80 FR 14853 - Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015; Corrections

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services

Federal Register Volume 80, Issue 54 (March 20, 2015)

Page Range		14853-14870
FR Document		2015-06427

This document corrects technical errors that appeared in the final rule with comment period published in the November 13, 2014 Federal Register (79 FR 67547-68092) entitled, ``Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015.'' The effective date for the rule was January 1, 2015.

Federal Register, Volume 80 Issue 54 (Friday, March 20, 2015)

[Federal Register Volume 80, Number 54 (Friday, March 20, 2015)]
[Rules and Regulations]
[Pages 14853-14870]
From the Federal Register Online [www.thefederalregister.org]
[FR Doc No: 2015-06427]

[[Page 14853]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 403, 405, 410, 411, 412, 413, 414, 425, 489, 495, and
498

[CMS-1612-F2]
RIN 0938-AS12

Medicare Program; Revisions to Payment Policies Under the
Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to
Identifiable Data for the Center for Medicare and Medicaid Innovation
Models & Other Revisions to Part B for CY 2015; Corrections

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

ACTION: Final rule; correcting amendment.

-----------------------------------------------------------------------

SUMMARY: This document corrects technical errors that appeared in the
final rule with comment period published in the November 13, 2014
Federal Register (79 FR 67547-68092) entitled, ``Medicare Program;
Revisions to Payment Policies under the Physician Fee Schedule,
Clinical Laboratory Fee Schedule, Access to Identifiable Data for the
Center for Medicare and Medicaid Innovation Models & Other Revisions to
Part B for CY 2015.'' The effective date for the rule was January 1,
2015.

DATES: Effective date: This correcting document is effective March 19,
2015. Applicability date: The corrections indicated in this document
are applicable beginning January 1, 2015.

FOR FURTHER INFORMATION CONTACT: Christine Estella, (410) 786-0485, for
issues related to the physician quality reporting system. Donta Henson,
(410) 786-1947 for all other issues.

SUPPLEMENTARY INFORMATION:

I. Background

In FR Doc. 2014-26183 (79 FR 67547 through 68092) the final rule
entitled, ``Medicare Program; Revisions to Payment Policies under the
Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to
Identifiable Data for the Center for Medicare and Medicaid Innovation
Models & Other Revisions to Part B for CY 2015'' (hereinafter referred
to as the CY 2015 PFS final rule with comment period), there were a
number of technical errors that are identified and corrected in section
IV., Correction of Errors. These corrections are applicable as of
January 1, 2015. We note that the Addenda B and C to the CY 2015 PFS
final rule with comment period as corrected by this correction document
are available on the CMS Web site at www.cms.gov/PhysicianFeeSched/.

