Medicare Program; Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates; Correction, 76176-76196 [05-24447]
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76176
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
II. Correction of Errors
In FR Doc. 05–15290, published on
August 4, 2005 (70 FR 45130), we are
making the following corrections:
Table A—Hospice Wage Index for
Urban Areas by CBSA
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1. On page 45147, in the fourth
column, in the 4th through 23rd entry,
for CBSA code 12060, change the MSA
code ‘‘520’’ to ‘‘0520’’.
2. On page 45148, in the third
column, in lines 37 through 39, for
CBSA code 13980, remove the asterisk
from the urban area county codes for
‘‘Montgomery, VA; Pulaski, VA; and
Radford City, VA.’’
3. On page 45149, in the first column,
in the 10th entry, for CBSA code 6580,
change the CBSA code ‘‘6580’’ to
‘‘16580.’’
4. On page 45150—
A. In the fourth column, in the 15th
entry, for CBSA code 17140, wage index
0.9207, urban area county code for
Bracken, KY*, change the MSA code
‘‘14’’ to ‘‘18.’’
B. In the third column, in the 15th
entry from the bottom, for CBSA code
17980, change the urban area county
‘‘Russell, AL,’’ to ‘‘Russell, AL*.’’
5. On page 45153—
A. In the fourth column, in the first
entry, for CBSA code 22744, change the
MSA code ‘‘2860’’ to ‘‘2680.’’
B. In the third column, for CBSA code
23540 as previously corrected on
September 30, 2005 (70 FR 57176)
change the wage index number for
Alachua, FL* from ‘‘0.9642’’ to ‘‘1.0033’’
and the wage index number for
‘‘Gilchrist, FL* from ‘‘1.0033’’ to
‘‘0.9642.’’
C. In the second column, for CBSA
code 24660, for urban area county code
Randolph, NC*, remove the wage index
number ‘‘0.9382’’ and add the wage
index number ‘‘0.9382’’ to the urban
area county code ‘‘Rockingham, NC*.’’
6. On page 45160 as corrected on
September 30, 2005 (70 FR 57176) in the
second column—
A. In the second entry from the
bottom, for the CBSA code 38540,
change the wage index number for
‘‘Bannock, ID*’’ from ‘‘0.9773’’ to
‘‘1.0183.’’
B. In the first entry from the bottom,
for the CBSA code 38540, change the
wage index number for ‘‘Power, ID*’’
from ‘‘1.0183’’ to ‘‘0.9773.’’
Table C—Blended Hospice Wage Index
Codes for Selected Areas
1. On page 45177, in the 6th column,
in the 20th line, for the county name of
Stanly, NC, change the special hospice
wage index code ‘‘50192’’ to ‘‘50092.’’
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2. On page 45188, in the 7th column,
in the 25th line from the bottom, for the
county name Pitt, NC, change the wage
index number ‘‘0.09740’’ to ‘‘0.9740.’’
3. On page 45190, in the 7th column,
in the 27th line, for the county name,
Crittenden, TN, change the wage index
number ‘‘0.09785’’ to ‘‘0.9785.’’
III. Waiver of Proposed Rulemaking
We ordinarily publish a notice of
proposed rulemaking in the Federal
Register to provide a period for public
comment before the provisions of a rule
take effect in accordance with section
553(b) of the Administrative Procedure
Act (APA) (5 U.S.C. 553(b)). However,
we can waive this notice and comment
procedure if the Secretary finds that the
notice and comment process is
impracticable, unnecessary, or contrary
to the public interest, and incorporates
a statement of the finding and the
reasons therefore in the notice.
The revisions contained in this rule
correct formatting and typographical
errors in various sections of Table A and
Table C of the addendum. These
corrections are necessary to ensure that
the final rule accurately reflects the
correct hospice wage index values.
Since they are not substantive, but
merely technical, we find that public
comments on these revisions are both
unnecessary and impracticable.
Therefore, we find good cause to waive
notice and comment procedures.
In addition, the Administrative
Procedure Act (APA) normally requires
a 30-day delay in the effective date of
a final rule. Since this notice simply
makes technical modifications to a final
rule that has previously gone through
notice-and-comment rulemaking and
the corrections are only to formatting
errors, we believe good cause also exists
under the APA to waive the 30-day
delay in the effective date.
Section 1871(e)(1)(A) of the Act, as
amended by section 903(a) of Pub .L.
108–173, provides that a substantive
change in regulations shall not be
applied retroactively to items and
services furnished before the effective
date of the change, unless the Secretary
finds that such retroactive application is
necessary to comply with statutory
requirements or failure to apply the
change retroactively would be contrary
to the public interest. Although this
correction notice is retroactive, it makes
no substantive changes, but only
corrects minor technical errors. Failure
to make these changes retroactive to
October 1, 2005, is contrary to the
public interest because the published
wage index values do not match the
actual wage index values utilized by
CMS as of October 1, 2005. Actual
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payments made by CMS to hospice
providers will not change. Therefore, we
believe there is sufficient cause to make
the corrections retroactive.
