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)
Centers for Medicare & Medicaid Services
Federal Register Volume 80, Issue 54 (March 20, 2015)
| Page Range | 14853-14870 | |
| FR Document | 2015-06427 |
[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]] ======================================================================= ----------------------------------------------------------------------- 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: ---------------------------------------------------------------------------------------------------------------- RUC/HCPAC HCPCS code Long descriptor CY 2014 WRVU recommended work CY 2015 work RVU CMS time RVU refinement ---------------------------------------------------------------------------------------------------------------- 92545........... Oscillating tracking 0.23 0.25 0.25 No test, with recording. ---------------------------------------------------------------------------------------------------------------- 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 ------------------------------------------------------------------------ ------------------------------------------------------------------------ January 1, 2015 through March 31, 2015 ------------------------------------------------------------------------ Conversion Factor in effect in CY .................... $35.8228 2014. ------------------------------------------------------------------------ Update............................ 0.0 percent (1.00).. .............. CY 2015 RVU Budget Neutrality -0.19 percent .............. Adjustment. (0.9981). CY 2015 Conversion Factor (1/1/ .................... $35.7547 2015 through 3/31/2015). ------------------------------------------------------------------------ April 1, 2015 through December 31, 2015 ------------------------------------------------------------------------ Conversion Factor in effect in CY .................... $35.8228 2014. [[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
![Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations 14853
DEPARTMENT OF HEALTH AND period as corrected by this correction certain PE direct inputs for CPT code
HUMAN SERVICES document are available on the CMS Web 31627 were inadvertently omitted.
site at www.cms.gov/ On pages 67678 through 67711, in
Centers for Medicare & Medicaid PhysicianFeeSched/. Table 31: CY 2015 Interim Final Codes
Services With Direct PE Input Recommendations
II. Summary of Errors Accepted with Refinements, due to
42 CFR Parts 403, 405, 410, 411, 412, A. Summary of Errors in the Preamble technical errors, on page 67678, entries
413, 414, 425, 489, 495, and 498 associated with CPT codes 77061 and
On page 67559, due to errors made in
77062 were inadvertently listed; on page
[CMS–1612–F2] ratesetting, many of the values
67702, entries associated with CPT
RIN 0938–AS12
contained in Table 4: Calculation of PE codes 93320, 93321, and 93325 were
RVUs Under Methodology for Selected inadvertently omitted and an input code
Medicare Program; Revisions to Codes, are incorrect. for CPT code 93880 was inadvertently
Payment Policies Under the Physician On page 67562, in Table 8: Codes omitted.
Fee Schedule, Clinical Laboratory Fee Affected by Removal of Film Inputs, we On page 67726, we incorrectly stated
Schedule, Access to Identifiable Data inadvertently included CPT codes that practitioners do not have to use any
for the Center for Medicare and 93320, 93321, and 93325. ‘‘specific content exchange standard.’’
Medicaid Innovation Models & Other On page 67591, we incorrectly stated On pages 67741 through 67742, we
Revisions to Part B for CY 2015; that in section II. G. of the rule, we incorrectly stated the CY 2015 PFS
Corrections address the interim final values and conversion factors.
establish CY 2015 inputs for the lower On page 67742, in Table 45:
AGENCY: Centers for Medicare & gastrointestinal procedures. Calculation of the CY 2015 PFS CF, due
Medicaid Services (CMS), HHS. On page 67612, in Table 14: Codes to corrections being made in this
ACTION: Final rule; correcting Reviewed by the 2014 Multi-Specialty document, the CY 2014 budget
amendment. Refinement Panel, the work RVUs for neutrality adjustment, the CY 2015 CFs,
CPT codes 43204, 43205, and 43233 are and the percentage changes from the CY
SUMMARY: This document corrects incorrect.
technical errors that appeared in the 2014 CF stated in the table are incorrect.