II. Summary of Errors

A. Summary of Errors in the Preamble

On page 67559, due to errors made in ratesetting, many of the
values contained in Table 4: Calculation of PE RVUs Under Methodology
for Selected Codes, are incorrect.
On page 67562, in Table 8: Codes Affected by Removal of Film
Inputs, we inadvertently included CPT codes 93320, 93321, and 93325.
On page 67591, we incorrectly stated that in section II. G. of the
rule, we address the interim final values and establish CY 2015 inputs
for the lower gastrointestinal procedures.
On page 67612, in Table 14: Codes Reviewed by the 2014 Multi-
Specialty Refinement Panel, the work RVUs for CPT codes 43204, 43205,
and 43233 are incorrect.
On page 67633, due to a typographical error we referred to CPT code
41391 rather than CPT code 43391.
On page 67636, due to a technical error, the final work RVU for
code 43278 is incorrect.
On pages 67651 through 67663, in Table 25: CY 2015 Interim Final
Work RVUS For New/Revised or Potentially Misvalued Codes, the RUC/HCPAC
recommended work RVUs listed on page 67658 for CPT codes 76932 and
76948 are incorrect and entries for CPT codes 76940 and 76965 were
inadvertently omitted from the table.
On page 67660, the RUC/HCPAC recommended work RVU listed for CPT
code 92545 is incorrect.
On page 67668,
a. We inadvertently omitted G0279 from the list of codes in the
title of (13).
b. Due to a typographical error, G0279 is referred to as G-2079.
c. We inadvertently omitted the phrase ``, whether or not a 2-D
mammography is furnished'' from the sentence beginning, ``In addition,
we are creating . . .''
On page 67669, we inadvertently listed CPT code 93644 in the title
of (18).
On page 67671, in Table 28: CY 2015 Interim Final Codes with Direct
PE Input Recommendations Accepted without Refinement, we inadvertently
listed CPT code 31620.
On page 67673, in Table 29: Invoices Received for New Direct PE
Inputs we inadvertently listed entries associated with CPT code 31620.
On page 67674, in Table 30: Invoices Received For Existing Direct
PE Inputs, certain PE direct inputs for CPT code 31627 were
inadvertently omitted.
On pages 67678 through 67711, in Table 31: CY 2015 Interim Final
Codes With Direct PE Input Recommendations Accepted with Refinements,
due to technical errors, on page 67678, entries associated with CPT
codes 77061 and 77062 were inadvertently listed; on page 67702, entries
associated with CPT codes 93320, 93321, and 93325 were inadvertently
omitted and an input code for CPT code 93880 was inadvertently omitted.
On page 67726, we incorrectly stated that practitioners do not have
to use any ``specific content exchange standard.''
On pages 67741 through 67742, we incorrectly stated the CY 2015 PFS
conversion factors.
On page 67742, in Table 45: Calculation of the CY 2015 PFS CF, due
to corrections being made in this document, the CY 2014 budget
neutrality adjustment, the CY 2015 CFs, and the percentage changes from
the CY 2014 CF stated in the table are incorrect.
On page 67743, due to technical errors, the budget neutrality
factor, the anesthesia CF in effect from January 1, 2015 through March
31, 2015, and the anesthesia CF in effect from April 1, 2015 through
December 31, 2015 are incorrectly stated. The entries in Table 46:
Calculation of the CY 2015 Anesthesia CF for budget neutrality
adjustments, CFs and percentage change are inaccurate.
On pages 67803 and 67804, in Table 52: Individual Quality Cross-
Cutting Measures for the PQRS to Be Available for Satisfactory
Reporting Via Claims, Registry, and EHR Beginning in 2015, we
inadvertently listed the incorrect National Quality Strategy (NQS)
domain for Physician Quality Reporting System (PQRS) Measure 131, Pain
Assessment and Follow-Up.
On pages 67848 and 67849, in Table 55: Measures Being Removed from
the Existing PQRS Measure Set Beginning in 2015, we inadvertently
omitted adding an ``X'' to the claims reporting option for Physician
Quality Reporting System (PQRS) Measure 0091/051: Chronic Obstructive
Pulmonary Disease (COPD): Spirometry Evaluation, Measure 0102/052:
Chronic Obstructive Pulmonary Disease (COPD): Inhaled Bronchodilator
Therapy, and Measure 0050/109: Osteoarthritis (OA) Function and Pain
Assessment.
On page 67854, in Table 56: Existing Individual Quality Measures
and Those Included in Measures Groups for the PQRS for Which Measure
Reporting Updates Will Be Effective Beginning in 2015, we inadvertently
added an ``X'' to the Group Practice Reporting Option

[[Page 14854]]

(GPRO) Web Interface reporting option for Physician Quality Reporting
System (PQRS) Measure 0067/006: Coronary Artery Disease (CAD):
Antiplatelet Therapy.
On page 67877, in Table 56: Existing Individual Quality Measures
and Those Included in Measures Groups for the PQRS for Which Measure
Reporting Updates Will Be Effective Beginning in 2015, we inadvertently
added an ``X'' to the claims reporting option and omitted adding an
``X'' to the registry reporting option for Physician Quality Reporting
System (PQRS) Measure 0409/205: HIV/AIDS: Sexually Transmitted Disease
Screening for Chlamydia, Gonorrhea, and Syphilis.
On page 67988, in Table 93: CY 2015 PFS Final Rule with Comment
Period Estimated Impact Table: Impacts of Work, Practice Expense, and
Malpractice RVUs, due to ratesetting errors, the values are inaccurate.
On page 67991 through 67992, in Table 94: Impact of the Final Rule
with Comment Period on CY 2014 Payment for Selected Procedures, due to
ratesetting errors, the stated payment rates are inaccurate.
On page 67999, the January 1-March 31, 2015 CF, the CY 2015
national payment amount in the nonfacility setting for CPT code 99203,
and the beneficiary coinsurance amount are incorrect.