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance; and Program No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
Dated: December 12, 2005.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. 05–24288 Filed 12–22–05; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 419 and 485
[CMS–1501–CN2]
RIN 0938–AN46
Medicare Program; Changes to the
Hospital Outpatient Prospective
Payment System and Calendar Year
2006 Payment Rates; Correction
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Correction of final rule with
comment period.
AGENCY:
SUMMARY: This document corrects
technical errors that appeared in the
final rule with comment period
published in the Federal Register on
November 10, 2005 entitled ‘‘Changes to
the Hospital Outpatient Prospective
Payment System and Calendar Year
2006 Payment Rates; Final Rule.’’
EFFECTIVE DATE: January 1, 2006.
FOR FURTHER INFORMATION CONTACT:
Rebecca Kane, (410) 786–0378.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 05–22136 (70 FR 68515),
we have identified a number of
technical errors that we have described
in the ‘‘Summary of Errors’’ section and
corrected in the ‘‘Correction of Errors’’
section below. The provisions in this
correction notice are effective as if they
had been included in the CY 2006 final
rule with comment period. Accordingly,
the corrections are effective January 1,
2006.
II. Summary of Errors
On November 10, 2005, we published
the CY 2006 Hospital Outpatient
Prospective Payment System (OPPS)
final rule with comment period.
Included in that document were several
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technical and typographical errors that
we are correcting in section III of this
notice.
A. Correction of Technical Errors
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We are correcting the following
technical errors that were included in
the CY 2006 OPPS final rule with
comment period affecting drug
administration code C8596, estimated
expenditures, regulation text, hospital
coding for sodium hyaluronate
products, and Addendum L.
On page 68680, we neglected to
remove the first row, referencing HCPCS
code C8956, from Table 31 and the
accompanying discussion regarding
C8956 from the response to the
comment included in the third column,
third paragraph. We are correcting these
errors in this notice.
On page 68726, we referred to the
transfer from the Federal government to
Medicare providers in billions rather
than millions in the accounting table.
We are correcting the error in this
notice.
On page 68728, we omitted a
reference to pass-through devices in the
regulation text as stated in the preamble
text at 68559. We correct this omission
in this notice.
On page 68643 and in Addendum B
we erroneously referred to the creation
of a code by the National HCPCS Panel,
specifically the creation of HCPCS code
J7318. This was incorrect as this code
was not created by the National HCPCS
Panel. Our error was discovered after
publication, and we are taking this
opportunity to revise Addendum B to
reflect the CY 2006 payment for Sodium
Hyaluronate products using HCPCS
codes J7317 and J7320, as originally
included in the CY 2006 OPPS proposed
rule.
On pages 68752–68913 we published
Addendum B—Payment Status by
HCPCS Code and Related Information—
CY 2006. We excluded several codes
from this table. In section III of this
correction notice we correct this error
by publishing the omitted codes.
On pages 68964 through 68980, we
published Addendum L—Out-Migration
Wage Adjustment CY 2006. We
excluded several providers from this
table. In Section III of this correction
notice, we republish Addendum L.
B. Other Corrections
We are also correcting typographical,
formatting, and other technical errors
that were contained in the CY 2006
OPPS final rule with comment period.
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III. Waiver of Proposed Rulemaking
and Delay in Effective Date
We ordinarily publish a notice of
proposed rulemaking in the Federal
Register to provide a period for public
comment before the provisions of a
notice such as this takes effect in
accordance with section 553(b) of the
Administrative Procedure Act (APA) (5
U.S.C. 553(b)). We also ordinarily
provide a 30-day delay in the effective
date of the provisions of a notice in
accordance with section 553(d) of the
APA (5 U.S.C. 553(d)). However, we can
waive both the notice and comment
procedure and the 30-day delay in
effective date if the Secretary finds, for
good cause, that it is impracticable,
unnecessary or contrary to the public
interest, and incorporates a statement of
the finding and the reasons therefore in
the notice.
The policies and payment
methodology finalized in the CY 2006
OPPS final rule with comment period
have previously been subjected to notice
and comment procedures. This
correction notice merely provides
technical corrections to the CY 2006
OPPS final rule with comment period
that was promulgated through notice
and comment rulemaking, and does not
make substantive changes to the policies
or payment methodology that were
finalized in the final rule with comment
period. For example, this notice corrects
typographical errors, makes
clarifications to the preamble and
regulations text, and revises inaccurate
tabular data. Therefore, we find it
unnecessary to undertake further notice
and comment procedures with respect
to this correction notice. We also believe
it is in the public interest to waive
notice and comment procedures and the
30-day delay in effective date for this
notice. This correction notice is
intended to ensure that the CY 2006
OPPS final rule with comment period
accurately reflects the policies
expressed in the final rule, and that the
corrected information is made available
to the public prior to January 1, 2006,
the date on which the final rule
becomes effective.
