81 FR 12024 - Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016; Corrections
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 81, Issue 45 (March 8, 2016)
Centers for Medicare & Medicaid Services
Federal Register Volume 81, Issue 45 (March 8, 2016)
| Page Range | 12024-12030 | |
| FR Document | 2016-05054 |
[Federal Register Volume 81, Number 45 (Tuesday, March 8, 2016)] [Rules and Regulations] [Pages 12024-12030] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2016-05054] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 405, 410, 411, 414, 425, and 495 [CMS-1631-F2] RIN 0938-AS40 Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016; Corrections AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final rule; correcting amendment. ----------------------------------------------------------------------- SUMMARY: This document corrects technical and typographical errors that appeared in the final rule with comment period published in the November 16, 2015 Federal Register (80 FR 70886 through 71386) entitled ``Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016.'' DATES: Effective date: This correcting document is effective March 7, 2016. Applicability date: The corrections indicated in this document are applicable beginning January 1, 2016. FOR FURTHER INFORMATION CONTACT: Lisa Ohrin Wilson (410) 786-8852, or Matthew Edgar (410) 786-0698, for issues related to physician self- referral updates. Jessica Bruton, (410) 786-5991 for all other issues. SUPPLEMENTARY INFORMATION: I. Background In FR Doc. 2015-28005 (80 FR 70886 through 71386), the final rule entitled ``Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016'' (hereinafter referred to as the CY 2016 PFS final rule with comment period), there were a number of technical and typographical errors that are identified and corrected in section IV., the Correction of Errors. The effective date for the rule was January 1, 2016, except for the definition of ``ownership or investment interest'' in Sec. 411.362(a), which has an effective date of January 1, 2017. These corrections are applicable as of January 1, 2016. We note that Addenda B and C to the CY 2016 PFS final rule with comment period as corrected by this correcting amendment are available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/. II. Summary of Errors A. Summary of Errors in the Preamble On page 70894, we inadvertently omitted a sentence from the first comment summary regarding applying the same overrides used for the MP RVU calculations to the PE calculations. On page 70894, we inadvertently omitted a clause from the response summary regarding the overrides that also apply to the MP RVU calculation in the development of PE RVUs. On page 70898, due to data errors made in the ratesetting process, many of the values contained in Table 4: Calculation of PE RVUs under Methodology for Selected Codes, are incorrect. On page 70953, we inadvertently included language regarding the application of the equipment utilization assumption. On page 70971, a. Due to a typographical error, the work RVU for CPT code 76945 was listed incorrectly. As a result, the work RVU for CPT code 76948 was also inadvertently listed incorrectly. b. Due to a typographical error, we inadvertently referred to CPT code 76948 rather than CPT code 76945. On page 70992, due to a typographical error in Table 13--CY 2016 Actions on Codes with CY 2015 Interim Final RVUs, the CY 2016 work RVU for CPT code 76948 was incorrectly displayed. On page 71317, we inadvertently included language in our comment discussion on the issue regarding compensation arrangements. On page 71357, a. Due to data errors, we incorrectly stated the estimated CY 2016 net reduction in expenditures. b. Due to data errors, we incorrectly stated the reduction to the conversion factor. c. Due to data errors, we incorrectly stated the CY 2016 PFS conversion factors. As a result, many of the values in Table 60-- Calculation of the CY 2016 PFS Conversion Factor, are incorrect. d. Due to data errors, we incorrectly stated the CY 2016 PFS anesthesia conversion factors. As a result, many of the values in Table 61--Calculation of the CY 2016 PFS Anesthesia Conversion Factor, are incorrect. On pages 71358 through 71359, due to data errors, many of the values in Table 62--CY 2016 PFS Estimated Impact On Total Allowed Charges By Specialty, are incorrect. On pages 71359 through 71360, due to data errors, many of the values in Table 63-- Impact on CY 2016 Payment for Selected Procedures, are incorrect. On page 71369, a. Due to data errors, we incorrectly stated the CY 2016 national payment amount in the nonfacility setting for CPT code 99203. b. Due to data errors, we incorrectly stated the CY 2016 proposed beneficiary coinsurance for CPT code 99203. B. Summary of Errors in Regulation Text On page 71375 of the CY 2016 PFS final rule with comment period, we made a typographical error in Sec. 411.357(d)(1)(iv). In this paragraph, we inadvertently included the word ``for''. On page 71377 of the CY 2016 PFS final rule with comment period, we made a typographical error in Sec. 411.357(x)(1)(vi)(A). In this paragraph, we inadvertently omitted the word ``directly''. C. 