United States Government Publishing Office publisher pbl distributor dst United States National Archives and Records Administration Office of the Federal Register author aut Government Organization text government publication eng FR Regulatory Information 2004_register executive 2010-09-22 article Part II Proposed Rules D09002ee1c814bbf5 D09002ee1c814c5e4 United States Department of Health and Human Services originator org United States Government Agency or Subagency United States Centers for Medicare & Medicaid Services originator org United States Government Agency or Subagency This proposed rule would refine the resource-based practice expense relative value units (RVUs) and make other changes to Medicare Part B payment policy. The proposed policy changes concern: supplemental survey data for practice expense, updated geographic practice cost indices for physician work and practice expense, updated malpractice RVUs, revised requirements for supervision of therapy assistants, revised payment rules for low osmolar contrast media, changes to payment policies for physicians and practitioners managing dialysis patients, clarification of care plan oversight requirements, revised requirements for supervision of diagnostic psychological testing services, clarifications to the policies affecting therapy services, revised requirements for assignment of Medicare claims, addition to the list of telehealth services, and several coding issues. We are proposing these changes to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. We solicit comments on these proposed policy changes. This proposed rule also addresses the following provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA): coverage of an initial preventive physical examination; coverage of cardiovascular screening blood tests; coverage of diabetes screening tests; incentive payment improvements for physicians in shortage areas; payment for covered outpatient drugs and biologicals; payment for renal dialysis services; coverage of routine costs associated with certain clinical trials of category A devices as defined by the Food and Drug Administration; hospice consultation service; indexing the Part B deductible to inflation; extension of coverage of intravenous immune globulin (IVIG) for the treatment in the home of primary immune deficiency diseases; revisions to reassignment provisions; clinical conditions for payment of covered items of durable medical equipment; and payment for diagnostic mammograms. In addition, we discuss physicians' services associated with drug administration services and payment for set-up of portable x-ray equipment. 69 FR 47488 https://www.govinfo.gov/app/details/FR-2004-08-05/04-17312 04-17312 fr05au04-28 RIN 0938-AM90 4120-01-P CMS-1429-P https://www.govinfo.gov/app/details/FR-2004-08-05/04-17312 https://www.govinfo.gov/content/pkg/FR-2004-08-05/html/04-17312.htm https://www.govinfo.gov/content/pkg/FR-2004-08-05/pdf/04-17312.pdf Administrative Practice and Procedure Health Facilities Health Professions Kidney Diseases Medical Devices Medicare Reporting and Recordkeeping Requirements Rural Areas X-Rays Laboratories Hospice Care Emergency Medical Services Grant Programs-Health 243 p. 47488 47730 69 FR 47488 Title 42 Part 405 42 CFR Part 405 Title 42 Part 410 42 CFR Part 410 Title 42 Part 411 42 CFR Part 411 Title 42 Part 414 42 CFR Part 414 Title 42 Part 418 42 CFR Part 418 Title 42 Part 424 42 CFR Part 424 Title 42 Part 484 42 CFR Part 484 Title 42 Part 486 42 CFR Part 486 RIN 0938-AM90 Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005; Federal Register Vol. 69, Issue PRORULE 04-17312 II DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 2004-09-24 CMS-1429-P 4120-01-P 04-17312 Proposed rule.

This proposed rule would refine the resource-based practice expense relative value units (RVUs) and make other changes to Medicare Part B payment policy. The proposed policy changes concern: supplemental survey data for practice expense, updated geographic practice cost indices for physician work and practice expense, updated malpractice RVUs, revised requirements for supervision of therapy assistants, revised payment rules for low osmolar contrast media, changes to payment policies for physicians and practitioners managing dialysis patients, clarification of care plan oversight requirements, revised requirements for supervision of diagnostic psychological testing services, clarifications to the policies affecting therapy services, revised requirements for assignment of Medicare claims, addition to the list of telehealth services, and several coding issues. We are proposing these changes to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. We solicit comments on these proposed policy changes. This proposed rule also addresses the following provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA): coverage of an initial preventive physical examination; coverage of cardiovascular screening blood tests; coverage of diabetes screening tests; incentive payment improvements for physicians in shortage areas; payment for covered outpatient drugs and biologicals; payment for renal dialysis services; coverage of routine costs associated with certain clinical trials of category A devices as defined by the Food and Drug Administration; hospice consultation service; indexing the Part B deductible to inflation; extension of coverage of intravenous immune globulin (IVIG) for the treatment in the home of primary immune deficiency diseases; revisions to reassignment provisions; clinical conditions for payment of covered items of durable medical equipment; and payment for diagnostic mammograms. In addition, we discuss physicians' services associated with drug administration services and payment for set-up of portable x-ray equipment.