For the reasons stated above, we find
that both notice and comment and the
30-day delay in effective date for this
correction notice are unnecessary and
that it is in the public interest to make
this notice effective in conjunction with
the final rule to which the corrections
apply. Therefore, we find there is good
cause to waive notice and comment
procedures and the 30-day delay in
effective date for this correction notice.
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76177
IV. Correction of Errors
In FR Doc. 05–22136 (70 FR 68515),
make the following corrections:
A. Corrections to Preamble Text
1. On page 68516, in column 3, in the
second full paragraph, line 3, the term
‘‘OPPA’’ is corrected to read ‘‘OPPS.’’
2. On page 68517, in column 1, in the
15th paragraph, line 1, the phrase ‘‘(Cost
center specific)’’ is removed.
3. On page 68518, in column 1, in the
11th paragraph, line 2, the phrase
‘‘and0651’’ is corrected to read ‘‘and
0651.’’
4. On page 68537,
a. In column 3, in the first full
paragraph, lines 5 to 6, the phrase ‘‘of
the proposed rule (76 FR 42690)’’ is
removed.
b. In column 3, in the first full
paragraph, line 6, the word ‘‘contained’’
is corrected to read ‘‘contains.’’
5. On page 68549,
a. In column 2, in the first full
paragraph, line 7, the amount ‘‘$246.04’’
is corrected to read ‘‘$245.91.’’
b. In column 2, in the first full
paragraph, line 8, the amount ‘‘$49.21’’
is corrected to read ‘‘$49.18.’’
6. On page 68551, in column 3; in the
second full paragraph, line 12, the term
‘‘TEFRA’’ is removed.
7. On page 68552,
a. In column 1, in the second partial
paragraph, line 32, the term ‘‘TEFRA’’ is
removed.
b. In column 2, in the first partial
paragraph carried over from column 1,
line 14, the term ‘‘TEFRA’’ is removed.
c. In column 2, in the first partial
paragraph carried over from column 1,
line 15, the line is corrected by inserting
the phrase ‘‘paid under the OPPS but
not under the IPPS’’ between the words
‘‘hospitals’’ and ‘‘will.’’
d. In column 3, in the first partial
paragraph carried over from column 2,
line 3, the term ‘‘TEFRA’’ is removed.
e. In column 3 in the first partial
paragraph carried over from column 2,
line 5, the term ‘‘TEFRA’’ is corrected to
read ‘‘these.’’
f. In column 3, in the first partial
paragraph carried over from column 2,
line 10, the term ‘‘TEFRA’’ is corrected
to read ‘‘these.’’
g. In column 3, in the first partial
paragraph carried over from column 2,
line 17, the term ‘‘TEFRA’’ is removed.
h. In column 3, in the first partial
paragraph carried over from column 2,
line 18, the line is corrected by inserting
the phrase term ‘‘not paid under the
IPPS’’ between the words ‘‘hospitals’’
and ‘‘that’’.
8. On page 68556, in column 2, in the
second full paragraph, in line 20, the
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sentence is corrected by adding the
following bolded text ‘‘payments,
brachytherapy seeds, and any service’’.
9. On page 68559,
a. In column 1, below the table
footnotes, line 14, following
‘‘biologicals’’ the word ‘‘and’’ is
removed.
b. In column 1, below the table
footnotes, line 16 is corrected adding, ‘‘,
and brachytherapy seeds.’’ after
‘‘payment policy’’.
10. On page 68561,
a. In column 1, line 7, add a ‘‘,’’ after
term ‘‘rural hospitals’’.
b. In column 1, in the last partial
paragraph, line 7, remove the word
‘‘because’’ and add ‘‘as’’ in its place.
c. In column 2, in the first partial
paragraph carried over from column 1,
line 11, ‘‘2 percent’’ is corrected to read
‘‘¥2 percent’’.
11. On page 68565, column 1, in the
fifth full paragraph, line 5, ‘‘2005’’ is
corrected to read ‘‘2006’’.
12. On page 68578, column 1, in the
last partial paragraph, line 2, the
number ‘‘0042’’ is corrected to read
‘‘0429.’’
13. On page 68596, column 2, in the
first full paragraph,
a. Line 8, the amount ‘‘$2,662.62’’ is
corrected to read ‘‘$2,709.14.’’
b. Line 12, the amount ‘‘$2,975.50’’ is
corrected to read ‘‘$3,051.67.’’
14. On page 68606, in column 1, in
the first full paragraph, line 10, the
number ‘‘0442’’ is corrected to read
‘‘0422.’’
15. On page 68628,
a. In column 2, in the first partial
paragraph carried over from column 1,
line 5, the word ‘‘where’’ is corrected to
read ‘‘when.’’
b. In column 2, in the third full
paragraph, line 17, the phrase
‘‘November 13, 2000 final rule’’ is
corrected to read ‘‘November 13, 2000
interim final rule with comment
period.’’