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 document, we are correcting errors in the work, PE or MP RVUs (or combinations of these RVUs) in Addendum B: CY 2016 Relative Value Units (RVUs) And Related Information Used In Determining Final Medicare Payments and Addendum C: CY 2016 [[Page 12025]] 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 http://www.cms.gov//PhysicianFeeSched/. In addition to the errors identified in section II.A. of this document, the following errors occur in the addenda. Due to a technical error in the development of PE RVUs, the PE RVUS displayed in Addenda B and C were incorrect. In constructing the algorithm used to adjust specialty-specific volume for individual codes as described on page 70895 of the CY 2016 PFS final rule, claims volumes for codes billed with payment modifiers with different adjustments for payment and time were erroneously adjusted based on the time-based adjustment factor, not the payment-based factor. As a result, payment-adjusted volume associated with those modifiers for which the time-based adjustment factor is different from the payment- based adjustment factor was inaccurate and has been corrected. The direct impact of the errors were limited to the practice expense for services frequently reported with payment modifiers with different adjustments for payment and time. However, the PE RVUs for many more codes may have been affected indirectly due to BN adjustments. The two specialties that report services paid under the anesthesia fee schedule were the only specialties significantly affected by the change. The PE RVUs that result from the correction of this error are reflected in the corrected Addendum B (and Addendum C, if applicable) available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/. Due to an error in the algorithm that we used to identify services that were subject to the phase-in of significant RVU reductions, CPT codes 67108, 67113, 67227 and 67228 were not included on the list of codes subject to the phase-in. These errors are corrected in the revised Codes Subject to Phase-in file available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/, and the resulting changes to the RVUs are reflected in the corrected Addenda B and C, available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/. Due to a data error, the useful life for the equipment item ``FibroScan'' (ER101) was incorrect in the direct PE input database. This error is corrected in the revised Direct PE Input Database available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/ . As a result of this error being corrected, changes to PE RVUs are reflected in the corrected Addenda B and C, available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/. Due to a data error, the incorrect CY 2016 global periods were included in Addendum B (and Addendum C, if applicable) for the following CPT codes: 20240, 43210, 61650, 67227, 67228, 73060, and 73560. The corrected CY 2016 global periods for these codes are reflected in the corrected Addendum B (and Addendum C, if applicable) available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/ . Due to an inadvertent error, the CY 2016 work RVUs for HCPCS codes G0296 and G0297 were incorrectly displayed in Addendum B. The correct CY 2016 work RVUS for these codes are reflected in the corrected Addendum B available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/. Due to a technical error, the clinical labor times associated with CPT codes 31654, 88333 and 99416 were inadvertently omitted from the direct PE input database. This error is corrected in the revised direct PE input database available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/. The PE RVUs that result from the correction of this error are reflected in the corrected Addendum B available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/. Due to a data input omission, the RVUs that reflect the appropriate payment rates for the treatment of intensive cardiac rehabilitation, as specified under section 1848(b)(5) of the Social Security Act (the Act), were not included in Addendum B. The appropriate RVUs for intensive cardiac rehabilitation are reflected in the corrected Addendum B available on the CMS Web site at http://www.cms.gov//PhysicianFeeSched/. III. Waiver of Proposed Rulemaking 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 APA notice and comment, and delay in effective date requirements; similarly, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the Act provide exceptions from the notice and comment, and delay in effective date requirements of the Act. Section 553(b)(B) of the APA and section 1871(b)(2)(C) of the Act authorize an agency to dispense with normal notice and comment rulemaking procedures for good cause if the agency makes a finding that the notice and comment process is impracticable, unnecessary, or contrary to the public interest; and includes a statement of the finding and the reasons for it in the notice. 