 635 and 636:
CMS-1503-FC 635 CPT Code 37227 Shor
Page 637 and 638:
Page 639 and 640:
Page 641 and 642:
Page 643 and 644:
Page 645 and 646:
CMS-1503-FC 645 CPT Code 93453 9345
Page 647 and 648:
Page 649 and 650:
Page 651 and 652:
CMS-1503-FC 651 CPT Code 93464 9356
Page 653 and 654:
CMS-1503-FC 653 CPT Code 95956 9644
Page 655 and 656:
CMS-1503-FC 655 VI. Provisions of t
Page 657 and 658:
CMS-1503-FC 657 care (74 FR 61846).
Page 659 and 660:
CMS-1503-FC 659 January 1, 2012, an
Page 661 and 662:
Page 663 and 664:
CMS-1503-FC 663 methods of reportin
Page 665 and 666:
CMS-1503-FC 665 particular, noted t
Page 667 and 668:
CMS-1503-FC 667 geographic adjustme
Page 669 and 670:
CMS-1503-FC 669 risk adjusted and s
Page 671 and 672:
CMS-1503-FC 671 influence. Others e
Page 673 and 674:
CMS-1503-FC 673 In determining diff
Page 675 and 676:
CMS-1503-FC 675 discontinue our use
Page 677 and 678:
CMS-1503-FC 677 Some commenters men
Page 679 and 680:
CMS-1503-FC 679 In addition, we rec
Page 681 and 682:
CMS-1503-FC 681 Medicare Prescripti
Page 683 and 684:
CMS-1503-FC 683 Section 136 of the
Page 685 and 686:
CMS-1503-FC 685 2. Amendment to Sec
Page 687 and 688:
CMS-1503-FC 687 to continue to oper
Page 689 and 690:
CMS-1503-FC 689 Interactive Psychot
Page 691 and 692:
CMS-1503-FC 691 H. Section 3108: Pe
Page 693 and 694:
CMS-1503-FC 693 that any changes to
Page 695 and 696:
CMS-1503-FC 695 Third, in order to
Page 697 and 698:
CMS-1503-FC 697 payment is made) to
Page 699 and 700:
CMS-1503-FC 699 K. Section 3122: Ex
Page 701 and 702:
CMS-1503-FC 701 equipment to a 75 p
Page 703 and 704:
CMS-1503-FC 703 forth in section 18
Page 705 and 706:
CMS-1503-FC 705 beneficiary, not th
Page 707 and 708:
CMS-1503-FC 707 Section 3136(a)(2)
Page 709 and 710:
CMS-1503-FC 709 standard power whee
Page 711 and 712:
CMS-1503-FC 711 power wheelchairs,
Page 713 and 714:
CMS-1503-FC 713 commenter requested
Page 715 and 716:
CMS-1503-FC 715 O. Section 3139: Pa
Page 717 and 718:
CMS-1503-FC 717 In summary, we are
Page 719 and 720:
CMS-1503-FC 719 proposed to be used
Page 721 and 722:
CMS-1503-FC 721 other health care p
Page 723 and 724:
CMS-1503-FC 723 To create a forecas
Page 725 and 726:
CMS-1503-FC 725 if the update facto
Page 727 and 728:
CMS-1503-FC 727 the annual update t
Page 729 and 730:
CMS-1503-FC 729 percentage increase
Page 731 and 732:
CMS-1503-FC 731 less than zero, the
Page 733 and 734:
CMS-1503-FC 733 purposes, we have m
Page 735 and 736:
CMS-1503-FC 735 proposed rule d. DM
Page 737 and 738:
CMS-1503-FC 737 sections 3401(m), (
Page 739 and 740:
CMS-1503-FC 739 or update of a list
Page 741 and 742:
CMS-1503-FC 741 Further, the ACA al
Page 743 and 744:
CMS-1503-FC 743 direct observation
Page 745 and 746:
CMS-1503-FC 745 ++ Ability to succe