16. On page 68630,
a. In column 1, in the first partial
paragraph carried over from page 68629,
line 4, the date ‘‘August 3’’ is corrected
to read ‘‘November 13.’’
b. In column 2, in the first full
paragraph, line 13, the date ‘‘August 3’’
is corrected to read ‘‘November 13.’’
c. In column 2, in the first full
paragraph, line 13, the line is corrected
by inserting ‘‘with comment period’’ at
the end of the sentence.
d. In column 2, in the first full
paragraph, line 33, the date ‘‘August 3’’
is corrected to read ‘‘November 13.’’
17. On page 68637, in Table 22, the
footnote is removed from the column
one heading.
18. On page 68679, in column 1; in
the first partial paragraph at the bottom
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of the page, line 6, the number ‘‘31’’ is
corrected to read ‘‘30.’’
19. On page 68680,
a. In column 3, in the third paragraph,
line 3, the term ‘‘codes’’ is corrected to
read ‘‘code.’’
b. In column 3, in the third paragraph,
lines 3 through 8, the sentence is
corrected by removing the phrase
‘‘C8956 (Refilling and maintenance of
portable or implantable pump or
reservoir for drug delivery for therapy/
diagnosis, systemic (e.g., intravenous,
intra-arterial)) and.’’
c. In Table 31, the table is corrected
by removing row 1.
20. On page 68717, in column 1, first
partial paragraph continued from the
previous page, line 24, the line is
corrected by inserting the phrase
‘‘brachytherapy seeds,’’ after the word
‘‘* * * biologicals,’’.
21. On page 68719, in column 1, the
third partial paragraph, line 9, the
sentence is corrected by inserting the
phrase ‘‘at least’’ between the word ‘‘of’’
and the number ‘‘0.2.’’
22. On page 68720, in column 3, in
the second full paragraph, line 30, the
number ‘‘3.2’’ is corrected to read ‘‘3.0.’’
23. On page 68726, in table 41, in
column 2, row 2, ‘‘$660 Billion.’’ is
corrected to read ‘‘$660 Million.’’
§ 419.43
[Amended]
24. On page 68728,
a. In column 1, in the first partial
paragraph carried over from page 68727,
line 1, the phrase ‘‘APC and devices of’’
is corrected to read ‘‘APC, devices of.’’
I b. In column 1, in the first partial
paragraph carried over from page 68727,
line 3, the sentence is corrected by
inserting the phrase, ‘‘, and devices paid
under § 419.66’’ after the phrase
‘‘(including a radioactive source).’’
I
I
B. Corrections to Addendum A
1. On page 68736, for APC 0339, row
22, column 3, ‘‘Q’’ is corrected to read
‘‘S.’’
2. On page 68738, for APC 0430, row
27, is removed.
3. On page 68743, for APC 1491, row
23, column 6, ‘‘$2.00’’ is removed.
4. On page 68746, APC 1611 is added
in numerical order as follows:
a. Column 2 reads ‘‘Hylan G–F 20
injection,’’
b. Column 3 reads ‘‘K,’’
c. Column 4 is blank,
d. Column 5 reads ‘‘$199.09,’’
e. Column 6 is blank,
f. Column 7 reads ‘‘$39.82.’’
5. On page 68748,
a. APC 1706, row 18, is removed.
b. For APC 1713, row 25, column 2,
‘‘Inj Fe-based MR contrast, ml’’ is
corrected to read ‘‘Inj Fe-base MR
contrast, 1m1.’’
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6. On page 68749, APC 7316 is added
as follows:
a. Column 2 reads ‘‘Sodium
hyaluronate injection,’’
b. Column 3 reads ‘‘K,’’
c. Column 4 is blank,
d. Column 5 reads ‘‘$106.70,’’
e. Column 6 is blank,
f. Column 7 reads ‘‘$21.34.’’
7. On page 68750,
a. For APC 9119, row 19, column 2,
‘‘Pentastarch 10% solution’’ is corrected
to read ‘‘Injection, pegfilgrastim 6mg.’’
b. For APC 9126, row 25, column 2,
‘‘Injection, Natalizumab, 1mg’’ is
corrected to read ‘‘Natalizumab
injection.’’
8. On page 68751, for APC 9164, row
7, column 2, ‘‘Inj Gad-base MR contrast,
ml’’ is corrected to read ‘‘Inj Gad-base
MR contrast, 1ml.’’
C. Corrections to Addendum B
1. On page 68876,
a. For HCPCS code 95965, row 9,
i. In column 4, ‘‘T’’ is corrected to
read ‘‘S,’’
ii. In column 5, ‘‘0430’’ is corrected to
read ‘‘1523,’’
iii. In column 6, ‘‘10.8452’’ is
removed,
iv. In column 7, ‘‘$645.41’’ is
corrected to read ‘‘$2,750.00,’’
v. In column 9, ‘‘$129.08’’ is corrected
to read ‘‘$550.00.’’
b. For HCPCS code 95966, row 10,
i. In column 4, ‘‘T’’ is corrected to
read ‘‘S,’’
ii. In column 5, ‘‘0430’’ is corrected to
read ‘‘1514,’’
iii. In column 6, ‘‘10.8452’’ is deleted,
iv. In column 7, ‘‘$645.41’’ is
corrected to read ‘‘$1,250.00,’’
v. In column 9, ‘‘$129.08’’ is corrected
to read ‘‘$250.00.’’
c. For HCPCS code 95967, row 11,
i. In column 4, ‘‘T’’ is corrected to
read ‘‘S,’’
ii. In column 5, ‘‘0430’’ is corrected to
read ‘‘1510,’’
iii. In column 6, ‘‘10.8452’’ is deleted,
iv. In column 7, ‘‘$645.41’’ is
corrected to read ‘‘$850.00,’’
v. In column 9, ‘‘$129.06’’ is corrected
to read ‘‘$170.00.’’