B. Summary and Correction of Errors in the Addenda on the CMS Web Site

Due to the errors identified and summarized in section II.A and B
of this correction document, we are correcting errors in the work, PE
or MP RVUs (or combinations of these RVUs) in Addendum B: CY 2015
Relative Value Units (RVUs) And Related Information Used In Determining
Final Medicare Payments and Addendum C: CY 2015 Interim Final Relative
Value Units (RVUs). We note that corrections to the RVUs for codes with
identified errors affect additional codes due to the budget neutrality
and relativity of the PFS. These errors are corrected in the revised
Addenda B and C available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
In addition to the errors identified in section II.A. of this
correction document, the following errors occur in the addenda.
Due to a technical error in the creation of the direct PE database,
nonfacility PE RVUs were created and displayed in Addendum B (and
Addendum C, if applicable) for the following CPT codes: 21811, 21812,
21813, 22858, 33418, 33951, 33952, 33953, 33954, 33955, 33956, 33957,
33958, 33959, 33962, 33963, 33964, 33965, 33966, 33969, 33984, 33985,
33986, 33987, 33988, 33989, 37218, 43180, 44380, 44382, 66179, and
66184. These errors are corrected in the revised Direct PE Input
Database available on the CMS Web site at www.cms.gov//PhysicianFeeSched/. Resulting changes to the PE RVUs are reflected in
the corrected Addendum B (and Addendum C, if applicable) available on
the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to technical errors in the creation of the direct PE database,
some or all of the PE inputs were inadvertently omitted for CPT codes
22510, 22511, 22512, 22513, 22514, 22515, 31620, 33951, 33952, 33953,
33954, 33955, 33956, 33957, 33958, 33959, 33962, 33963, 33964, 33969,
33984, 33985, 33986, 33988, 33989, 58541, 58542, 58543, 58544, 58570,
58571, 58572, 64486, 64487, 64488, 64489, 70496, 70498, 76700, 76705,
77080, 88348, 93260, 93261, and 93644. These errors are corrected in
the revised Direct PE Input Database available on the CMS Web site at
www.cms.gov//PhysicianFeeSched/.
Due to technical errors in the creation of the direct PE database,
the incorrect inputs were used for creating PE RVUs for CPT codes
20982, 31620, 31627, 32998, 33262, 32998, 41530, 50592, 64600, 64605,
64610, 64633, 64634, 64635, 64636, 93925, 93880, and 93990. These
errors are corrected in the revised Direct PE Input Database available
on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, we incorrectly displayed in Addenda B and
C PE RVUs in a nonfacility setting for CPT codes 33270, 33271, 33272,
and 33273. The PE RVUs for these codes in a non-facility setting have
been removed in the corrected Addenda B and C available on the CMS Web
site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, HCPCS codes 33330, 33474, 61610, and
61870 were inadvertently left out of Addendum B. These codes are
reflected in the corrected Addendum B available on the CMS Web site at
www.cms.gov//PhysicianFeeSched/.
Due to a technical error, the average risk factor, and not the
specialty risk factor that we indicated that we were using in the
preamble, was applied when calculating the MP RVUs for CPT codes 33620
and 33622. As a result, the MP RVUs listed in Addendum B are incorrect
for these codes. We have corrected these errors in the corrected
Addendum B available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, the incorrect work RVUs were applied in
calculating the MP RVUs for CPT codes 33418 and 33419. As a result, the
MP RVUs listed in Addenda B and C are incorrect for these codes. We
have corrected these errors in the corrected Addenda B and C available
on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, the incorrect CY 2015 work RVUs are
included in Addendum B (and Addendum C, if applicable) for the
following codes: 43191, 43192, 43193, 43194, 43195, 43196, 43197,
43198, 43200, 43201, 43202, 43204, 43205, 43211, 43212, 43214, 43215,
43229, 43232, 43233, 43235, 43236, 43238, 43239, 43242, 43247, 43253,
43254, 43257, 43266, 43270, 43274, 43276, 43278, 58541, 58542, 58543,
58544, 58570, 58571, 58572, 58573, 71275, 76930, 76932, 76948, 92545,
93315, 93317, 93318, and 95973. The correct CY 2015 work RVUS for these
codes are reflected in the corrected Addenda B and C available on the
CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error in the creation of the direct PE database,
PE RVUs for the facility setting were created and are displayed in
Addendum B for HCPCS code 77372 and Addenda B and C for HCPCS code
G0277. These technical errors are corrected in Addenda B and C
available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to technical errors in the creation of the direct PE database,
direct PE inputs were inadvertently included for CPT code 99183 and are
reflected in the PE RVUs shown in Addenda B and C. This error is
corrected in the Direct PE Input Database available on the CMS Web site
at www.cms.gov//PhysicianFeeSched/. The corrected PE RVUS are included
in Addenda B and C available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, in Addendum B, work and MP RVUs for CPT
codes 99487 and 99489 were inadvertently included. The work and MP RVUs
for these codes have been removed in the corrected Addendum B available
on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error in the creation of the direct PE database,
PE RVUs were not created for CPT code 99490 in the facility setting.
The correct PE RVU for this code is reflected in the corrected Addendum
B available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, HCPCS codes G9407 through G9472 are
inadvertently included in Addendum B. These codes

[[Page 14855]]

have been removed in the corrected Addendum B available on the CMS Web
site at www.cms.gov//PhysicianFeeSched/.

C. Summary of Errors in the Regulations Text

On page 68002 of the CY 2015 PFS final rule with comment period, we
made a technical error in Sec. 410.26(b)(5). In this paragraph, we
inadvertently omitted language to limit the applicability of the
exception that allows general, rather than direct, supervision of
transitional care management services furnished incident to a
practitioner's professional services to the non-face-to-face aspects of
the service.