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 the agency includes in the rule a statement of the finding and the reasons for it. In our view, this correcting document does not constitute a rulemaking that would be subject to these requirements. This document merely corrects typographical and technical errors in the CY 2016 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 subject to notice and comment procedures in the CY 2016 PFS final rule with comment period. As a result, the corrections made through this correcting document are intended to ensure that the CY 2016 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 2016 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 2016 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 [[Page 12026]] finalized. This correcting document is intended solely to ensure that the CY 2016 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. Correction of Errors In FR Doc. 2015-28005 of November 16, 2015 (80 FR 70886), make the following corrections: A. Correction of Errors in the Preamble 1. On page 70894, first column, a. First full paragraph, line 9, is corrected by adding the sentence ``One commenter suggested that for CY 2016 we apply the same overrides used for the MP RVU calculations to the PE calculations.''. b. Second full paragraph, lines 21 through 27, the sentence ``Therefore, we are finalizing the policy as proposed for CY 2016 but will seek comment on the proposed CY 2017 PFS rates and whether or not the incorporation a new year of utilization data mitigates the need for service-level overrides.'' is corrected to read ``Therefore, we are finalizing the policy as proposed for CY 2016 and only apply the overrides that also apply to the MP RVU calculation in the development of PE RVUs but will seek comment on the proposed CY 2017 PFS rates and whether or not the incorporation of a new year of utilization data mitigates the need for service-level overrides.''. 2. On page 70898, Table 4-Calculation of PE RVUs under Methodology for Selected Codes, the table is corrected to read as follows: BILLING CODE 4120-01-P [[Page 12027]] [GRAPHIC] [TIFF OMITTED] TR08MR16.001 BILLING CODE 4120-01-C 3. On page 70953, second column, first partial paragraph, lines 3 through 6, the sentence ``This approach is consistent with the application of the equipment utilization assumption for advanced diagnostic imaging'' is deleted. 4. On page 70971, a. First column, first full paragraph, line 15, the phrase ``work RVU of 0.56'' is corrected to read ``work RVU of 0.67''. b. First column, third full paragraph, line 12, the CPT code ``76945'' is corrected to read ``76948''. c. First column, fourth full paragraph, line 4 the CPT code ``76945'' is corrected to read ``76948''. [[Page 12028]] d. First column, fourth full paragraph, line 16 the CPT code ``76945'' is corrected to read ``76948''. 5. On page 70992, in Table 13--CY 2016 Actions on Codes with CY 2015 Interim Final RVUs, bottom half of the page, in columns 3 and 4, the work RVU ``0.38'' for CPT code 76948 is corrected to read ``0.67''. 6. On page 71317, a. Third column, second full paragraph, line 2, the phrase ``on this issue (38, 50, 68, 73, 80)'' is corrected to read ``on this issue''. b. Third column, second full paragraph, line 10, the phrase ``Another commenter (38)'' is corrected to read ``Another commenter''. 7. On page 71357, a. Third column, first partial paragraph, line 13, the figure ``0.23'' is corrected to read ``0.22''. b. Third column, first partial paragraph, line 24, the figure ``- 0.77'' is corrected to read ``-0.78.'' c. Third column, first full paragraph, line 9, the figure ``$35.8279'' is corrected to read ``$35.8043''. d. Third column, first full paragraph, line 17, the figure ``$22.3309'' is corrected to read ``$21.9935''. e. Table 60--Calculation of the CY 2016 PFS Conversion Factor, the table is corrected to read as follows: ------------------------------------------------------------------------ ------------------------------------------------------------------------ Conversion Factor in effect in ....................... 35.9335 CY 2015. Update Factor.................. 0.5 percent (1.005).... .............. CY 2016 RVU Budget Neutrality -0.076 percent .............. Adjustment. (0.99924). CY 2016 Target Recapture Amount -0.78 percent (0.9922). .............. CY 2016 Conversion Factor...... ....................... 35.8043 ------------------------------------------------------------------------ f. Table 61--Calculation of the CY 2016 Anesthesia Conversion, the table is corrected to read as follows: ------------------------------------------------------------------------ ------------------------------------------------------------------------ CY 2015 National Average ....................... 22.6093 Anesthesia Conversion Factor. Update Factor.................. 0.5 percent (1.005).... .............. CY 2016 RVU Budget Neutrality -0.076 percent .............. Adjustment. (0.99924). CY 2016 Anesthesia Fee Schedule -2.372 percent .............. Practice Expense Adjustment. (0.97628). CY 2016 Anesthesia Fee Schedule -0.78 percent (0.9922). .............. Malpractice Adjustment. CY 2016 Target Recapture Amount -0.78 percent (0.9922). .............. CY 2016 Conversion Factor...... ....................... 