2. On page 68880,
a. For HCPCS code 0001F, row 1,
column 4, ‘‘D’’ is corrected to read ‘‘E.’’
b. For HCPCS code 0005F, row 7,
column 4, ‘‘D’’ is corrected to read ‘‘E.’’
3. On page 68888, for HCPCS code
C8956, row 14,
a. In column 4, ‘‘T’’ is corrected to
read ‘‘D,’’
b. In column 5, ‘‘0125’’ is removed,
c. In column 6, ‘‘1.9021’’ is removed,
d. In column 7, ‘‘$113.20’’ is removed,
e. In column 9, ‘‘$22.64’’ is removed.
4. On page 68895,
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a. For HCPCS code G0375, row 36,
column 8, ‘‘$2.00’’ is removed.
b. For HCPCS code G0376, row 37,
column 8, ‘‘$2.00’’ is removed.
5. On page 68901,
a. For HCPCS code J2505, row 20,
column 2, ‘‘Pentastarch 10% solution’’
is corrected to read ‘‘Injection,
pegfilgrastim 6mg.’’
b. For HCPCS code J2510, row 21,
column 2, ‘‘Sincalide injection’’ is
corrected to read ‘‘Penicillin g procaine
inj.’’
6. On page 68902, for HCPCS code
J3070, row 26, column 2, ‘‘Pentazocine
hcl injection’’ is corrected to read
‘‘Pentazocine injection.’’
7. On page 68904,
a. For HCPCS code J7317, row 12,
column 4,
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HCPCS/CPT
22010
22015
32503
32504
33507
33548
33768
33880
33881
33883
33884
33886
33889
33891
33925
33926
43770
43771
43772
43773
43774
44187
44188
44227
45395
45397
45400
45402
46710
46712
50250
61630
61635
61640
61641
61642
75956
75957
75958
75959
80195
82271
82272
83037
83631
83695
83700
83701
83704
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i. ‘‘D’’ is corrected to read ‘‘K,’’
ii. In column 5, ‘‘7316’’ is added,
iii. In column 7, ‘‘$106.70’’ is added,
iv. In column 9, ‘‘$21.34’’ is added.
b. For HCPCS code J7318, row 13,
i. In column 4, ‘‘K’’ is corrected to
read ‘‘D,’’
ii. In column 5, ‘‘1706’’ is removed,
iii. In column 7, ‘‘$7.20’’ is removed,
iv. In column 9, ‘‘$1.44’’ is removed,
c. For HCPCS code J7320, row 14,
i. In column 4, ‘‘D’’ is corrected to
read ‘‘K,’’
ii. In column 5, ‘‘1611’’ is added,
iii. In column 7, ‘‘$199.09’’ is added,
iv. In column 9, ‘‘$39.82’’ is added.
8. On page 68907, for HCPCS code
K0105, row 8, column 4, ‘‘D’’ is
corrected to read ‘‘Y.’’
9. On page 68912,
CI
I&d, p-spine, c/t/cerv-thor .......
I&d, p-spine, l/s/ls ...................
Resect apical lung tumor .......
Resect apical lung tum/chest
Repair art, intramural .............
Restore/remodel, ventricle .....
Cavopulmonary shunting ........
Endovasc taa repr incl subcl ..
Endovasc taa repr w/o subcl ..
Insert endovasc prosth, taa ....
Endovasc prosth, taa, add-on
Endovasc prosth, delayed ......
Artery transpose/endovas taa
Car-car bp grft/endovas taa ...
Rpr pul art unifocal w/o cpb ...
Repr pul art, unifocal w/cpb ...
Lap, place gastr adjust band ..
Lap, revise adjust gast band ..
Lap, remove adjust gast band
Lap, change adjust gast band
Lap remov adj gast band/port
Lap, ileo/jejuno-stomy ............
Lap, colostomy .......................
Lap, close enterostomy ..........
Lap, removal of rectum ..........
Lap, remove rectum w/pouch
Laparoscopic proctopexy .......
Lap proctopexy w/sig resect ..
Repr per/vag pouch sngl proc
Repr per/vag pouch dbl proc
Cryoablate renal mass open ..
Intracranial angioplasty ..........
Intracran angioplsty w/stent ...
Dilate ic vasospasm, init ........
Dilate ic vasospasm add-on ...