To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on September 24, 2004. Pam West (410) 786-2302 (for issues related to Practice Expense, Respiratory Therapy Coding, and Therapy Supervision). Rick Ensor (410) 786-5617 (for issues related to Geographic Practice Cost Index (GPCI) and malpractice RVUs). Craig Dobyski (410) 786-4584 (for issues related to list of telehealth services or payments for physicians and practitioners managing dialysis patients). Bill Larson or Tiffany Sanders (410) 786-7176 (for issues related to coverage of an initial preventive physical examination). Cathleen Scally (410) 786-5714 (for issues related to payment of an initial preventive physical examination). Joyce Eng (410) 786-7176 (for issues related to coverage of cardiovascular screening tests). Betty Shaw (410) 786-7176 (for issues related to coverage of diabetes screening tests). Anita Greenberg (410) 786-0548 (for issues related to payment of cardiovascular and diabetes screening tests). David Worgo (410) 786-5919, (for issues related to incentive payment improvements for physicians practicing in shortage areas). Angela Mason or Jennifer Fan (410) 786-0548 (for issues related to payment for covered outpatient drugs and biologicals). David Walczak (410) 786-4475 (for issues related to reassignment provisions). Henry Richter (410) 786-4562 (for issues related to payments for ESRD facilities). Steve Berkowitz (410) 786-7176 (for issues related to coverage of routine costs associated with certain clinical trials of category A devices). Terri Deutsch (410) 786-9462 (for issues related to hospice consultation services). Karen Daily (410) 786-7176 (for issues related to clinical conditions for payment of covered items of durable medical equipment). Dorothy Shannon (410) 786-3396 (for issues related to outpatient therapy services performed "incident to" physicians' services). Roberta Epps (410) 786-5919 (for issues related to low osmolar contrast media or supervision of diagnostic psychological testing services). Gail Addis (410) 786-4522 (for issues related to care plan oversight). Diane Milstead (410) 786-3355 or Gaysha Brooks (410) 786-9649 (for all other issues). Administrative Practice and Procedure Health Facilities Health Professions Kidney Diseases Medical Devices Medicare Reporting and Recordkeeping Requirements Rural Areas X-Rays Laboratories Hospice Care Emergency Medical Services Grant Programs-Health Medicare: Physician fee schedule (2005 CY); payment policies and relative value units, Christopher_Martin@omb.eop.gov http://www.access.gpo.gov/nara/index.html http://www.cms.hhs.gov http://www.cms.hhs.gov/ http://www.cms.hhs.gov/coverage http://www.cms.hhs.gov/manuals/pm_trans/R6BP.pdf http://www.cms.hhs.gov/manuals/pm_trans/R74CP.pdf http://www.cms.hhs.gov/physicians/pfs http://www.cms.hhs.gov/physicians/pfs/ http://www.cms.hhs.gov/regulations/ecomments www.cms.hhs.gov/physicians/telehealth Vol. 69, no. 150 Office of the Federal Register, National Archives and Records Administration 2004-08-05 continuing daily deposited born digital 422 p. Table of Contents: AE 2.7: GS 4.107: AE 2.106: KF70.A2 https://www.govinfo.gov/app/details/FR-2004-08-05 P0b002ee18096e2e3 0097-6326 0042-1219 0364-1406 769-004-00000-9 000582072 f:fr05au04 https://www.govinfo.gov/app/details/FR-2004-08-05 https://www.govinfo.gov/content/pkg/FR-2004-08-05/pdf/FR-2004-08-05.pdf https://www.govinfo.gov/content/pkg/FR-2004-08-05/xml/FR-2004-08-05.xml fdlp 47353 47762 DGPO 2010-09-22 2024-06-06 FR-2004-08-05 machine generated eng FR FR-2004-08-05 69 150