III. Waiver of Proposed Rulemaking and Delay in Effective Date

Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA),
the agency is required to publish a notice of the proposed rule in the
Federal Register before the provisions of a rule take effect.
Similarly, section 1871(b)(1) of the Act requires the Secretary to
provide for notice of the proposed rule in the Federal Register and
provide a period of not less than 60 days for public comment. In
addition, section 553(d) of the APA, and section 1871(e)(1)(B)(i) of
the Act mandate a 30-day delay in effective date after issuance or
publication of a rule. Sections 553(b)(B) and 553(d)(3) of the APA
provide for exceptions from the notice and comment and delay in
effective date APA requirements; in cases in which these exceptions
apply, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the Act provide
exceptions from the notice and 60-day comment period and delay in
effective date requirements of the Act as well. Section 553(b)(B) of
the APA and section 1871(b)(2)(C) of the Act authorize an agency to
dispense with normal rulemaking requirements for good cause if the
agency makes a finding that the notice and comment process are
impracticable, unnecessary, or contrary to the public interest. In
addition, both section 553(d)(3) of the APA and section
1871(e)(1)(B)(ii) of the Act allow the agency to avoid the 30-day delay
in effective date where such delay is contrary to the public interest
and an agency includes a statement of support.
In our view, this correction document does not constitute a
rulemaking that would be subject to these requirements. This correction
document corrects technical errors in the CY 2015 PFS final rule with
comment period and the corresponding addenda posted on the CMS Web
site. The corrections contained in this document are consistent with,
and do not make substantive changes to, the policies and payment
methodologies that were adopted subjected to notice and comment
procedures in the CY 2015 PFS final rule with comment period. As a
result, the corrections made through this correction document are
intended to ensure that the CY 2015 PFS final rule with comment period
accurately reflects the policies adopted in that rule.
Even if this were a rulemaking to which the notice and comment and
delayed effective date requirements applied, we find that there is good
cause to waive such requirements. Undertaking further notice and
comment procedures to incorporate the corrections in this document into
the CY 2015 PFS final rule with comment period or delaying the
effective date of the corrections would be contrary to the public
interest because it is in the public interest to ensure that the CY
2015 PFS final rule with comment period accurately reflects our final
policies as soon as possible following the date they take effect.
Further, such procedures would be unnecessary, because we are not
altering the payment methodologies or policies, but rather, we are
simply correcting the Federal Register document to reflect the policies
that we previously proposed, received comment on, and subsequently
finalized. This correcting document is intended solely to ensure that
the CY 2015 PFS final rule with comment period accurately reflects
these policies. For these reasons, we believe there is good cause to
waive the requirements for notice and comment and delay in effective
date.

IV. Correction of Errors

In FR Doc. 2014-26183 of November 13, 2014 (79 FR 67547), make the
following corrections:

A. Correction of Errors in the Preamble

1. On page 67559, in Table 4: Calculation of PE RVUs Under
Methodology for Selected Codes, the table is corrected to read as
follows:

[[Page 14856]]