Dilate ic vasospasm add-on ...
Xray, endovasc thor ao repr ..
Xray, endovasc thor ao repr ..
Xray, place prox ext thor ao ...
Xray, place dist ext thor ao ....
Assay of sirolimus ..................
Occult blood, feces, single .....
Blood occult peroxidase .........
Glycosylated hb, home device
Lactoferrin, fecal (quant) ........
Assay of lipoprotein(a) ...........
Lipopro bld, electrophoretic ....
Lipoprotein bld, hr fraction .....
Lipoprotein, bld, by nmr .........
15:34 Dec 22, 2005
Jkt 208001
PO 00000
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
SI
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
Frm 00051
APC
a. For HCPCS code Q4079, row 15,
column 2, ‘‘Injection, Natalizumab, 1
MG’’ is corrected to read ‘‘Natalizumab
injection.’’
b. For HCPCS code Q9946, row 21,
column 2, ‘‘LOCM <=149 mg/ml iodine,
1ml’’ is corrected to read ‘‘LOCM 150–
199 mg/ml iodine, 1ml.’’
c. For HCPCS code Q9952, row 27,
column 2, ‘‘Inj Gad-base MR contrast,
ml’’ is corrected to read ‘‘Inj Gad-base
MR contrast, 1ml.’’
d. For HCPCS code Q9953, row 28,
column 2, ‘‘Inj Fe-based MR contrast,
ml’’ is corrected to read ‘‘Inj Fe-based
MR contrast, 1ml.’’
10. The following HCPCS codes were
inadvertently omitted from the
Addendum B. We correct this error by
listing the omitted codes below.
Relative
weight
Payment
rate
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
B
B
B
B
B
C
C
C
C
A
A
A
A
A
A
A
A
A
Fmt 4700
Sfmt 4700
76179
E:\FR\FM\23DER1.SGM
23DER1
National
unadjusted
copayment
Minimum
unadjusted
copayment
76180
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
HCPCS/CPT
Short descriptor
erjones on PROD1PC68 with RULES
83900
83907
83908
83909
83914
86200
86355
86357
86367
86480
87209
87900
90649
90736
90760
90761
90765
90766
90767
90768
90774
90775
92630
92633
95251
96409
96411
96413
96415
96417
97760
97761
97762
98960
98961
98962
99051
99053
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
99060
99304
99305
99306
99307
99308
99309
99310
99318
99324
99325
99326
99327
99328
99334
99335
99336
99337
99339
99340
0090T
0091T
0092T
0093T
0094T
0095T
0096T
0097T
0098T
0103T
0104T
0105T
0111T
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
VerDate Aug<31>2005
CI
Molecule nucleic ampli 2 seq
Lyse cells for nucleic ext ........
Nucleic acid, signal ampli .......
Nucleic acid, high resolute .....
Mutation ident ola/sbce/aspe
Ccp antibody ..........................
B cells, total count ..................
Nk cells, total count ................
Stem cells, total count ............
Tb test, cell immun measure ..
Smear, complex stain .............
Phenotype, infect agent drug
H papilloma vacc 3 dose im ...
Zoster vacc, sc .......................
Hydration iv infusion, init ........
Hydrate iv infusion, add-on ....
Ther/proph/diag iv inf, init .......
Ther/proph/dg iv inf, add-on ...
Tx/proph/dg addl seq iv inf .....
Ther/diag concurrent inf .........
Ther/proph/diag inj, iv push ....
Ther/proph/diag inj add-on .....
Aud rehab pre-ling hear loss ..
Aud rehab postling hear loss
Gluc monitor, cont, phys i&r ...
Chemo, iv push, sngl drug .....
Chemo, iv push, addl drug .....
Chemo, iv infusion, 1 hr .........
Chemo, iv infusion, addl hr ....
Chemo iv infus each addl seq
Orthotic mgmt and training .....
Prosthetic training ...................
C/o for orthotic/prosth use ......
Self-mgmt educ & train, 1 pt ..
Self-mgmt educ/train, 2–4 pt ..
Self-mgmt educ/train, 5–8 pt ..
Med serv, eve/wkend/holiday
Med serv 10pm–8am, 24 hr
fac.
Out of office emerg med serv
Nursing facility care, init .........
Nursing facility care, init .........
Nursing facility care, init .........
Nursing fac care, subseq .......
Nursing fac care, subseq .......
Nursing fac care, subseq .......
Nursing fac care, subseq .......
Annual nursing fac assessmnt
Domicil/r-home visit new pat ..
Domicil/r-home visit new pat ..
Domicil/r-home visit new pat ..
Domicil/r-home visit new pat ..
Domicil/r-home visit new pat ..
Domicil/r-home visit est pat ....
Domicil/r-home visit est pat ....
Domicil/r-home visit est pat ....
Domicil/r-home visit est pat ....
Domicil/r-home care supervis
Domicil/r-home care supervis
Cervical artific disc .................
Lumbar artific disc ..................
Artific disc addl .......................