Page 747 and 748:
CMS-1503-FC 747 term "health profes
Page 749 and 750:
CMS-1503-FC 749 include language on
Page 751 and 752:
CMS-1503-FC 751 vitamins. ++ Use or
Page 753 and 754:
CMS-1503-FC 753 beneficiary shall b
Page 755 and 756:
CMS-1503-FC 755 appropriate, to hea
Page 757 and 758:
CMS-1503-FC 757 However, other comm
Page 759 and 760:
CMS-1503-FC 759 recommendation at t
Page 761 and 762:
CMS-1503-FC 761 ++ The list of risk
Page 763 and 764:
CMS-1503-FC 763 or through an HRA,
Page 765 and 766:
CMS-1503-FC 765 therefore, we are i
Page 767 and 768:
CMS-1503-FC 767 satisfaction and re
Page 769 and 770:
Page 771 and 772:
CMS-1503-FC 771 in Opening a Nation
Page 773 and 774:
CMS-1503-FC 773 In summary, as a re
Page 775 and 776:
CMS-1503-FC 775 GXXXA or GXXXB, pro
Page 777 and 778:
CMS-1503-FC 777 AMA RUCs process to
Page 779 and 780:
CMS-1503-FC 779 as discussed in sec
Page 781 and 782:
CMS-1503-FC 781 visit for an establ
Page 783 and 784:
CMS-1503-FC 783 the CPT codes. We c
Page 785 and 786:
CMS-1503-FC 785 CY 2011 proposal to
Page 787 and 788:
CMS-1503-FC 787 beneficiaries when
Page 789 and 790:
CMS-1503-FC 789 ● The specific se
Page 791 and 792:
Page 793 and 794:
CMS-1503-FC 793 is an "additional p
Page 795 and 796:
CMS-1503-FC 795 considered "additio
Page 797 and 798:
Page 799 and 800:
CMS-1503-FC 799 Wellness Visits Pro
Page 801 and 802:
CMS-1503-FC 801 for clinical labora
Page 803 and 804:
CMS-1503-FC 803 and fecal occult bl
Page 805 and 806:
CMS-1503-FC 805 In §410.152, we pr
Page 807 and 808:
CMS-1503-FC 807 Response: Glaucoma
Page 809 and 810:
CMS-1503-FC 809 Medicare Part A or
Page 811 and 812:
CMS-1503-FC 811 publication of the
Page 813 and 814:
CMS-1503-FC 813 Medicare will conti
Page 815 and 816:
CMS-1503-FC 815 report, the CMS-222
Page 817 and 818:
CMS-1503-FC 817 with the provisions
Page 819 and 820:
CMS-1503-FC 819 Preventive Service
Page 821 and 822:
Page 823 and 824:
Page 825 and 826:
Page 827 and 828:
Page 829 and 830:
CMS-1503-FC 829 3. Extension of Wai
Page 831 and 832:
CMS-1503-FC 831 circumstances under
Page 833 and 834:
CMS-1503-FC 833 E/M visits; ● 992
Page 835 and 836:
CMS-1503-FC 835 practitioner, 89-ce
Page 837 and 838:
CMS-1503-FC 837 Medicare, arguing t
Page 839 and 840:
CMS-1503-FC 839 would limit the num
Page 841 and 842:
CMS-1503-FC 841 for the PCIP, regar
Page 843 and 844:
CMS-1503-FC 843 denominator for pur
Page 845 and 846:
CMS-1503-FC 845 CPT Code Descriptio
Page 847 and 848:
CMS-1503-FC 847 was limited to prim
Page 849 and 850:
CMS-1503-FC 849 optional method. Th
Page 851 and 852:
CMS-1503-FC 851 flexibility in dete
Page 853 and 854:
CMS-1503-FC 853 determining eligibi
Page 855 and 856:
CMS-1503-FC 855 applicable (eligibi
Page 857 and 858:
CMS-1503-FC 857 monitor changes in
