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DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for ...

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CMS-1503-FC 688<br />

proposed rule, in order to con<strong>for</strong>m the regulations to the requirements set <strong>for</strong>th in sections<br />

3105 and 10311 of the ACA. We note that in §414.610(c)(1), we have made minor<br />

<strong>for</strong>matting revisions <strong>for</strong> clarification purposes. In addition, in §414.610(c)(1)(i), we have<br />

corrected a typographical error that appeared in the CY 2011 PFS proposed rule<br />

(75 FR 40258) by changing "December 21" to "December 31" to con<strong>for</strong>m with the ACA<br />

requirements. As we discuss above, sections 3105 and 10311 of the ACA are<br />

self-implementing and do not require any substantive exercise of discretion by the<br />

Secretary.<br />

G. Section 3107: Extension of Physician Fee Schedule Mental Health Add-On<br />

Section 3107 of the ACA amended section 138(a)(1) of the MIPPA to continue the<br />

5 percent increase in Medicare payment <strong>for</strong> specified mental health services through<br />

December 31, 2010. This payment increase was originally authorized under section 138<br />

of the MIPPA from July 1, 2008 until December 31, 2009. Accordingly, payment <strong>for</strong> the<br />

24 psychiatry CPT codes in Table 56, representing "specified services," remains<br />

increased by 5 percent through December 31, 2010.<br />

TABLE 56: Specified Mental Health Services Subject to the Five Percent<br />

Increase in Medicare Payment through December 31, 2010<br />

Office or Other Outpatient Facility<br />

Insight Oriented, Behavior Modifying and/or Supportive Psychotherapy<br />

90804 (Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or<br />

outpatient facility, approximately 20 to 30 minutes face-to-face with the patient;)<br />

90805 (Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or<br />

outpatient facility, approximately 20 to 30 minutes face-to-face with the patient; with medical<br />

evaluation and management services)<br />

90806 (Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or<br />

outpatient facility, approximately 45 to 50 minutes face-to-face with the patient;)<br />

90807 (Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or<br />

outpatient facility, approximately 45 to 50 minutes face-to-face with the patient; with medical<br />

evaluation and management services)<br />

90808 (Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or<br />

outpatient facility, approximately 75 to 80 minutes face-to-face with the patient;)<br />

90809 (Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or<br />

outpatient facility, approximately 75 to 80 minutes face-to-face with the patient; with medical<br />

evaluation and management services)

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