Cervical artific diskectomy ......
Lumbar artific diskectomy ......
Artific diskectomy addl ...........
Rev cervical artific disc ..........
Rev lumbar artific disc ............
Rev artific disc addl ................
Holotranscobalamin ................
At rest cardio gas rebreathe ..
Exerc cardio gas rebreathe ....
Rbc membranes fatty acids ...
15:34 Dec 22, 2005
Jkt 208001
PO 00000
SI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
Relative
weight
Payment
rate
A
A
A
A
A
A
A
A
A
A
A
A
E
E
B
B
B
B
B
B
B
B
E
E
B
B
B
B
B
B
A
A
A
E
E
E
B
B
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
APC
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
C
C
C
C
C
C
C
C
C
A
A
A
A
Frm 00052
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
National
unadjusted
copayment
Minimum
unadjusted
copayment
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
HCPCS/CPT
Short descriptor
0115T
0116T
0117T
0130T
0140T
................
................
................
................
................
0141T
0142T
0143T
0153T
1003F
1004F
1005F
1006F
1007F
1008F
2000F
2001F
2002F
2003F
2004F
3000F
3002F
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
4003F
4012F
4014F
4015F
4016F
4017F
4018F
A0998
................
................
................
................
................
................
................
................
A4233
A4234
A4235
A4236
A4363
A4411
A4412
A4604
A5120
A5512
A5513
A6457
A6513
................
................
................
................
................
................
................
................
................
................
................
................
................
A6530 ................
A6531 ................
erjones on PROD1PC68 with RULES
A6532 ................
A6533
A6534
A6535
A6536
A6537
A6538
A6539
A6540
A6541
A6542
A6543
A6544
A6549
A9275
A9281
A9282
B4185
E0170
E0171
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
VerDate Aug<31>2005
CI
Med tx mngmt 15 min ............
Med tx mngmt subsqt .............
Med tx mngmt addl 15 min ....
Chron care drug investigatn ...
Exhaled breath condensate
ph.
Perq islet transplant ...............
Open islet transplant ..............
Laparoscopic islet transplnt ....
Implant aneur sensor add-on
Level of activity assess ..........
Clin symp vol ovrld assess ....
Asthma symptoms evaluate ...
Osteoarthritis assess ..............
Anti-inflm/anlgsc otc assess ...
Gi/renal risk assess ................
Blood pressure measure ........
Weight record .........................
Clin sign vol ovrld assess ......
Auscultation heart perform .....
Initial exam involved joints .....
Blood press </= 140/90 mmhg
Blood pressure > 140/90
mmhg.
Pt ed write/oral, pts w/ hf .......
Warfarin therapy rx .................
Written discharge instr prvd ...
Persist asthma medicine ctrl ..
Anti-inflm/anlgsc agent rx .......
Gi prophylaxis for nsaid rx .....
Therapy exercise joint rx ........
Ambulance response/treatment.
Alkalin batt for glucose mon ...
J-cell batt for glucose mon .....
Lithium batt for glucose mon ..
Silvr oxide batt glucose mon ..
Ostomy clamp, replacement ..
Ost skn barr extnd =4 sq ........
Ost pouch drain high output ...
Tubing with heating element ..
Skin barrier, wipe or swab .....
Multi den insert direct form ....
Multi den insert custom mold
Tubular dressing .....................
Compress burn mask face/
neck.
Compression stocking BK18–
30.
Compression stocking BK30–
40.
Compression stocking BK40–
50.
Gc stocking thighlngth 18–30
Gc stocking thighlngth 30–40
Gc stocking thighlngth 40–50
Gc stocking full lngth 18–30 ...
Gc stocking full lngth 30–40 ...
Gc stocking full lngth 40–50 ...
Gc stocking waistlngth 18–30
Gc stocking waistlngth 30–40
Gc stocking waistlngth 40–50
Gc stocking custom made ......
Gc stocking lymphedema .......
Gc stocking garter belt ...........
G compression stocking .........
Disp home glucose monitor ...
Reaching/grabbing device ......
Wig any type ..........................
Parenteral sol 10 gm lipids ....
Commode chair electric .........
Commode chair non-electric ..
15:34 Dec 22, 2005
Jkt 208001
PO 00000
SI
NI
NI
NI
NI
NI
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
E
E
E
E
E
E
E
E
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
Y
Y
Y
Y
A
A
A
Y
A
B
B
A
B
NI ...................
E
NI ...................
A
NI ...................
A
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
Payment
rate
E
E
E
C
E
E
E
E
E
E
E
E
E
E
E
E
E
NI
NI
NI
NI
NI
NI
NI
NI
Relative
weight
B
B
B
B
A
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
APC
E
E
E
E
E
E
E
E
E
E
E
E
E
E
E
E
B
Y
Y
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
Frm 00053
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
National
unadjusted
copayment
76181
Minimum
unadjusted
copayment
76182
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
HCPCS/CPT
Short descriptor
E0172 ................
E0485 ................
E0486 ................
E0641 ................