Page 859 and 860:
CMS-1503-FC 859 or not the service
Page 861 and 862:
CMS-1503-FC 861 We note that Medica
Page 863 and 864:
CMS-1503-FC 863 2. Section 5501(b):
Page 865 and 866:
CMS-1503-FC 865 professional servic
Page 867 and 868:
CMS-1503-FC 867 "HPSA surgical ince
Page 869 and 870:
CMS-1503-FC 869 in surgical special
Page 871 and 872:
CMS-1503-FC 871 in areas that are d
Page 873 and 874:
CMS-1503-FC 873 1834(g)(2)(B) of th
Page 875 and 876:
CMS-1503-FC 875 (DHS) payable by Me
Page 877 and 878:
CMS-1503-FC 877 patient's signature
Page 879 and 880:
CMS-1503-FC 879 purposes of the phy
Page 881 and 882:
CMS-1503-FC 881 procedure or immedi
Page 883 and 884:
Page 885 and 886:
CMS-1503-FC 885 are finalizing our
Page 887 and 888:
CMS-1503-FC 887 notice include supp
Page 889 and 890:
CMS-1503-FC 889 referral be include
Page 891 and 892:
CMS-1503-FC 891 services for which
Page 893 and 894:
CMS-1503-FC 893 patient's main medi
Page 895 and 896:
CMS-1503-FC 895 minimum time limit
Page 897 and 898:
CMS-1503-FC 897 retroactive claims
Page 899 and 900:
CMS-1503-FC 899 State Medicaid Agen
Page 901 and 902:
CMS-1503-FC 901 from the date the p
Page 903 and 904:
CMS-1503-FC 903 intention to provid
Page 905 and 906:
CMS-1503-FC 905 an extension of tim
Page 907 and 908:
CMS-1503-FC 907 entitled to Medicar
Page 909 and 910:
CMS-1503-FC 909 because we did not
Page 911 and 912:
CMS-1503-FC 911 trigger when the ex
Page 913 and 914:
CMS-1503-FC 913 delays caused by th
Page 915 and 916:
CMS-1503-FC 915 benefits exhaust cl
Page 917 and 918:
CMS-1503-FC 917 year after the date
Page 919 and 920:
CMS-1503-FC 919 therefore will not
Page 921 and 922:
CMS-1503-FC 921 correction will tri
Page 923 and 924:
CMS-1503-FC 923 2. Subdividing Larg
Page 925 and 926:
CMS-1503-FC 925 We found that count
Page 927 and 928:
CMS-1503-FC 927 these islands or wh
Page 929 and 930:
CMS-1503-FC 929 commenter provide a
Page 931 and 932:
CMS-1503-FC 931 CBA Name County TAB
Page 933 and 934:
CMS-1503-FC 933 items must currentl
Page 935 and 936:
CMS-1503-FC 935 PAOC that removing
Page 937 and 938:
CMS-1503-FC 937 DMEPOS Allowed Amou
Page 939 and 940:
CMS-1503-FC 939 21 Additional MSAs
Page 941 and 942:
CMS-1503-FC 941 additional reportin
Page 943 and 944:
CMS-1503-FC 943 nation, in order to
Page 945 and 946:
CMS-1503-FC 945 VII. Other Provisio
Page 947 and 948:
CMS-1503-FC 947 Although problems w
Page 949 and 950:
Previous Quarter Reported NDCs CMS-
Page 951 and 952:
CMS-1503-FC 951 be done to obtain a
Page 953 and 954:
CMS-1503-FC 953 Comment: A commente
Page 955 and 956:
CMS-1503-FC 955 reported, then a ma
Page 957 and 958:
CMS-1503-FC 957 monitor manufacture
Page 959 and 960:
CMS-1503-FC 959 Although this secti
Page 961 and 962:
CMS-1503-FC 961 the Act and is also