21.9935 ------------------------------------------------------------------------ 8. On pages 71358 through 71359, Table 62--CY 2016 PFS Estimated Impact On Total Allowed Charges By Specialty, the table is corrected to read as follows: ---------------------------------------------------------------------------------------------------------------- (A) (B) (C) (D) (E) (F) Specialty Allowed Impact of work Impact of PE Impact of MP Combined charges RVU changes RVU changes RVU changes impact ** (mil) (percent) (percent) (percent) (percent) ---------------------------------------------------------------------------------------------------------------- TOTAL........................... $89,020 0 0 0 0 ALLERGY/IMMUNOLOGY.............. 221 0 1 0 1 ANESTHESIOLOGY.................. 1,970 0 0 -2 -2 AUDIOLOGIST..................... 61 0 -1 1 0 CARDIAC SURGERY................. 343 0 0 0 0 CARDIOLOGY...................... 6,498 0 0 0 0 CHIROPRACTOR.................... 789 0 0 0 0 CLINICAL PSYCHOLOGIST........... 720 0 0 0 0 CLINICAL SOCIAL WORKER.......... 558 0 0 0 0 COLON AND RECTAL SURGERY........ 161 -1 0 0 -1 CRITICAL CARE................... 296 0 0 0 0 DERMATOLOGY..................... 3,217 0 0 0 1 DIAGNOSTIC TESTING FACILITY..... 725 0 0 0 0 EMERGENCY MEDICINE.............. 3,120 0 0 0 0 ENDOCRINOLOGY................... 454 0 0 0 0 FAMILY PRACTICE................. 6,089 0 0 0 0 GASTROENTEROLOGY................ 1,843 -2 -1 -1 -4 GENERAL PRACTICE................ 478 0 0 0 0 GENERAL SURGERY................. 2,210 0 0 0 0 GERIATRICS...................... 216 0 0 0 0 HAND SURGERY.................... 169 0 0 0 0 HEMATOLOGY/ONCOLOGY............. 1,788 0 0 0 0 INDEPENDENT LABORATORY.......... 834 1 8 0 9 INFECTIOUS DISEASE.............. 660 0 0 0 0 INTERNAL MEDICINE............... 11,058 0 0 0 0 INTERVENTIONAL PAIN MGMT........ 720 0 0 0 0 INTERVENTIONAL RADIOLOGY........ 298 0 0 0 1 MULTISPECIALTY CLINIC/OTHER PHYS 96 0 0 0 0 NEPHROLOGY...................... 2,199 0 0 0 0 [[Page 12029]] NEUROLOGY....................... 1,524 0 0 0 0 NEUROSURGERY.................... 776 0 0 0 0 NUCLEAR MEDICINE................ 46 0 0 0 -1 NURSE ANES/ANES ASST............ 1,187 0 0 -2 -2 NURSE PRACTITIONER.............. 2,551 0 0 0 0 OBSTETRICS/GYNECOLOGY........... 669 0 0 0 0 OPHTHALMOLOGY................... 5,506 0 0 0 -1 OPTOMETRY....................... 1,178 0 0 0 0 ORAL/MAXILLOFACIAL SURGERY...... 47 0 0 0 0 ORTHOPEDIC SURGERY.............. 3,672 0 0 0 0 OTHER........................... 25 0 0 0 0 OTOLARNGOLOGY................... 1,197 0 0 0 0 PATHOLOGY....................... 1,330 4 4 0 8 PEDIATRICS...................... 59 0 0 0 0 PHYSICAL MEDICINE............... 1,035 0 0 0 0 PHYSICAL/OCCUPATIONAL THERAPY... 3,102 0 0 0 0 PHYSICIAN ASSISTANT............. 1,728 0 0 0 0 PLASTIC SURGERY................. 376 0 0 0 0 PODIATRY........................ 1,999 0 0 0 0 PORTABLE X-RAY SUPPLIER......... 106 0 1 0 1 PSYCHIATRY...................... 1,317 0 0 0 0 PULMONARY DISEASE............... 1,780 0 0 0 0 RADIATION ONCOLOGY.............. 1,776 0 -2 0 -2 RADIATION THERAPY CENTERS....... 52 0 -1 0 -1 RADIOLOGY....................... 4,494 0 0 0 0 RHEUMATOLOGY.................... 536 0 0 0 0 THORACIC SURGERY................ 350 0 0 0 0 UROLOGY......................... 1,796 0 0 0 0 VASCULAR SURGERY................ 1,019 0 -1 0 -1 ---------------------------------------------------------------------------------------------------------------- ** Column F may not equal the sum of columns C, D, and E due to rounding. 9. On pages 71359 through 71360, Table 63--Impact on CY 2016 Payment for Selected Procedures, the table is corrected to read as follows: ---------------------------------------------------------------------------------------------------------------- Facility Non facility --------------------------------------------------------- CPT/HCPCS \1\ MOD Short descriptor CY 2015 CY 2016 % CY 2015 CY 2016 % \2\ \3\ Change \2\ \3\ Change ---------------------------------------------------------------------------------------------------------------- 11721................... ....... Debride nail 6 or $25.15 $25.42 1 $45.28 $45.47 0 more. 17000................... ....... Destruct premalg 53.90 54.42 1 67.20 67.67 1 lesion. 27130................... ....... Total hip 1,407.87 1,400.66 -1 NA NA NA arthroplasty. 27244................... ....... Treat thigh 1,277.80 1,271.05 -1 NA NA NA fracture. 27447................... ....... Total knee 1,407.52 1,400.31 -1 NA NA NA arthroplasty. 33533................... ....... Cabg arterial 1,952.63 1,947.04 0 NA NA NA single. 35301................... ....... Rechanneling of 1,203.41 1,199.44 0 NA NA NA artery. 43239................... ....... Egd biopsy single/ 154.15 151.45 -2 412.52 403.87 -2 multiple. 66821................... ....... After cataract 316.21 315.44 0 334.90 334.05 0 laser surgery. 66984................... ....... Cataract surg w/iol 650.40 648.42 0 NA NA NA 1 stage. 67210................... ....... Treatment of 508.82 507.35 0 526.79 524.89 0 retinal lesion. 71010................... ....... Chest x-ray 1 view NA NA NA 22.64 22.56 0 frontal. 