Table 4--Calculation of PR RVUs Under Methodology for Selected Codes
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
99213
Office 33533 CABG, 71020 Chest 71020-TC 71020-26 93000 ECG, 93005 ECG, 93010 ECG,
Factor (CF) (2nd part) Step Source Formula visit, est arterial, x-ray non- Chest x- Chest x- complete, tracing, report non-
non- single facility ray, non- ray, non- non- non- facility
facility facility facility facility facility facility
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(1) Labor cost (Lab)........... Step 1........... AMA.............. ................. 13.32 77.52 5.74 5.74 0 5.1 5.1 0
(2) Supply cost (Sup).......... Step 1........... AMA.............. ................. 2.98 7.34 0.53 0.53 0 1.19 1.19 0
(3) Equipment cost (Eqp)....... Step 1........... AMA.............. ................. 0.17 0.58 6.92 6.92 0 0.09 0.09 0
(4) Direct cost (Dir).......... Step 1........... ................. '%=(1)+(2)+(3) 16.48 85.45 13.19 13.19 0 6.38 6.38 0
(5) Direct adjustment (Dir. Steps 2-4........ See footnote *... ................. 0.5953 0.5953 0.5953 0.5953 0.5953 0.5953 0.5953 0.5953
Adj.).
(6) Adjusted Labor............. Steps 2-4........ '%=Labor * Dir '%=(1) * (5) 7.93 46.15 3.42 3.42 0 3.04 3.04 0
Adj.
(7) Adjusted Supplies.......... Steps 2-4........ '%=Eqp * Dir Adj. '%=(2) * (5) 1.78 4.37 0.32 0.32 0 0.71 0.71 0
(8) Adjusted Equipment......... Steps 2-4........ '%=Sup * Dir Adj. '%=(3) * (5) 0.1 0.35 4.12 4.12 0 0.05 0.05 0
(9) Adjusted Direct............ Steps 2-4........ ................. '%=(6)+(7)+(8) 9.81 50.87 7.85 7.85 0 3.8 3.8 0
(10) Conversion Factor (CF).... Step 5........... PFS.............. ................. 35.8228 35.8228 35.8228 35.8228 35.8228 35.8228 35.8228 35.8228
(11) Adj. labor cost converted. Step 5........... '%=(Lab * Dir '%=(6)/(10) 0.22 1.29 0.1 0.1 0 0.08 0.08 0
Adj)/CF.
(12) Adj. supply cost converted Step 5........... '%=(Sup * Dir '%=(7)/(10) 0.05 0.12 0.01 0.01 0 0.02 0.02 0
Adj)/CF.
(13) Adj. equipment cost Step 5........... '%=(Eqp * Dir '%=(8)/(10) 0 0.01 0.11 0.11 0 0 0 0
converted. Adj)/CF.
(14) Adj. direct cost converted Step 5........... ................. '%=(11)+(12)+(13) 0.27 1.42 0.22 0.22 0 0.11 0.11 0
(15) Work RVU.................. Setup File....... PFS.............. ................. 0.97 33.75 0.22 0 0.22 0.17 0 0.17
(16) Dir_pct................... Steps 6,7........ Surveys.......... ................. 0.25 0.17 0.29 0.29 0.29 0.29 0.29 0.29
(17) Ind_pct................... Steps 6,7........ Surveys.......... ................. 0.75 0.83 0.71 0.71 0.71 0.71 0.71 0.71
(18) Ind. Alloc. Formula (1st Step 8........... See Step 8....... ................. (14)/(16) * (14)/(16) * (14)/(16) * (14)/(16) * (14)/(16) * (14)/(16) * (14)/(16) * (14)/(16) *
part). (17) (17) (17) (17) (17) (17) (17) (17)
(19) Ind. Alloc. (1st part).... Step 8........... ................. See 18 0.83 6.73 0.53 0.53 0 0.26 0.26 0
(20) Ind. Alloc. Formula (2nd Step 8........... See Step 8....... ................. -15% -15% %(15+11) -11% -15% %(15+11) -11% -15%
part).
(21) Ind. Alloc. (2nd part).... Step 8........... ................. See 20 0.97 33.75 0.32 0.1 0.22 0.25 0.08 0.17
(22) Indirect Allocator (1st + Step 8........... ................. '%=(19)+(21) 1.8 40.48 0.85 0.63 0.22 0.52 0.35 0.17
2nd).
(23) Indirect Adjustment (Ind. Steps 9-11....... See Footnote * *. ................. 0.3829 0.3829 0.3829 0.3829 0.3829 0.3829 0.3829 0.3829
Adj.).
(24) Adjusted Indirect Steps 9-11....... '%=Ind Alloc * ................. 0.69 15.5 0.33 0.24 0.08 0.2 0.13 0.07
Allocator. Ind Adj.
(25) Ind. Practice Cost Index Steps 12-16...... ................. ................. 1.07 0.75 0.99 0.99 0.99 0.91 0.91 0.91
(IPCI).
(26) Adjusted Indirect......... Step 17.......... '%= Adj.Ind Alloc '%=(24) * (25) 0.74 11.64 0.32 0.24 0.08 0.18 0.12 0.06
* PCI.
(27) Final PE RVU.............. Step 18.......... '%=(Adj Dir + Adj '%=((14)+(26)) * 1.01 12.99 0.54 0.46 0.08 0.29 0.23 0.06
Ind) * Other Adj. Other Adj)
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Note: PE RVUs in Table 4, row 27, may not match Addendum B due to rounding.
* The direct adj = [current pe rvus * CF * avg dir pct]/[sum direct inputs] = [step2]/[step3]
* * The indirect adj = [current pe rvus * avg ind pct]/[sum of ind allocators] = [step9]/[step10]
Note: The use of any particular conversion factor (CF) in Table 4 to illustrate the PE Calculation has no effect on the resulting RVUs.

[[Page 14857]]

2. On page 67562, in Table 8: Codes Affected by Removal of Film
Inputs, the following listed entries are removed.

------------------------------------------------------------------------
HCPCS Short descriptor
------------------------------------------------------------------------
93320.............................. Doppler echo exam heart
93321.............................. Doppler echo exam heart
93325.............................. Doppler color flow add-on
------------------------------------------------------------------------

3. On page 67591, third column, first full paragraph, line 10, the
sentence ``In section II.G. of this CY 2015 PFS final rule with comment
period, we address interim final values and establish CY 2015 inputs
for the lower gastrointestinal procedures, many of which are also
listed in Appendix G.'' is corrected to read ``In section II.G. of this
CY 2015 PFS final rule with comment period, we note that we are
delaying the adoption of the new code set for lower gastrointestinal
procedures until CY 2016; many of these codes are also listed in
Appendix G.''
4. On page 67612, in Table 14: Codes reviewed by the 2014 Multi-
Specialty Refinement Panel, the entries for CPT codes 43204, 43205 and
43233 are corrected to read as follows:

----------------------------------------------------------------------------------------------------------------
Refinement
HCPCS code Descriptor CY 2014 interim RUC recommended panel median CY 2015 work RVU
final work RVU work RVU rating
----------------------------------------------------------------------------------------------------------------
43204........... Injection of dilated 2.40 2.89 2.77 2.43
esophageal veins
using an endoscope.
43205........... Tying of esophageal 2.51 3.00 2.88 2.54
veins using an
endoscope.
43233........... Balloon dilation of 4.05 4.45 4.26 4.17
esophagus, stomach,
and/or upper small
bowel using an
endoscope.
----------------------------------------------------------------------------------------------------------------

5. On page 67633, third column, first full paragraph, line 14, the
phrase ``CPT code 41391,'' is corrected to read ``CPT code 43391,''.
6. On page 67636, third column, first partial paragraph, lines 24
through 25, the sentence ``The final work RVU for CPT code 43278 is
8.'' is corrected to read ``The final work RVU for CPT code 43278 is
8.02.''
7. On pages 67651 through 67663, in Table 25: CY 2015 Interim Final
Work RVUS For New/Revised or Potentially Misvalued Codes, the listed
entries on page 67658 are corrected to read:

----------------------------------------------------------------------------------------------------------------
RUC/HCPAC
HCPCS code Long descriptor CY 2014 WRVU recommended work CY 2015 work RVU CMS time
RVU refinement
----------------------------------------------------------------------------------------------------------------
76932........... Ultrasonic guidance C 0.67 0.67 No
for endomyocardial
biopsy, imaging
supervision and
interpretation.
76940........... Ultrasound guidance 2.00 2.00 2.00 No
for, and monitoring
of, parenchymal
tissue ablation.
76948........... Ultrasonic guidance 0.38 0.38 0.38 No
for aspiration of
ova, imaging
supervision and
interpretation.
76965........... Ultrasonic guidance 1.34 1.34 1.34 No
for interstitial
radioelement
application.
----------------------------------------------------------------------------------------------------------------

8. On page 67660, in Table 25: CY 2015 Interim Final Work RVUS For
New/Revised or Potentially Misvalued Codes, the listed entry is
corrected to read:

9. On page 67668,
a. First column, line 1, the title ``(13) Breast Tomosynthesis (CPT
codes 77061, 77062, and 77063)'' is corrected to read ``(13) Breast
Tomosynthesis (CPT codes 77061, 77062, 77063 and G2079)''.
b. Second column, line 19, the phrase ``a new code, G-2079'' is
corrected to read ``a new code, G0279''.
c. Second column, line 27, is corrected by adding ``whether or not
a 2-D mammography is furnished'' after the phrase ``diagnostic breast
tomosynthesis''.
10. On page 67669, second column, lines 8 through 11, we are
correcting the title ``(18) Interventional Transesophageal
Echocardiography (TEE) (CPT Codes 93312, 93313, 93314, 93315, 93316,
93317, 93318, 93355, and 93644)'' to read ``(18) Interventional
Transesophageal Echocardiography (TEE) (CPT Codes 93312, 93313, 93314,
93315, 93316, 93317, 93318, and 93355).''
11. On page 67671, in Table 28: CY 2015 Interim Final Codes with
Direct PE Input Recommendations Accepted without Refinements, the
following listed entry is removed:

------------------------------------------------------------------------
HCPCS Short descriptor
------------------------------------------------------------------------
31620.............................. Endobronchial us add-on
------------------------------------------------------------------------

12. On page 67673, in Table 29: Invoices Received for New Direct PE
Inputs, the following listed entries for CPT code 31620 are removed:

[[Page 14858]]

--------------------------------------------------------------------------------------------------------------------------------------------------------
Non-facility allowed services
Number of for HCPCS codes using this
CPT/HCPCS codes Item name CMS code Average price invoices item (or projected services
for new CPT codes*)
--------------------------------------------------------------------------------------------------------------------------------------------------------
31620............................... Flexible dual-channeled EQ361 $160,260.06.................. 6 107
EBUS bronchoscope, with
radial probe.
31620............................... Video system, Ultrasound ER099 $13,379.57................... 6 107
(processor, digital
capture, monitor,
printer, cart).
31620............................... EBUS, single use SC10$145.82...................... 5 107
aspiration needle, 21 g.
31620............................... Balloon for Bronchosopy SD294 $28.68....................... 4 107
Fiberscope.
--------------------------------------------------------------------------------------------------------------------------------------------------------

13. On page 67674, Table 30: Invoices Received for Existing Direct
PE Inputs, the list entries for CPT code 31627 are corrected by adding
the following:

--------------------------------------------------------------------------------------------------------------------------------------------------------
Non-facility
Number of allowed services
CPT/HCPCS codes Item name CMS code Current price Updated price % Change invoices for HCPCS codes
using this item
--------------------------------------------------------------------------------------------------------------------------------------------------------
31627........................... sensor, patch, SD235 $1.10.............. $3.00.............. 173 2 37
bronchosopy (for
kit, locatable
guide) (patient).
31627........................... system, EQ326 $137,800.00........ $189,327.66........ 37 4 37
navigational
bronchoscopy
(superDimension).
31627........................... kit, locatable SA097 $995.00............ $1,063.67.......... 7 3 37
guide, ext.
working channel, w-
b-scope adapter.
--------------------------------------------------------------------------------------------------------------------------------------------------------