Page 963 and 964:
CMS-1503-FC 963 amount for each HCP
Page 965 and 966:
CMS-1503-FC 965 Product" indicates
Page 967 and 968:
CMS-1503-FC 967 acquisition costs b
Page 969 and 970:
CMS-1503-FC 969 prohibited. They st
Page 971 and 972:
CMS-1503-FC 971 Response: For the r
Page 973 and 974:
CMS-1503-FC 973 calculations be car
Page 975 and 976:
CMS-1503-FC 975 supplier or any oth
Page 977 and 978:
CMS-1503-FC 977 Response: We descri
Page 979 and 980:
CMS-1503-FC 979 For CY 2011, we pro
Page 981 and 982:
CMS-1503-FC 981 specify the timing
Page 983 and 984:
CMS-1503-FC 983 Association of Chai
Page 985 and 986:
CMS-1503-FC 985 After careful revie
Page 987 and 988:
CMS-1503-FC 987 B. Ambulance Fee Sc
Page 989 and 990:
CMS-1503-FC 989 Claims Processing M
Page 991 and 992:
CMS-1503-FC 991 mile or less than o
Page 993 and 994:
CMS-1503-FC 993 Second, we consider
Page 995 and 996:
CMS-1503-FC 995 system should be co
Page 997 and 998:
CMS-1503-FC 997 instructions set fo
Page 999 and 1000:
CMS-1503-FC 999 For the reasons dis
Page 1001 and 1002:
CMS-1503-FC 1001 requiring that the
Page 1003 and 1004:
CMS-1503-FC 1003 we monitored. (See
Page 1005 and 1006:
CMS-1503-FC 1005 not change the amb
Page 1007 and 1008:
CMS-1503-FC 1007 rates for ambulanc
Page 1009 and 1010:
CMS-1503-FC 1009 overburdened and u
Page 1011 and 1012:
CMS-1503-FC 1011 fractional mileage
Page 1013 and 1014:
CMS-1503-FC 1013 trip computer, or
Page 1015 and 1016:
CMS-1503-FC 1015 then implementatio
Page 1017 and 1018:
CMS-1503-FC 1017 cannot comply with
Page 1019 and 1020:
CMS-1503-FC 1019 billing policy is
Page 1021 and 1022:
CMS-1503-FC 1021 be required to rep
Page 1023 and 1024:
CMS-1503-FC 1023 requisition. While
Page 1025 and 1026:
CMS-1503-FC 1025 documenting that t
Page 1027 and 1028:
CMS-1503-FC 1027 are two different
Page 1029 and 1030:
CMS-1503-FC 1029 services. One of t
Page 1031 and 1032:
CMS-1503-FC 1031 laboratory test pa
Page 1033 and 1034:
CMS-1503-FC 1033 shipping addresses
Page 1035 and 1036:
CMS-1503-FC 1035 physician. The com
Page 1037 and 1038:
CMS-1503-FC 1037 of analyses used t
Page 1039 and 1040:
CMS-1503-FC 1039 section 651 of MMA
Page 1041 and 1042:
CMS-1503-FC 1041 continue to update
Page 1043 and 1044:
CMS-1503-FC 1043 2. Estimating Per
Page 1045 and 1046:
CMS-1503-FC 1045 Comment: One comme
Page 1047 and 1048:
CMS-1503-FC 1047 access to dialysis
Page 1049 and 1050:
CMS-1503-FC 1049 Also, in the CY 20
Page 1051 and 1052:
CMS-1503-FC 1051 Using treatment co
Page 1053 and 1054:
CMS-1503-FC 1053 F. Issues Related
Page 1055 and 1056:
CMS-1503-FC 1055 "Physician Quality
Page 1057 and 1058:
CMS-1503-FC 1057 educational videos
Page 1059 and 1060:
CMS-1503-FC 1059 Response: As we no
Page 1061 and 1062:
CMS-1503-FC 1061 practice. Commente