71010................... 26 Chest x-ray 1 view 9.34 9.31 0 9.34 9.31 0 frontal. 77056................... ....... Mammogram both NA NA NA 116.42 116.01 0 breasts. 77056................... 26 Mammogram both 44.56 44.40 0 44.56 44.40 0 breasts. 77057................... ....... Mammogram screening NA NA NA 83.01 82.71 0 77057................... 26 Mammogram screening 35.93 35.80 0 35.93 35.80 0 77427................... ....... Radiation tx 187.57 187.61 0 187.57 187.61 0 management x5. 88305................... 26 Tissue exam by 39.17 39.74 1 39.17 39.74 1 pathologist. 90935................... ....... Hemodialysis one 73.66 73.40 0 NA NA NA evaluation. 92012................... ....... Eye exam establish 53.18 53.35 0 86.24 85.93 0 patient. 92014................... ....... Eye exam&tx estab 80.85 80.92 0 124.69 124.60 0 pt 1/>vst. 93000................... ....... Electrocardiogram NA NA NA 17.25 17.19 0 complete. 93010................... ....... Electrocardiogram 8.62 8.59 0 8.62 8.59 0 report. 93015................... ....... Cardiovascular NA NA NA 77.26 76.98 0 stress test. 93307................... 26 Tte w/o doppler 45.99 45.83 0 45.99 45.83 0 complete. 93458................... 26 L hrt artery/ 323.76 323.31 0 323.76 323.31 0 ventricle angio. 98941................... ....... Chiropract manj 3-4 35.21 35.09 0 41.32 41.17 0 regions. 99203................... ....... Office/outpatient 77.98 77.70 0 109.60 108.85 -1 visit new. [[Page 12030]] 99213................... ....... Office/outpatient 51.38 51.56 0 73.30 73.40 0 visit est. 99214................... ....... Office/outpatient 79.41 79.13 0 108.88 108.13 -1 visit est. 99222................... ....... Initial hospital 139.06 138.20 -1 NA NA NA care. 99223................... ....... Initial hospital 205.90 204.44 -1 NA NA NA care. 99231................... ....... Subsequent hospital 39.53 39.74 1 NA NA NA care. 99232................... ....... Subsequent hospital 73.30 72.68 -1 NA NA NA care. 99233................... ....... Subsequent hospital 105.64 104.91 -1 NA NA NA care. 99236................... ....... Observ/hosp same 220.99 219.48 -1 NA NA NA date. 99239................... ....... Hospital discharge 108.88 108.13 -1 NA NA NA day. 99283................... ....... Emergency dept 62.88 62.66 0 NA NA NA visit. 99284................... ....... Emergency dept 119.66 118.87 -1 NA NA NA visit. 99291................... ....... Critical care first 227.46 225.93 -1 279.20 277.48 -1 hour. 99292................... ....... Critical care addl 113.55 113.14 0 124.33 123.88 0 30 min. 99348................... ....... Home visit est NA NA NA 84.80 84.86 0 patient. 99350................... ....... Home visit est NA NA NA 178.95 179.38 0 patient. G0008................... ....... Immunization admin. NA NA NA 25.51 25.42 0 ---------------------------------------------------------------------------------------------------------------- \1\ CPT codes and descriptions are copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply. \2\ Payments based on the July-December 2015 conversion factor of 35.9335. \3\ Payments based on the 2016 conversion factor of $35.8043. 10. On page 71369, a. Second column, fifth paragraph, line 20, the figure ``$109.28'' is corrected to read ``108.85''. b. Second column, fifth paragraph, line 23, the figure ``$21.86'' is corrected to read ``21.77''. List of Subjects in 42 CFR Part 411 Kidney diseases, Medicare, Physician referral, Reporting and recordkeeping requirements. Accordingly, 42 CFR chapter IV is corrected by making the following correcting amendments to part 411: PART 411--EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT 0 1. The authority citation for part 411 continues to read as follows: Authority: Secs. 1102, 1860D-1 through 1860D-42, 1871, and 1877 of the Social Security Act (42 U.S.C. 1302, 1395w-101 through 1395w- 152, 1395hh, and 1395nn). 0 2. Section 411.357 is amended: 0 a. In paragraph (d)(1)(iv) by removing the phrase ``is for at least 1 year'' and adding in its place the phrase ``is at least 1 year''. 0 b. In paragraph (x)(1)(vi)(A) by removing the phrase ``The nonphysician practitioner has a compensation arrangement with'' and adding in its place the phrase ``The nonphysician practitioner has a compensation arrangement directly with''. Dated: February 29, 2016. Wilma Robinson, Deputy Executive, Secretary to the Department, Department of Health and Human Services. [FR Doc. 2016-05054 Filed 3-7-16; 8:45 am] BILLING CODE 4120-01-P
![12024 Federal Register / Vol. 81, No. 45 / Tuesday, March 8, 2016 / Rules and Regulations
its metabolites and degradates, in or on Applicability date: The corrections On page 70992, due to a typographical
the commodities in the table below. indicated in this document are error in Table 13—CY 2016 Actions on
Compliance with the tolerance levels applicable beginning January 1, 2016. Codes with CY 2015 Interim Final
specified in the table is to be FOR FURTHER INFORMATION CONTACT: Lisa RVUs, the CY 2016 work RVU for CPT
determined by measuring only Ohrin Wilson (410) 786–8852, or code 76948 was incorrectly displayed.