[[Page 14859]]

14. On pages 67678 through 67711, in Table 31: CY 2015 Interim
Final Codes With Direct PE Input Recommendations Accepted with
Refinements, we are correcting the table by
a. On page 67687, deleting the following listed entries:
[GRAPHIC] [TIFF OMITTED] TR20MR15.015

[[Page 14860]]

b. On page 67702, correcting the bottom half of the table to read:
[GRAPHIC] [TIFF OMITTED] TR20MR15.016

[[Page 14861]]

[GRAPHIC] [TIFF OMITTED] TR20MR15.017

15. On page 67726, first column, second full paragraph, lines 6
through 8, the phrase ``with a clarification that practitioners do not
have to use any specific content exchange standard in CY 2015.'' is
corrected to read ``with a clarification that practitioners do not have
to use any specific exchange or transfer standard in CY 2015.''
16. On page 67741, first column, first paragraph, we are correcting
the entire paragraph to read:
The CY 2015 PFS CF for January 1, 2015 through March 31, 2015 is
$35.7547. The CY 2015 PFS CF for April 1, 2015 through December 31,
2015 is $28.1872. The CY 2015 national average anesthesia CF for
January 1, 2015 through March 31, 2015 is $22.4968. The CY 2015
national average anesthesia CF for April 1, 2015 through December 31,
2015 is $17.7454.
17. On page 67742, third column, first partial paragraph,
a. Line 3, the phrase ``by 0.06 percent'' is corrected to read ``by
0.19 percent''.
b. Third column, first full paragraph, line 8, the figure
``$35.8013.'' is corrected to read ``$35.7547.''
c. Third column, second full paragraph, line 6, the figure
``$28.2239.'' is corrected to read ``$28.1872.''
d. Third column, second full paragraph, line 9, the phrase ``21.2
percent'' is corrected to read ``21.3 percent''.
18. On page 67742, in Table 45: Calculation of the CY 2015 PFS CF,
the table is corrected to read as follows:

Table 45--Calculation of the CY 2015 PFS CF
------------------------------------------------------------------------

[[Page 14862]]

CY 2014 Conversion Factor had .................... $27.2006
statutory increases not applied.
CY 2015 Medicare Economic Index... 0.8 percent (1.008). ..............
CY 2015 Update Adjustment Factor.. 3.0 percent (1.03).. ..............
CY 2015 RVU Budget Neutrality -0.19 percent ..............
Adjustment. (0.9981).
CY 2015 Conversion Factor (4/1/ .................... $28.1872
2015 through 12/31/2015).
Percent Change in Conversion .................... -21.3%
Factor on 4/1/2015 (relative to
the CY 2014 CF).
Percent Change in Update (without .................... -21.2%
budget neutrality adjustment) on
4/1/2015 (relative to the CY 2014
CF).
------------------------------------------------------------------------

19. On page 67743,
a. First column, first full paragraph, line 5, the sentence ``After
applying the 0.9994 budget'' is corrected to read ``After applying the
0.9981 budget''.
b. Second column, line 2, the figure ``$22.5550.'' is corrected to
read ``$22.4968.''
c. Third column, line 12, the figure ``$17.7913.'' is corrected to
read ``$17.7454.''
d. Table 46: Calculation of the CY 2015 Anesthesia CF is corrected
to read as follows:

Table 46--Calculation of the CY 2015 Anesthesia CF
------------------------------------------------------------------------

------------------------------------------------------------------------
January 1, 2015 through March 31, 2015
------------------------------------------------------------------------
CY 2014 National Average .................... $22.6765
Anesthesia CF.
------------------------------------------------------------------------
Update............................ 0.0 percent (1.00).. ..............
CY 2015 RVU Budget Neutrality -0.19 percent ..............
Adjustment. (0.9981).
CY 2015 Anesthesia Fee Schedule -0.00494 percent ..............
Practice Expense Adjustment. (0.99506).
CY 2015 National Average .................... $22.4968
Anesthesia CF (1/1/2015 through 3/
31/2015).
------------------------------------------------------------------------
April 1, 2015 through December 31, 2015
------------------------------------------------------------------------
2014 National Average Anesthesia .................... $22.6765
Conversion Factor in effect in CY
2015.
2014 National Anesthesia .................... $17.2283
Conversion Factor had Statutory
Increases Not Applied.
CY 2015 Medicare Economic Index... 0.8 percent (1.008). ..............
CY 2015 Update Adjustment Factor.. 3.0 percent (1.03).. ..............
CY 2015 Budget Neutrality Work and -0.19 percent ..............
Malpractice Adjustment. (0.9981).
CY 2015 Anesthesia Fee Schedule -0.00494 percent ..............
Practice Expense Adjustment. (0.99506).
CY 2015 Anesthesia Fee Schedule -0.00494 percent ..............
Practice Expense Adjustment. (0.99506).
CY 2015 Anesthesia Conversion .................... $17.7454
Factor (4/1/2015 through 12/31/
2015).
Percent Change from 2014 to 2015 .................... -21.7%
(4/1/2015 through 12/31/2015).
------------------------------------------------------------------------