Page 1063 and 1064:
CMS-1503-FC 1063 reported, and is c
Page 1065 and 1066:
CMS-1503-FC 1065 Quality Reporting
Page 1067 and 1068:
CMS-1503-FC 1067 2015, where it is
Page 1069 and 1070:
CMS-1503-FC 1069 Response: We appre
Page 1071 and 1072:
CMS-1503-FC 1071 reporting with res
Page 1073 and 1074:
CMS-1503-FC 1073 numerator and deno
Page 1075 and 1076:
CMS-1503-FC 1075 will include both
Page 1077 and 1078:
CMS-1503-FC 1077 The following is a
Page 1079 and 1080:
CMS-1503-FC 1079 period (that is, J
Page 1081 and 1082:
CMS-1503-FC 1081 in-person registry
Page 1083 and 1084:
CMS-1503-FC 1083 ● Obtain and kee
Page 1085 and 1086:
CMS-1503-FC 1085 and performance ra
Page 1087 and 1088:
CMS-1503-FC 1087 calculate the meas
Page 1089 and 1090:
Page 1091 and 1092:
CMS-1503-FC 1091 2011 will need to
Page 1093 and 1094:
CMS-1503-FC 1093 ● Be able to inc
Page 1095 and 1096:
CMS-1503-FC 1095 that self-nominate
Page 1097 and 1098:
CMS-1503-FC 1097 For the 2011 Physi
Page 1099 and 1100:
CMS-1503-FC 1099 required to report
Page 1101 and 1102:
CMS-1503-FC 1101 reporting threshol
Page 1103 and 1104:
CMS-1503-FC 1103 Reporting System q
Page 1105 and 1106:
CMS-1503-FC 1105 measures group app
Page 1107 and 1108:
CMS-1503-FC 1107 Based on the comme
Page 1109 and 1110:
CMS-1503-FC 1109 g. Reporting Optio
Page 1111 and 1112:
CMS-1503-FC 1111 reporting option i
Page 1113 and 1114:
CMS-1503-FC 1113 Response: We agree
Page 1115 and 1116:
Page 1117 and 1118:
CMS-1503-FC 1117 criteria for satis
Page 1119 and 1120:
CMS-1503-FC 1119 identical to the r
Page 1121 and 1122:
CMS-1503-FC 1121 such a short time
Page 1123 and 1124:
CMS-1503-FC 1123 • Agree to atten
Page 1125 and 1126:
CMS-1503-FC 1125 those Medicare Par
Page 1127 and 1128:
CMS-1503-FC 1127 nominating before
Page 1129 and 1130:
CMS-1503-FC 1129 Program, we propos
Page 1131 and 1132:
Page 1133 and 1134:
CMS-1503-FC 1133 groups can select
Page 1135 and 1136:
CMS-1503-FC 1135 VII.F.2.(i).(5). o
Page 1137 and 1138:
CMS-1503-FC 1137 opportunity to pro
Page 1139 and 1140:
CMS-1503-FC 1139 ++ Section 1848(k)
Page 1141 and 1142:
CMS-1503-FC 1141 programs to which
Page 1143 and 1144:
Page 1145 and 1146:
CMS-1503-FC 1145 depend on the deve
Page 1147 and 1148:
Page 1149 and 1150:
CMS-1503-FC 1149 151, 154, 155, 173
Page 1151 and 1152:
CMS-1503-FC 1151 groups should be a
Page 1153 and 1154:
CMS-1503-FC 1153 well. One commente
Page 1155 and 1156:
CMS-1503-FC 1155 Response: We will
Page 1157 and 1158:
CMS-1503-FC 1157 Although they were
Page 1159 and 1160:
CMS-1503-FC 1159 Physician Quality
Page 1161 and 1162:
Page 1163 and 1164:
Page 1165 and 1166:
CMS-1503-FC 1165 Please note that d
Page 1167 and 1168:
CMS-1503-FC 1167 applicable measure
Page 1169 and 1170:
Page 1171 and 1172:
CMS-1503-FC 1171 implementation, an
Page 1173 and 1174:
CMS-1503-FC 1173 Comment: Several c
Page 1175 and 1176:
CMS-1503-FC 1175 The titles of the
Page 1177 and 1178:
CMS-1503-FC 1177 • Measure #2: Di
Page 1179 and 1180:
CMS-1503-FC 1179 Comment: Because t
Page 1181 and 1182:
Page 1183 and 1184:
CMS-1503-FC 1183 Comment: We receiv
Page 1185 and 1186:
CMS-1503-FC 1185 would not be appro
Page 1187 and 1188:
CMS-1503-FC 1187 TABLE 85: Measures
Page 1189 and 1190:
CMS-1503-FC 1189 TABLE 89: Measures
Page 1191 and 1192:
CMS-1503-FC 1191 * This measures gr
Page 1193 and 1194:
CMS-1503-FC 1193 part of the PGP an
Page 1195 and 1196:
Page 1197 and 1198:
CMS-1503-FC 1197 on the Physician C
Page 1199 and 1200:
CMS-1503-FC 1199 report 2011 Physic
Page 1201 and 1202:
CMS-1503-FC 1201 • Ensure that th
Page 1203 and 1204:
CMS-1503-FC 1203 Comment: Some comm
Page 1205 and 1206:
CMS-1503-FC 1205 requirements throu
Page 1207 and 1208:
CMS-1503-FC 1207 not satisfactorily
Page 1209 and 1210:
CMS-1503-FC 1209 practice assessmen
Page 1211 and 1212:
CMS-1503-FC 1211 ("Additional Incen
Page 1213 and 1214:
CMS-1503-FC 1213 is required to qua
Page 1215 and 1216:
CMS-1503-FC 1215 experience with ca
Page 1217 and 1218:
CMS-1503-FC 1217 the year the eligi
Page 1219 and 1220:
CMS-1503-FC 1219 Response: While we
Page 1221 and 1222:
CMS-1503-FC 1221 System]." Therefor
Page 1223 and 1224:
CMS-1503-FC 1223 quality improvemen
Page 1225 and 1226:
CMS-1503-FC 1225 participation, the
Page 1227 and 1228:
CMS-1503-FC 1227 However, with resp
Page 1229 and 1230:
CMS-1503-FC 1229 comments of ensuri
Page 1231 and 1232:
Page 1233 and 1234:
CMS-1503-FC 1233 physicians exclude
Page 1235 and 1236:
Page 1237 and 1238:
CMS-1503-FC 1237 we believe interim
Page 1239 and 1240:
CMS-1503-FC 1239 improves successfu
Page 1241 and 1242:
CMS-1503-FC 1241 before July 1, 201
Page 1243 and 1244:
CMS-1503-FC 1243 professionals repo
Page 1245 and 1246:
CMS-1503-FC 1245 • Given that thi
Page 1247 and 1248:
CMS-1503-FC 1247 review process whe
Page 1249 and 1250:
CMS-1503-FC 1249 section 1848(m)(5)
Page 1251 and 1252:
CMS-1503-FC 1251 practice) earns an
Page 1253 and 1254:
CMS-1503-FC 1253 which eligible pro
Page 1255 and 1256:
CMS-1503-FC 1255 feedback reports w
Page 1257 and 1258:
CMS-1503-FC 1257 Under section 1848
Page 1259 and 1260:
CMS-1503-FC 1259 end of the 2012 pa
Page 1261 and 1262:
CMS-1503-FC 1261 Eligible professio
Page 1263 and 1264:
CMS-1503-FC 1263 Although we are fi
Page 1265 and 1266:
CMS-1503-FC 1265 patient visit. The
Page 1267 and 1268:
CMS-1503-FC 1267 Part B covered pro
Page 1269 and 1270:
CMS-1503-FC 1269 (a) Generate a com
Page 1271 and 1272:
CMS-1503-FC 1271 Inquiry and Respon
Page 1273 and 1274:
CMS-1503-FC 1273 We intend to post
Page 1275 and 1276:
CMS-1503-FC 1275 Comment: Several c
Page 1277 and 1278:
CMS-1503-FC 1277 claims data). If t
Page 1279 and 1280:
CMS-1503-FC 1279 incentive payment
Page 1281 and 1282:
CMS-1503-FC 1281 EHR Reporting"), t
Page 1283 and 1284:
CMS-1503-FC 1283 option for large g
Page 1285 and 1286:
CMS-1503-FC 1285 required to indica
Page 1287 and 1288:
CMS-1503-FC 1287 our proposal to re
Page 1289 and 1290:
CMS-1503-FC 1289 1848(a)(5) (A)(i)
Page 1291 and 1292:
Page 1293 and 1294:
CMS-1503-FC 1293 for the year. Unde
Page 1295 and 1296:
CMS-1503-FC 1295 electronic prescri
Page 1297 and 1298:
CMS-1503-FC 1297 if the successful
Page 1299 and 1300:
CMS-1503-FC 1299 disadvantage eligi
Page 1301 and 1302:
CMS-1503-FC 1301 they have successf
Page 1303 and 1304:
CMS-1503-FC 1303 Comment: While our
Page 1305 and 1306:
CMS-1503-FC 1305 • Eligible profe
Page 1307 and 1308:
CMS-1503-FC 1307 2012 to better ref
Page 1309 and 1310:
CMS-1503-FC 1309 electronic prescri
Page 1311 and 1312:
CMS-1503-FC 1311 G. DMEPOS Provisio
Page 1313 and 1314:
CMS-1503-FC 1313 The fee schedule m
Page 1315 and 1316:
CMS-1503-FC 1315 and services" in s
Page 1317 and 1318:
CMS-1503-FC 1317 revise the nationa
Page 1319 and 1320:
CMS-1503-FC 1319 proposed to define
Page 1321 and 1322:
CMS-1503-FC 1321 solicited public c
Page 1323 and 1324:
Page 1325 and 1326:
CMS-1503-FC 1325 (2) Definition of
Page 1327 and 1328:
CMS-1503-FC 1327 not result in the
Page 1329 and 1330:
CMS-1503-FC 1329 beneficiary’s ho
Page 1331 and 1332:
CMS-1503-FC 1331 replacement diabet
Page 1333 and 1334:
CMS-1503-FC 1333 For purposes of im
Page 1335 and 1336:
CMS-1503-FC 1335 Response: We disag
Page 1337 and 1338:
CMS-1503-FC 1337 manufacturer, mode
Page 1339 and 1340:
CMS-1503-FC 1339 may continue to as
Page 1341 and 1342:
Page 1343 and 1344:
CMS-1503-FC 1343 practitioner to hi
Page 1345 and 1346:
CMS-1503-FC 1345 include OTS orthot
Page 1347 and 1348:
CMS-1503-FC 1347 data. Therefore, t
Page 1349 and 1350:
CMS-1503-FC 1349 reduce the number
Page 1351 and 1352:
CMS-1503-FC 1351 with supporting in
Page 1353 and 1354:
CMS-1503-FC 1353 supplier’s contr
Page 1355 and 1356:
CMS-1503-FC 1355 We proposed the fo
Page 1357 and 1358:
CMS-1503-FC 1357 not involved with
Page 1359 and 1360:
CMS-1503-FC 1359 Issues to be resol
Page 1361 and 1362:
CMS-1503-FC 1361 The HO would make
Page 1363 and 1364:
CMS-1503-FC 1363 within 5 days of r
Page 1365 and 1366:
CMS-1503-FC 1365 terminate contract
Page 1367 and 1368:
CMS-1503-FC 1367 §414.226(c)(1)(ii
Page 1369 and 1370:
CMS-1503-FC 1369 b. Furnishing Oxyg
Page 1371 and 1372:
CMS-1503-FC 1371 For this reason, w
Page 1373 and 1374:
CMS-1503-FC 1373 payment period in
Page 1375 and 1376:
CMS-1503-FC 1375 H. Provider and Su
Page 1377 and 1378:
CMS-1503-FC 1377 Medicare program."
