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 2012_register executive 2012-11-16 article Part II Rules and Regulations D09002ee1c7fc2f10 D09002ee1c7fc305a 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 major final rule with comment period addresses changes to the physician fee schedule, payments for Part B drugs, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also implements provisions of the Affordable Care Act by establishing a face-to-face encounter as a condition of payment for certain durable medical equipment (DME) items. In addition, it implements statutory changes regarding the termination of non-random prepayment review. This final rule with comment period also includes a discussion in the Supplementary Information regarding various programs . (See the Table of Contents for a listing of the specific issues addressed in this final rule with comment period.) 77 FR 68892 https://www.govinfo.gov/app/details/FR-2012-11-16/2012-26900 2012-26900 fr16no12-12 RIN 0938-AR11 4120-01-P CMS-1590-FC https://www.govinfo.gov/app/details/FR-2012-11-16/2012-26900 https://www.govinfo.gov/content/pkg/FR-2012-11-16/html/2012-26900.htm https://www.govinfo.gov/content/pkg/FR-2012-11-16/pdf/2012-26900.pdf Health Facilities Health Professions Kidney Diseases Laboratories Medicare Reporting and Recordkeeping Requirements Rural Areas X-Rays Administrative Practice and Procedure Emergency Medical Services Health Maintenance Organizations (Hmo) Health Professionals Incorporation by Reference Penalties Privacy Grant Programs-Health Electronic Health Records Medicaid 482 p. 68892 69373 77 FR 68892 Title 42 Part 410 42 CFR Part 410 Title 42 Part 414 42 CFR Part 414 Title 42 Part 415 42 CFR Part 415 Title 42 Part 421 42 CFR Part 421 Title 42 Part 423 42 CFR Part 423 Title 42 Part 425 42 CFR Part 425 Title 42 Part 486 42 CFR Part 486 Title 42 Part 495 42 CFR Part 495 RIN 0938-AR11 Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME Face-to-Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013; Federal Register Vol. 77, Issue RULE 2012-26900 II DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services CMS-1590-FC 4120-01-P 2012-26900 Final rule with comment period.

This major final rule with comment period addresses changes to the physician fee schedule, payments for Part B drugs, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also implements provisions of the Affordable Care Act by establishing a face-to-face encounter as a condition of payment for certain durable medical equipment (DME) items. In addition, it implements statutory changes regarding the termination of non-random prepayment review. This final rule with comment period also includes a discussion in the Supplementary Information regarding various programs . (See the Table of Contents for a listing of the specific issues addressed in this final rule with comment period.)

Effective date: The provisions of this final rule with comment period are effective on January 1, 2013 with the exception of provisions in Sec. 410.38 which are effective on July 1, 2013. The incorporation by reference of certain publications listed in the rule was approved by the Director of the Federal Register on May 16, 2012. Elliott Isaac, (410) 786-4735, for any physician payment issue not identified below. Ryan Howe, (410) 786-3355, for issues related to practice expense methodology and direct practice expense inputs, telehealth services, and issues related to primary care and care coordination. Sara Vitolo, (410) 786-5714, for issues related to potentially misvalued services, malpractice RVUs, molecular pathology, and payment for new preventive service HCPCS G-codes, and the sustainable growth rate. Carol Schwartz, (410) 786- 0576, for issues related to colonoscopy and preventive services. Ken Marsalek, (410) 786-4502, for issues related to the multiple procedure payment reduction and payment for the technical component of pathology services. Craig Dobyski, (410) 786-4584, for issues related to geographic practice cost indices. Pam West, (410) 786-2302, for issues related to therapy services. Chava Sheffield, (410) 786-2298, for issues related to certified registered nurse anesthetists scope of benefit. Roberta Epps, (410) 786-4503, for issues related to portable x-ray. Anne Tayloe-Hauswald, (410) 786-4546, for issues related to ambulance fee schedule and Part B drug payment. Amanda Burd, (410) 786-2074, for issues related to the DME provisions. Debbie Skinner, (410) 786-7480, for issues related to non-random prepayment complex medical review. Latesha Walker, (410) 786-1101, for issues related to ambulance coverage--physician certification statement. Alexandra Mugge, (410) 786-4457, for issues related to physician compare. Christine Estella, (410) 786-0485, for issues related to the physician quality reporting system, incentives for e-prescribing, and Medicare shared savings program. Pauline Lapin, (410) 786-6883, for issues related to the chiropractic services demonstration budget neutrality issue. Gift Tee, (410) 786-9316, for issues related to the physician feedback reporting program and value-based payment modifier. Jamie Hermansen, (410) 786-2064, for issues related to Medicare coverage for hepatitis B vaccine. Andrew Morgan, (410) 786-2543, for issues related to e-prescribing under Medicare Part D. Health Facilities Health Professions Kidney Diseases Laboratories Medicare Reporting and Recordkeeping Requirements Rural Areas X-Rays Administrative Practice and Procedure Emergency Medical Services Health Maintenance Organizations (Hmo) Health Professionals Incorporation by Reference Penalties Privacy Grant Programs-Health Electronic Health Records Medicaid Medicare Program: Revisions to Payment Policies Under the Physician Fee Schedule, DME Face to Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013 , OIRA_submission@omb.eop.gov cms.gov http://apps.who.int/classifications/icfbrowser/ http://cms.gov/Regulations-and-Guidance/Guidance/FACA/MEITAP.html http://iom.edu/eports/2012/Geographic-Adjustment-in-Medicare-Payment-Phase-II.aspx http://iom.edu/Reports/2011/Geographic-Adjustment-in-Medicare-Payment-Phase-I-Improving-Accuracy.aspx http://medpac.gov/transcripts/092012_transcript.pdf 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Table of Contents: AE 2.7: GS 4.107: AE 2.106: KF70.A2 https://www.govinfo.gov/app/details/FR-2012-11-16 P0b002ee1837e8b87 0097-6326 0042-1219 0364-1406 769-004-00000-9 000582072 f:fr16no12 https://www.govinfo.gov/app/details/FR-2012-11-16 https://www.govinfo.gov/content/pkg/FR-2012-11-16/pdf/FR-2012-11-16.pdf https://www.govinfo.gov/content/pkg/FR-2012-11-16/xml/FR-2012-11-16.xml fdlp 68679 69380 DGPO 2012-11-16 2024-06-03 FR-2012-11-16 machine generated eng FR FR-2012-11-16 77 222