On page 67633, due to a typographical On page 67743, due to technical
final rule with comment period error we referred to CPT code 41391 errors, the budget neutrality factor, the
published in the November 13, 2014 rather than CPT code 43391. anesthesia CF in effect from January 1,
Federal Register (79 FR 67547–68092) On page 67636, due to a technical 2015 through March 31, 2015, and the
entitled, ‘‘Medicare Program; Revisions error, the final work RVU for code anesthesia CF in effect from April 1,
to Payment Policies under the Physician 43278 is incorrect. 2015 through December 31, 2015 are
Fee Schedule, Clinical Laboratory Fee On pages 67651 through 67663, in incorrectly stated. The entries in Table
Schedule, Access to Identifiable Data for Table 25: CY 2015 Interim Final Work 46: Calculation of the CY 2015
the Center for Medicare and Medicaid RVUS For New/Revised or Potentially Anesthesia CF for budget neutrality
Innovation Models & Other Revisions to Misvalued Codes, the RUC/HCPAC adjustments, CFs and percentage change
Part B for CY 2015.’’ The effective date recommended work RVUs listed on are inaccurate.
for the rule was January 1, 2015. page 67658 for CPT codes 76932 and On pages 67803 and 67804, in Table
DATES: Effective date: This correcting 76948 are incorrect and entries for CPT 52: Individual Quality Cross-Cutting
document is effective March 19, 2015. codes 76940 and 76965 were Measures for the PQRS to Be Available
Applicability date: The corrections inadvertently omitted from the table. for Satisfactory Reporting Via Claims,
indicated in this document are On page 67660, the RUC/HCPAC Registry, and EHR Beginning in 2015,
applicable beginning January 1, 2015. recommended work RVU listed for CPT we inadvertently listed the incorrect
FOR FURTHER INFORMATION CONTACT: code 92545 is incorrect. National Quality Strategy (NQS) domain
Christine Estella, (410) 786–0485, for On page 67668, for Physician Quality Reporting System
issues related to the physician quality a. We inadvertently omitted G0279 (PQRS) Measure 131, Pain Assessment
reporting system. Donta Henson, (410) from the list of codes in the title of (13). and Follow-Up.
786–1947 for all other issues. b. Due to a typographical error, G0279 On pages 67848 and 67849, in Table
SUPPLEMENTARY INFORMATION: is referred to as G–2079. 55: Measures Being Removed from the
c. We inadvertently omitted the Existing PQRS Measure Set Beginning
I. Background phrase ‘‘, whether or not a 2–D in 2015, we inadvertently omitted
In FR Doc. 2014–26183 (79 FR 67547 mammography is furnished’’ from the adding an ‘‘X’’ to the claims reporting
through 68092) the final rule entitled, sentence beginning, ‘‘In addition, we are option for Physician Quality Reporting
‘‘Medicare Program; Revisions to creating . . .’’ System (PQRS) Measure 0091/051:
Payment Policies under the Physician On page 67669, we inadvertently Chronic Obstructive Pulmonary Disease
Fee Schedule, Clinical Laboratory Fee listed CPT code 93644 in the title of (COPD): Spirometry Evaluation,
Schedule, Access to Identifiable Data for (18). Measure 0102/052: Chronic Obstructive
the Center for Medicare and Medicaid On page 67671, in Table 28: CY 2015 Pulmonary Disease (COPD): Inhaled
Innovation Models & Other Revisions to Interim Final Codes with Direct PE Bronchodilator Therapy, and Measure
Part B for CY 2015’’ (hereinafter referred Input Recommendations Accepted 0050/109: Osteoarthritis (OA) Function
to as the CY 2015 PFS final rule with without Refinement, we inadvertently and Pain Assessment.
mstockstill on DSK4VPTVN1PROD with RULES
comment period), there were a number listed CPT code 31620. On page 67854, in Table 56: Existing
of technical errors that are identified On page 67673, in Table 29: Invoices Individual Quality Measures and Those
and corrected in section IV., Correction Received for New Direct PE Inputs we Included in Measures Groups for the
of Errors. These corrections are inadvertently listed entries associated PQRS for Which Measure Reporting
applicable as of January 1, 2015. We with CPT code 31620. Updates Will Be Effective Beginning in
note that the Addenda B and C to the On page 67674, in Table 30: Invoices 2015, we inadvertently added an ‘‘X’’ to
CY 2015 PFS final rule with comment Received For Existing Direct PE Inputs, the Group Practice Reporting Option
VerDate Sep<11>2014 18:21 Mar 19, 2015 Jkt 235001 PO 00000 Frm 00049 Fmt 4700 Sfmt 4700 E:\FR\FM\20MRR1.SGM 20MRR1](https://thefederalregister.org/doc/80_FR_14907/page/1.svg)
![mstockstill on DSK4VPTVN1PROD with RULES
TABLE 4—CALCULATION OF PR RVUS UNDER METHODOLOGY FOR SELECTED CODES
33533
14856
99213 Of- 71020 71020–TC 71020–26 93000 ECG, 93005 ECG, 93010 ECG,
CABG, arte-
Factor (CF) (2nd part) Step Source Formula fice visit, est Chest x-ray Chest x-ray, Chest x-ray, complete, tracing, non- report non-
rial, single
non-facility non-facility non-facility non-facility non-facility facility facility
VerDate Sep<11>2014
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. Adj.) ...... Steps 2–4 ........... See footnote * ..... .............................. 0.5953 0.5953 0.5953 0.5953 0.5953 0.5953 0.5953 0.5953
(6) Adjusted Labor .......................... Steps 2–4 ........... ’%=Labor * Dir ’%=(1) * (5) 7.93 46.15 3.42 3.42 0 3.04 3.04 0
18:21 Mar 19, 2015
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
Jkt 235001
(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
PO 00000
Adj)/CF.