fluopyram in or on the commodity. Matthew Edgar (410) 786–0698, for On page 71317, we inadvertently
issues related to physician self-referral included language in our comment
Commodity Parts per updates. Jessica Bruton, (410) 786–5991 discussion on the issue regarding
million compensation arrangements.
for all other issues.
On page 71357,
Sugarcane, cane ........................ 0.08 SUPPLEMENTARY INFORMATION: a. Due to data errors, we incorrectly
I. Background stated the estimated CY 2016 net
(d) Indirect or inadvertent residues. It
reduction in expenditures.
is recommended that tolerances be In FR Doc. 2015–28005 (80 FR 70886 b. Due to data errors, we incorrectly
established for indirect or inadvertent through 71386), the final rule entitled stated the reduction to the conversion
residues of fungicide fluopyram, N-[2- ‘‘Medicare Program; Revisions to factor.
[3-chloro-5-(trifluoromethyl)-2- Payment Policies Under the Physician c. Due to data errors, we incorrectly
pyridinyl]ethyl]-2- Fee Schedule and Other Revisions to stated the CY 2016 PFS conversion
(trifluoromethyl)benzamide, including Part B for CY 2016’’ (hereinafter referred factors. As a result, many of the values
its metabolites and degradates, in or on to as the CY 2016 PFS final rule with in Table 60—Calculation of the CY 2016
the commodities in the table below. comment period), there were a number PFS Conversion Factor, are incorrect.
Compliance with the tolerance levels of technical and typographical errors d. Due to data errors, we incorrectly
specified in the table is to be that are identified and corrected in stated the CY 2016 PFS anesthesia
determined by measuring only section IV., the Correction of Errors. The conversion factors. As a result, many of
fluopyram in or on the commodity. effective date for the rule was January 1, the values in Table 61—Calculation of
2016, except for the definition of the CY 2016 PFS Anesthesia Conversion
Parts per ‘‘ownership or investment interest’’ in
Commodity million Factor, are incorrect.
§ 411.362(a), which has an effective date On pages 71358 through 71359, due to
Alfalfa, forage ............................. 0.45 of January 1, 2017. These corrections are data errors, many of the values in Table
Alfalfa, hay .................................. 1.1 applicable as of January 1, 2016. We 62—CY 2016 PFS Estimated Impact On
Soybean, seed ............................ 0.10 note that Addenda B and C to the CY Total Allowed Charges By Specialty, are
2016 PFS final rule with comment incorrect.
[FR Doc. 2016–05025 Filed 3–7–16; 8:45 am] period as corrected by this correcting On pages 71359 through 71360, due to
BILLING CODE 6560–50–P amendment are available on the CMS data errors, many of the values in Table
Web site at http://www.cms.gov// 63— Impact on CY 2016 Payment for
PhysicianFeeSched/. Selected Procedures, are incorrect.
DEPARTMENT OF HEALTH AND II. Summary of Errors On page 71369,
HUMAN SERVICES a. Due to data errors, we incorrectly
A. Summary of Errors in the Preamble stated the CY 2016 national payment
Centers for Medicare & Medicaid On page 70894, we inadvertently amount in the nonfacility setting for
Services omitted a sentence from the first CPT code 99203.
comment summary regarding applying b. Due to data errors, we incorrectly
42 CFR Parts 405, 410, 411, 414, 425, the same overrides used for the MP RVU stated the CY 2016 proposed beneficiary
and 495 calculations to the PE calculations. coinsurance for CPT code 99203.