20. On page 67803, last row, in Table 52: Individual Quality Cross-
Cutting Measures for the PQRS to Be Available for Satisfactory
Reporting Via Claims, Registry, and EHR Beginning in 2015, the listed
entry is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR20MR15.007

[[Page 14863]]

BILLING CODE 4120-01-P
21. On page 67848, the last two rows, and the first row on page
67849, in Table 55: Measures Being Removed from the Existing PQRS
Measure Set Beginning in 2015, the listed are corrected to read as
follows:
[GRAPHIC] [TIFF OMITTED] TR20MR15.008

[[Page 14864]]

22. On page 67854, the second row, in Table 56: Existing Individual
Quality Measures and Those Included in Measures Groups for the PQRS for
Which Measure Reporting Updates Will Be Effective Beginning in 2015,
the listed entry is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR20MR15.009

[[Page 14865]]

23. On page 67877, second row, in Table 56: Existing Individual
Quality Measures and Those Included in Measures Groups for the PQRS for
Which Measure Reporting Updates Will Be Effective Beginning in 2015,
the listed entry is corrected to read as follows:
BILLING CODE 4120-01-C
[GRAPHIC] [TIFF OMITTED] TR20MR15.010

24. On page 67988, in Table 93: CY 2015 PFS Final Rule with Comment
Period Estimated Impact Table: Impacts of Work, Practice Expense, and
Malpractice RVUs, the table is corrected to read as follows:

[[Page 14866]]

[GRAPHIC] [TIFF OMITTED] TR20MR15.013

[[Page 14867]]

25. On page 67991 through 67992, in Table 94: Impact of Final Rule
with Comment Period on CY 2015 Payment for Selected Procedures the
table is corrected to read as follows:
BILLING CODE 4120-01-P
[GRAPHIC] [TIFF OMITTED] TR20MR15.014

[[Page 14868]]

[GRAPHIC] [TIFF OMITTED] TR20MR15.011

[[Page 14869]]

[GRAPHIC] [TIFF OMITTED] TR20MR15.012

27. On page 67999, third column, first full paragraph,
a. Line 18, the figure ``35.8013,'' is corrected to read
``35.7547,''.
b. Line 21, the figure ``$109.19,'' is corrected to read
``$108.18,''.
c. Line 23, the phrase ``this service would be $21.84.'' is
corrected to read ``this service would be $21.74.''

[[Page 14870]]

List of Subjects in 42 CFR Part 410

Health facilities, Health professions, Kidney diseases,
Laboratories, Medicare, Reporting and recordkeeping requirements, Rural
areas, X-rays.

Accordingly, 42 CFR chapter IV is corrected by making the following
correcting amendments to part 410:

PART 410--SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS

0
1. The authority citation for part 410 continues to read as follows:

Authority: Secs. 1102, 1834, 1871, 1881, and 1893 of the Social
Security Act (42 U.S.C. 1302, 1395m, 1395hh, and 1395ddd.

0
2. Section 410.26 is amended by revising paragraph (b)(5) to read as
follows:

Sec. 410.26 Services and supplies incident to a physician's
professional services: Conditions.

* * * * *
(b) * * *
(5) In general, services and supplies must be furnished under the
direct supervision of the physician (or other practitioner). Chronic
care management services and transitional care management services
(other than the required face-to-face visit) can be furnished under
general supervision of the physician (or other practitioner) when they
are provided by clinical staff incident to the services of a physician
(or other practitioner). The physician (or other practitioner)
supervising the auxiliary personnel need not be the same physician (or
other practitioner) upon whose professional service the incident to
service is based.
* * * * *

Dated: March 13, 2015.
C'Reda Weeden,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2015-06427 Filed 3-19-15; 8:45 am]
BILLING CODE 4120-01-C

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Rules and Regulations
Action		Final rule; correcting amendment.
Contact		Christine Estella, (410) 786-0485, for issues related to the physician quality reporting system. Donta Henson, (410) 786-1947 for all other issues.
FR Citation		80 FR 14853
RIN Number		0938-AS12
CFR Citation		42 CFR 403 42 CFR 405 42 CFR 410 42 CFR 411 42 CFR 412 42 CFR 413 42 CFR 414 42 CFR 425 42 CFR 489 42 CFR 495 42 CFR 498
CFR Associated		Health Facilities; Health Professions; Kidney Diseases; Laboratories; Medicare; Reporting and Recordkeeping Requirements; Rural Areas and X-Rays

80 FR 14853 - Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015; Corrections

DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Medicare & Medicaid Services

Federal Register Volume 80, Issue 54 (March 20, 2015)

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services