(13) Adj. equipment cost converted Step 5 ................. ’%=(Eqp * Dir ’%=(8)/(10) 0 0.01 0.11 0.11 0 0 0 0
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
Frm 00052
(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 part) ... Step 8 ................. See Step 8 ......... .............................. (14)/ (14)/ (14)/ (14)/ (14)/ (14)/ (14)/ (14)/
(16) * (17) (16) * (17) (16) * (17) (16) * (17) (16) * (17) (16) * (17) (16) * (17) (16) * (17)
Fmt 4700
(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 part) .. Step 8 ................. See Step 8 ......... .............................. ¥15% ¥15% %(15+11) ¥11% ¥15% %(15+11) ¥11% ¥15%
(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 + 2nd) ... Step 8 ................. ............................. ’%=(19)+(21) 1.8 40.48 0.85 0.63 0.22 0.52 0.35 0.17
Sfmt 4700
(23) Indirect Adjustment (Ind. Adj.) Steps 9–11 ......... See Footnote * * .. .............................. 0.3829 0.3829 0.3829 0.3829 0.3829 0.3829 0.3829 0.3829
(24) Adjusted Indirect Allocator ....... Steps 9–11 ......... ’%=Ind Alloc * Ind .............................. 0.69 15.5 0.33 0.24 0.08 0.2 0.13 0.07
Adj.
(25) Ind. Practice Cost Index (IPCI) Steps 12–16 ....... ............................. .............................. 1.07 0.75 0.99 0.99 0.99 0.91 0.91 0.91
(26) Adjusted Indirect ...................... Step 17 ............... ’%= Adj.Ind ’%=(24) * (25) 0.74 11.64 0.32 0.24 0.08 0.18 0.12 0.06
Alloc * 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.
E:\FR\FM\20MRR1.SGM
* 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.
20MRR1
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![14870 Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
List of Subjects in 42 CFR Part 410 DEPARTMENT OF COMMERCE select number of management measures,
such as closure thresholds, gear
Health facilities, Health professions, National Oceanic and Atmospheric restrictions, and possession limits. The
Kidney diseases, Laboratories, Administration Council’s process for establishing
Medicare, Reporting and recordkeeping specifications relies on provisions
requirements, Rural areas, X-rays. 50 CFR Part 648 within the Atlantic Mackerel, Squid,
Accordingly, 42 CFR chapter IV is [Docket No. 140902739–5224–02] and Butterfish Fishery Management
corrected by making the following Plan (FMP) and its implementing
RIN 0648–BE49 regulations, as well as requirements
correcting amendments to part 410:
established by the Magnuson-Stevens
Fisheries of the Northeastern United
PART 410—SUPPLEMENTARY Fishery Conservation and Management
States; Atlantic Mackerel, Squid, and
MEDICAL INSURANCE (SMI) Act. Specifically, section 302(g)(1)(B) of
Butterfish Fisheries; Specifications
BENEFITS the Magnuson-Stevens Act states that
and Management Measures
the Scientific and Statistical Committee
AGENCY: National Marine Fisheries (SSC) for each Regional Fishery
■ 1. The authority citation for part 410
Service (NMFS), National Oceanic and Management Council shall provide its
continues to read as follows: Atmospheric Administration (NOAA), Council ongoing scientific advice for
Authority: Secs. 1102, 1834, 1871, 1881, Commerce. fishery management decisions,
and 1893 of the Social Security Act (42 ACTION: Final rule. including recommendations for
U.S.C. 1302, 1395m, 1395hh, and 1395ddd. acceptable biological catch (ABC),
SUMMARY: NMFS is implementing 2015 preventing overfishing, maximum
■ 2. Section 410.26 is amended by specifications and management sustainable yield, and achieving
revising paragraph (b)(5) to read as measures for Atlantic mackerel, 2015– rebuilding targets. The ABC is a level of
follows: 2017 specifications for Illex squid, catch that accounts for the scientific
2015–2017 specifications for longfin uncertainty in the estimate of the stock’s
§ 410.26 Services and supplies incident to squid, and 2015–2017 specifications for
a physician’s professional services: defined overfishing level (OFL).