[CMS–1631–F2] On page 70894, we inadvertently B. Summary of Errors in Regulation Text
omitted a clause from the response On page 71375 of the CY 2016 PFS
RIN 0938–AS40 summary regarding the overrides that final rule with comment period, we
Medicare Program; Revisions to also apply to the MP RVU calculation in made a typographical error in
Payment Policies Under the Physician the development of PE RVUs. § 411.357(d)(1)(iv). In this paragraph, we
Fee Schedule and Other Revisions to On page 70898, due to data errors inadvertently included the word ‘‘for’’.
Part B for CY 2016; Corrections made in the ratesetting process, many of On page 71377 of the CY 2016 PFS
the values contained in Table 4: final rule with comment period, we
AGENCY: Centers for Medicare & Calculation of PE RVUs under made a typographical error in
Medicaid Services (CMS), HHS. Methodology for Selected Codes, are § 411.357(x)(1)(vi)(A). In this paragraph,
ACTION: Final rule; correcting incorrect. we inadvertently omitted the word
amendment. On page 70953, we inadvertently ‘‘directly’’.
included language regarding the
SUMMARY: This document corrects application of the equipment utilization C. Summary and Correction of Errors in
technical and typographical errors that assumption. the Addenda on the CMS Web site
appeared in the final rule with comment On page 70971, Due to the errors identified and
asabaliauskas on DSK3SPTVN1PROD with RULES
period published in the November 16, a. Due to a typographical error, the summarized in section II.A and B of this
2015 Federal Register (80 FR 70886 work RVU for CPT code 76945 was document, we are correcting errors in
through 71386) entitled ‘‘Medicare listed incorrectly. As a result, the work the work, PE or MP RVUs (or
Program; Revisions to Payment Policies RVU for CPT code 76948 was also combinations of these RVUs) in
Under the Physician Fee Schedule and inadvertently listed incorrectly. Addendum B: CY 2016 Relative Value
Other Revisions to Part B for CY 2016.’’ b. Due to a typographical error, we Units (RVUs) And Related Information
DATES: Effective date: This correcting inadvertently referred to CPT code Used In Determining Final Medicare
document is effective March 7, 2016. 76948 rather than CPT code 76945. Payments and Addendum C: CY 2016
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![12030 Federal Register / Vol. 81, No. 45 / Tuesday, March 8, 2016 / Rules and Regulations
Facility Non facility
CPT/HCPCS 1 MOD Short descriptor CY CY % CY CY %
2015 2 2016 3 Change 2015 2 2016 3 Change
99213 ................ ............ Office/outpatient visit est ......................................... 51.38 51.56 0 73.30 73.40 0
99214 ................ ............ Office/outpatient visit est ......................................... 79.41 79.13 0 108.88 108.13 ¥1
99222 ................ ............ Initial hospital care ................................................... 139.06 138.20 ¥1 NA NA NA
99223 ................ ............ Initial hospital care ................................................... 205.90 204.44 ¥1 NA NA NA
99231 ................ ............ Subsequent hospital care ........................................ 39.53 39.74 1 NA NA NA
99232 ................ ............ Subsequent hospital care ........................................ 73.30 72.68 ¥1 NA NA NA
99233 ................ ............ Subsequent hospital care ........................................ 105.64 104.91 ¥1 NA NA NA
99236 ................ ............ Observ/hosp same date .......................................... 220.99 219.48 ¥1 NA NA NA
99239 ................ ............ Hospital discharge day ............................................ 108.88 108.13 ¥1 NA NA NA
99283 ................ ............ Emergency dept visit ............................................... 62.88 62.66 0 NA NA NA
99284 ................ ............ Emergency dept visit ............................................... 119.66 118.87 ¥1 NA NA NA
99291 ................ ............ Critical care first hour .............................................. 227.46 225.93 ¥1 279.20 277.48 ¥1
99292 ................ ............ Critical care addl 30 min .......................................... 113.55 113.14 0 124.33 123.88 0
99348 ................ ............ Home visit est patient .............................................. NA NA NA 84.80 84.86 0
99350 ................ ............ Home visit est patient .............................................. NA NA NA 178.95 179.38 0
G0008 ............... ............ Immunization admin ................................................. NA NA NA 25.51 25.42 0
1 CPT codes and descriptions are copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
2 Payments based on the July–December 2015 conversion factor of 35.9335.
3 Payments based on the 2016 conversion factor of $35.8043.
10. On page 71369, DEPARTMENT OF COMMERCE apportioned among the coastal states
a. Second column, fifth paragraph, from Maine through North Carolina. The
line 20, the figure ‘‘$109.28’’ is National Oceanic and Atmospheric process to set the annual commercial
corrected to read ‘‘108.85’’. Administration quota and the percent allocated to each
b. Second column, fifth paragraph, state are described in § 648.102.