Page 1379 and 1380:
CMS-1503-FC 1379 certification revo
Page 1381 and 1382:
CMS-1503-FC 1381 specified in 14 CF
Page 1383 and 1384:
CMS-1503-FC 1383 J. Physician Self-
Page 1385 and 1386:
CMS-1503-FC 1385 c. Revisions Effec
Page 1387 and 1388:
CMS-1503-FC 1387 at 411.355(g), we
Page 1389 and 1390:
CMS-1503-FC 1389 RADIATION THERAPY
Page 1391 and 1392:
CMS-1503-FC 1391 recognized timely
Page 1393 and 1394:
CMS-1503-FC 1393 1861(ddd)(1), as a
Page 1395 and 1396:
CMS-1503-FC 1395 §410.32(a)(2)) wh
Page 1397 and 1398:
CMS-1503-FC 1397 remains unchanged
Page 1399 and 1400:
CMS-1503-FC 1399 bid items received
Page 1401 and 1402:
CMS-1503-FC 1401 data to CMS. While
Page 1403 and 1404:
CMS-1503-FC 1403 vary along with th
Page 1405 and 1406:
CMS-1503-FC 1405 being 1.75 minutes
Page 1407 and 1408:
CMS-1503-FC 1407 each measure the r
Page 1409 and 1410:
CMS-1503-FC 1409 the technical capa
Page 1411 and 1412:
CMS-1503-FC 1411 Quality Reporting
Page 1413 and 1414:
CMS-1503-FC 1413 Section VII.F.2 of
Page 1415 and 1416:
CMS-1503-FC 1415 measure X 25 cases
Page 1417 and 1418:
CMS-1503-FC 1417 clinical data ware
Page 1419 and 1420:
CMS-1503-FC 1419 individual eligibl
Page 1421 and 1422:
CMS-1503-FC 1421 XI. Regulatory Imp
Page 1423 and 1424:
CMS-1503-FC 1423 for managed care.
Page 1425 and 1426:
CMS-1503-FC 1425 governments in the
Page 1427 and 1428:
CMS-1503-FC 1427 ● Column A (Spec
Page 1429 and 1430:
CMS-1503-FC 1429 (A) (B) (C) (D) (E
Page 1431 and 1432:
CMS-1503-FC 1431 proportion of tota
Page 1433 and 1434:
CMS-1503-FC 1433 We note that in se
Page 1435 and 1436:
CMS-1503-FC 1435 TABLE 102: Impact
Page 1437 and 1438:
CMS-1503-FC 1437 CPT/ HCPCS Code MO
Page 1439 and 1440:
CMS-1503-FC 1439 Section 1848(e)(1)
Page 1441 and 1442:
CMS-1503-FC 1441 3. Section 3102: E
Page 1443 and 1444:
CMS-1503-FC 1443 7. Section 3107: E
Page 1445 and 1446:
CMS-1503-FC 1445 provided in a sing
Page 1447 and 1448:
CMS-1503-FC 1447 ESRD market basket
Page 1449 and 1450:
CMS-1503-FC 1449 In section VI.T of
Page 1451 and 1452:
CMS-1503-FC 1451 impact of this pro
Page 1453 and 1454:
CMS-1503-FC 1453 services. Effectiv
Page 1455 and 1456:
CMS-1503-FC 1455 various classes of
Page 1457 and 1458:
CMS-1503-FC 1457 through the ESRD P
Page 1459 and 1460:
CMS-1503-FC 1459 Improvements - Phy
Page 1461 and 1462:
CMS-1503-FC 1461 account for salary
Page 1463 and 1464:
CMS-1503-FC 1463 participating in P
Page 1465 and 1466:
CMS-1503-FC 1465 approximately 79 h
Page 1467 and 1468:
CMS-1503-FC 1467 An EHR vendor inte
Page 1469 and 1470:
CMS-1503-FC 1469 Program in prior y
Page 1471 and 1472:
CMS-1503-FC 1471 claims an individu
Page 1473 and 1474:
CMS-1503-FC 1473 that the costs for
Page 1475 and 1476:
CMS-1503-FC 1475 a. Off-the-Shelf (
Page 1477 and 1478:
CMS-1503-FC 1477 Also, we considere
Page 1479 and 1480:
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CMS-1503-FC 1483 List of Subjects 4
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CMS-1503-FC 1485 For the reasons se
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CMS-1503-FC 1487 6. Section 409.20
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CMS-1503-FC 1489 Eligible beneficia
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CMS-1503-FC 1491 (viii) Furnishing
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CMS-1503-FC 1493 (vi) Furnishing of
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CMS-1503-FC 1495 as follows: * * *
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CMS-1503-FC 2023 Composite Rate ESR
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