butterfish. This action also establishes a
Conditions. The Council’s SSC met on May 7 and
simplified butterfish fishery closure
* * * * * mechanism. These specifications set 8, 2014, to recommend ABCs for the
(b) * * * catch levels to prevent overfishing and 2015 Atlantic mackerel specifications,
allocate catch to commercial and and the 2015–2017 butterfish, Illex
(5) In general, services and supplies squid, and longfin squid specifications.
recreational fisheries. Additionally, the
must be furnished under the direct On November 14, 2014, NMFS
simplified butterfish closure mechanism
supervision of the physician (or other published a proposed rule for fishing
makes operation of the fishery more
practitioner). Chronic care management year 2015 for the mackerel, squid, and
efficient and consistent with the higher
services and transitional care catch limit for butterfish. These butterfish fishery specifications and
management services (other than the specifications and management management measures (79 FR 68202);
required face-to-face visit) can be measures are consistent with the the public comment period for the
furnished under general supervision of Atlantic Mackerel, Squid, and Butterfish proposed rule ended December 15,
the physician (or other practitioner) Fishery Management Plan and the 2014.
when they are provided by clinical staff recommendations of the Mid-Atlantic The Atlantic Mackerel, Squid, and
incident to the services of a physician Fishery Management Council. Butterfish FMP regulations require the
(or other practitioner). The physician (or DATES: Effective April 20, 2015. specification of annual catch limits
other practitioner) supervising the ADDRESSES: Copies of the specifications (ACL) and accountability measures
auxiliary personnel need not be the document, including the Environmental (AM) for mackerel and butterfish (both
same physician (or other practitioner) Assessment and Initial Regulatory squid species are exempt from the ACL/
upon whose professional service the Flexibility Analysis (EA/IRFA) and AM requirements because they have a
incident to service is based. other supporting documents for the life cycle of less than 1 year). In
* * * * * specifications, are available from Dr. addition, the regulations require the
Christopher Moore, Executive Director, specification of domestic annual harvest
Dated: March 13, 2015. (DAH), domestic annual processing
Mid-Atlantic Fishery Management
C’Reda Weeden, Council, Suite 201, 800 N. State Street, (DAP), and total allowable level of
Executive Secretary to the Department, Dover, DE 19901. The specifications foreign fishing (TALFF), along with
Department of Health and Human Services. document is also accessible via the joint venture processing for (JVP)
[FR Doc. 2015–06427 Filed 3–19–15; 8:45 am] Internet at: http:// commercial and recreational annual
BILLING CODE 4120–01–C www.greateratlantic.fisheries.noaa.gov/. catch totals (ACT) for mackerel, the
FOR FURTHER INFORMATION CONTACT: butterfish mortality cap in the longfin
Carly Bari, Fishery Policy Analyst, (978) squid fishery, and initial optimum yield
281–9224. (IOY) for both squid species. Details
concerning the Council’s development
SUPPLEMENTARY INFORMATION:
of these measures were presented in the
mstockstill on DSK4VPTVN1PROD with RULES
Background preamble of the proposed rule and are
Specifications, as referred to in this not repeated here.
rule, are the combined suite of In addition to the specifications, this
commercial and recreational catch action simplifies the management
levels established for one or more measure for the directed buttefish
fishing years. The specifications process fishery and changes the regulations in
also allows for the modification of a regard to possession limits.
VerDate Sep<11>2014 18:21 Mar 19, 2015 Jkt 235001 PO 00000 Frm 00066 Fmt 4700 Sfmt 4700 E:\FR\FM\20MRR1.SGM 20MRR1](https://thefederalregister.org/doc/80_FR_14907/page/18.svg)
Document Created: 2015-12-18 11:34:07
Document Modified: 2015-12-18 11:34:07
| 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 |
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