line 23, the figure ‘‘$21.86’’ is corrected 50 CFR Part 648 The final rule implementing
to read ‘‘21.77’’. Amendment 5 to the Summer Flounder
[Docket No. 140117052–4402–02]
List of Subjects in 42 CFR Part 411 Fishery Management Plan, as published
RIN 0648–XE449
Kidney diseases, Medicare, Physician in the Federal Register on December 17,
referral, Reporting and recordkeeping Fisheries of the Northeastern United 1993 (58 FR 65936), provided a
requirements. States; Summer Flounder Fishery; mechanism for transferring summer
Quota Transfer flounder commercial quota from one
Accordingly, 42 CFR chapter IV is
state to another. Two or more states,
corrected by making the following AGENCY: National Marine Fisheries under mutual agreement and with the
correcting amendments to part 411: Service (NMFS), National Oceanic and concurrence of the NMFS Greater
PART 411—EXCLUSIONS FROM Atmospheric Administration (NOAA), Atlantic Regional Administrator, can
MEDICARE AND LIMITATIONS ON Commerce. transfer or combine summer flounder
MEDICARE PAYMENT ACTION: Temporary rule; quota transfer. commercial quota under § 648.102(c)(2).
The Regional Administrator is required
■ 1. The authority citation for part 411 SUMMARY: NMFS announces that the to consider the criteria in
continues to read as follows: State of North Carolina is transferring § 648.102(c)(2)(i)(A) through (C) in the
portions of its 2016 commercial summer evaluation of requests for quota transfers
Authority: Secs. 1102, 1860D–1 through
1860D–42, 1871, and 1877 of the Social flounder quota to the States of New or combinations.
Security Act (42 U.S.C. 1302, 1395w–101 Jersey and Rhode Island, and the North Carolina is transferring a total
through 1395w–152, 1395hh, and 1395nn). Commonwealths of Virginia and of 64,978 lb (29,473 kg) of summer
Massachusetts. These quota adjustments flounder commercial quota to the
■ 2. Section 411.357 is amended:
■ a. In paragraph (d)(1)(iv) by removing are necessary to comply with the following states: New Jersey, 13,200 lb
the phrase ‘‘is for at least 1 year’’ and Summer Flounder, Scup and Black Sea (5,987 kg); Massachusetts, 9,805 lb
adding in its place the phrase ‘‘is at least Bass Fishery Management Plan quota (4,447 kg); Virginia, 30,573 lb (13,868
1 year’’. transfer provision. This announcement kg); and Rhode Island, 11,400 lb (5,171
■ b. In paragraph (x)(1)(vi)(A) by informs the public of the revised kg). These transfers were requested by
removing the phrase ‘‘The nonphysician commercial quota for each state the State of North Carolina to repay
practitioner has a compensation involved. landings by North Carolina permitted
arrangement with’’ and adding in its DATES: Effective March 7, 2016, through vessels that landed in these other states
place the phrase ‘‘The nonphysician December 31, 2016. under safe harbor agreements.
practitioner has a compensation FOR FURTHER INFORMATION CONTACT: The revised summer flounder quotas
arrangement directly with’’.
asabaliauskas on DSK3SPTVN1PROD with RULES
Elizabeth Scheimer, Fishery for calendar year 2016 are: North
Dated: February 29, 2016. Management Specialist, (978) 281–9236. Carolina, 2,164,731 lb (981,905 kg);
Wilma Robinson, SUPPLEMENTARY INFORMATION: Virginia, 1,762,354 lb (799,390 kg);
Deputy Executive, Secretary to the Regulations governing the summer Rhode Island, 1,285,491 lb (583,089 kg);
Department, Department of Health and flounder fishery are in 50 CFR 648.100 Massachusetts, 563,902 lb (255,782 kg);
Human Services. through 50 CFR 648.110. The and New Jersey, 1,371,944 lb (622,303
[FR Doc. 2016–05054 Filed 3–7–16; 8:45 am] regulations require annual specification kg), based on the quotas published in
BILLING CODE 4120–01–P of a commercial quota that is the 2016–2018 Summer Flounder, Scup
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Document Created: 2018-02-02 15:10:29
Document Modified: 2018-02-02 15:10:29
| 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. | |
| Dates | Effective date: This correcting document is effective March 7, 2016. | |
| Contact | Lisa Ohrin Wilson (410) 786-8852, or Matthew Edgar (410) 786-0698, for issues related to physician self- referral updates. Jessica Bruton, (410) 786-5991 for all other issues. | |
| FR Citation | 81 FR 12024 | |
| RIN Number | 0938-AS40 | |
| CFR Citation | 42
CFR
405 42 CFR 410 42 CFR 411 42 CFR 414 42 CFR 425 42 CFR 495 | |
| CFR Associated | Kidney Diseases; Medicare; Physician Referral and Reporting and Recordkeeping Requirements |
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