[Federal Register Volume 68, Number 124 (Friday, June 27, 2003)]
[Notices]
[Pages 38370-38371]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-16056]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-1259-N]


Medicare Program; Public Meeting in Calendar Year 2003 for New 
Clinical Laboratory Tests Payment Determinations

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice of meeting.

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SUMMARY: This notice announces the date and location of a public 
meeting in accordance with section 1833 (h) of the Social Security Act 
and section 531 (b) of the Benefits Improvement and Protection Act 
(BIPA), Pub. L. 106-554. The meeting will be held on July 28, 2003 to 
discuss payment determinations for specific new Physicians' Current 
Procedural Terminology (CPT) codes for clinical laboratory tests. The 
meeting provides a forum for interested individuals to make oral 
presentations and/or submit written comments on the new codes that will 
be included in Medicare's Clinical Laboratory Fee

[[Page 38371]]

Schedule for calendar year 2004, which will be effective on January 1, 
2004. The presentations and comments are to be directed toward 
technical issues relating to payment determinations for a specified 
list of new clinical laboratory codes. The development of the codes for 
clinical laboratory tests is largely performed by the CPT Editorial 
Panel and will not be further discussed at the CMS meeting.

DATES: The public meeting is scheduled for Monday, July 28, 2003 from 
8:30 a.m. to 4 p.m., e.d.t.

ADDRESSES: The meeting will be held at the Centers for Medicare & 
Medicaid Services (CMS) Auditorium located at 7500 Security Boulevard, 
Baltimore, Maryland 21244.
    Registration: Registration Procedures: Beginning July 2, 2003 
registration may be completed on-line at http://www.cms.hhs.gov/paymentsystems. The following information must be submitted when 
registering: name, company name, address, telephone number, and e-mail 
address. When registering, individuals who want to make a presentation 
must also specify for which new clinical laboratory test code(s) they 
will be presenting. A confirmation will be sent upon receipt of the 
registration.
    Registration Deadline: Individuals must register by July 23, 2003. 
If on-line registration is not used, individuals may register by fax to 
the attention of Anita Greenberg at (410) 786-0169.

FOR FURTHER INFORMATION CONTACT: Anita Greenberg (410) 786-4601.

SUPPLEMENTARY INFORMATION:

I. Background

    On December 21, 2000, the Congress passed the Medicare, Medicaid, 
and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), Pub. 
L. 106-554. Section 531(b) of BIPA mandated procedures that permit 
public consultation for payment determinations for new clinical 
laboratory tests under Part B of title XVIII of the Social Security Act 
(the Act) in a manner consistent with the procedures established for 
implementing coding modifications for International Classification of 
Diseases (ICD-9-CM). The procedures and public meeting announced in 
this notice for new clinical laboratory tests are in accordance with 
the procedures published to implement section 531(b) of BIPA in the 
Federal Register at 66 FR 58743 on November 23, 2001. The public 
meeting is intended to provide expert input on the nature of new 
clinical laboratory tests and receive individual recommendations to 
either cross walk or gap-fill for payment. Decisions regarding payment 
for the newly created Physicians' Current Procedural Terminology (CPT) 
codes will not be made at this meeting. A summary of the new codes and 
the payment recommendations that are presented during the public 
meeting will be posted on CMS web site by September 10, 2003 and can be 
accessed at http://www.cms.hhs.gov/paymentsystems. The summary will 
also display CMS' tentative payment determinations, and interested 
individuals may submit written comments on the tentative payment 
determinations by September 24, 2003 to the address specified in the 
summary.

II. Presentations

    This meeting is open to the public. The on-site check-in for 
visitors will be held from 8 to 8:30 a.m., followed by opening remarks. 
Registered persons from the public may discuss and recommend payment 
determinations for specific new CPT codes for the 2004 Clinical 
Laboratory Fee Schedule. A newly created CPT code can either represent 
a refinement or modification of existing test methods, or a 
substantially new test method. The newly created CPT codes for the 
calendar year 2004 will be listed at the web site http://www.cms.hhs.gov/paymentsystems on or after July 2, 2003.
    Presentations should be brief, and three written copies should be 
submitted to accompany the oral presentation. Presenters may also make 
copies available for approximately 50 meeting participants. Presenters 
should address the new test code(s) and descriptor, the test purpose 
and method, costs, charges, and a recommendation with rationale for one 
of two methods for determining payment for new clinical laboratory 
codes. In the first method, called cross walking, a new test is 
determined to be similar to an existing test, multiple existing test 
codes, or a portion of an existing test code. The new test code is then 
assigned the related existing local fee schedule amounts and resulting 
national limitation amount. The second method, called gap-filling, is 
used when no comparable, existing test is available. Then instructions 
are provided to each Medicare carrier to determine a payment amount for 
its geographic area(s) for use in the first year, and the carrier-
specific amounts are used to establish a national limitation amount for 
following years. For each new clinical laboratory test code, a 
determination must be made to either cross walk or to gap-fill, and, if 
cross walking is appropriate, to know what tests to which to cross 
walk.

III. General Information

    The meeting will be held in a Federal government building; 
therefore, Federal security measures are applicable. In order to gain 
access to the building and grounds, participants must bring a 
government-issued photo identification and a copy of their registration 
confirmation. Security measures include inspection of vehicles, at 
entrance to the grounds, and the requirement for persons to pass 
through a metal detector when entering the building. All items brought 
to CMS, whether personal or for the purpose of demonstration or to 
support a presentation, are subject to inspection.
    Special Accommodation: Persons attending the meeting who are 
hearing or visually impaired and have special requirements, or a 
condition that requires special assistance, should provide such 
information upon registering for the meeting.

    Authority: Section 1102 and 1871 of the Social Security Act (42 
U.S.C. 1302 and 42 U.S.C. 1395hh)

(Catalog of Federal Domestic Assistance Program No. 93.774, 
Medicare--Supplementary Medical Insurance Program)

    Dated: June 11, 2003.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 03-16056 Filed 6-26-03; 8:45 am]
BILLING CODE 4120-01-P