E0642 ................
E0705 ................
E0762 ................
E0764 ................
E0911 ................
E0912 ................
E1392 ................
E1812 ................
E2207 ................
E2208 ................
E2209 ................
E2210 ................
E2211 ................
E2212 ................
E2213 ................
E2214 ................
E2215 ................
E2216 ................
E2217 ................
E2218 ................
E2219 ................
E2220 ................
E2221 ................
E2222 ................
E2223 ................
E2224 ................
E2225 ................
E2226 ................
E2371 ................
E2372 ................
G0333 ...............
G0372 ...............
G8006 ...............
G8007 ...............
G8008 ...............
G8009 ...............
G8010 ...............
G8011 ...............
G8012 ...............
G8013 ...............
G8014 ...............
G8015 ...............
G8016 ...............
Seat lift mechanism toilet .......
Oral device/appliance prefab
Oral device/appliance cusfab
Multi-position stnd fram sys ...
Dynamic standing frame ........
Transfer board or device ........
Trans elec jt stim dev sys ......
Functional neuromuscularstim
HD trapeze bar attach to bed
HD trapeze bar free standing
Portable oxygen concentrator
Knee ext/flex w act res ctrl .....
Crutch and cane holder ..........
Cylinder tank carrier ...............
Arm trough each .....................
Wheelchair bearings ...............
Pneumatic propulsion tire .......
Pneumatic prop tire tube ........
Pneumatic prop tire insert ......
Pneumatic caster tire each ....
Pneumatic caster tire tube .....
Foam filled propulsion tire ......
Foam filled caster tire each ....
Foam propulsion tire each .....
Foam caster tire any size ea
Solid propulsion tire each .......
Solid caster tire each .............
Solid caster integrated whl .....
Valve replacement only each
Propulsion whl excludes tire ..
Caster wheel excludes tire .....
Caster fork replacement only
Gr27 sealed leadacid battery
Gr27 non-sealed leadacid ......
Dispense fee initial 30 day .....
MD service required for PMD
AMI pt recd aspirin at arriv .....
AMI pt did not receiv aspiri ....
AMI pt ineligible for aspiri .......
AMI pt recd Bblock at arr .......
AMI pt did not rec bblock .......
AMI pt inelig Bbloc at arriv .....
Pneum pt recv antibiotic 4 h ..
Pneum pt w/o antibiotic 4 hr ..
Pneum pt not elig antibiotic ....
Diabetic pt w/ HBA1c>9% ......
Diabetic pt w/ HBA1c < or =
9%.
DM pt inelig for HBA1c measu
Care not provided for HbA1c
Diabetic pt w/LDL> 100mg/dl
Diab pt w/LDL < or = 100mg/
dl.
Diab pt inelig for LDL meas ...
Care not provided for LDL .....
DM pt w BP> 140/80 ..............
Diabetic pt wBP< 140/80 ........
Diabetic pt inelig for BP me ...
Diabet pt w no care re BP me
HF p w/LVSD on ACE-I/ARB
HF pt w/LVSD not on ACE-I/
AR.
HF pt not elig for ACE-I/ARB
HF pt w/LVSD on Bblocker ....
HF pt w/LVSD not on
Bblocker.
HF pt not elig for Bblocker .....
AMI-CAD pt on Bblocker ........
AMI-CAD pt not on Bblocker ..
AMI-CAD pt inelig Bblocker ...
AMI-CAD pt doc on antiplatel
AMI-CAD pt not docu on antip
G8017
G8018
G8019
G8020
...............
...............
...............
...............
G8021
G8022
G8023
G8024
G8025
G8026
G8027
G8028
...............
...............
...............
...............
...............
...............
...............
...............
erjones on PROD1PC68 with RULES
G8029 ...............
G8030 ...............
G8031 ...............
G8032
G8033
G8034
G8035
G8036
G8037
...............
...............
...............
...............
...............
...............
VerDate Aug<31>2005
15:34 Dec 22, 2005
Jkt 208001
CI
PO 00000
SI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
M
M
M
M
M
M
M
M
NI ...................
NI ...................
NI ...................
M
M
M
NI
NI
NI
NI
NI
NI
Payment
rate
M
M
M
M
NI
NI
NI
NI
NI
NI
NI
NI
Relative
weight
E
Y
Y
E
E
B
B
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
M
M
M
M
M
M
M
M
M
M
M
M
M
NI
NI
NI
NI
APC
M
M
M
M
M
M
...................
...................
...................
...................
...................
...................
Frm 00054
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
National
unadjusted
copayment
Minimum
unadjusted
copayment
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
HCPCS/CPT
G8038
G8039
G8040
G8041
G8051
G8052
G8053
G8055
G8056
G8057
G8058
G8059
G8060
G8061
G8062
G8075
Short descriptor
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
G8076 ...............
G8077
G8078
G8079
G8080
G8081
G8082
G8093
G8094
...............
...............
...............
...............
...............
...............
...............
...............
G8099 ...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
...............
G8156
G8157
G8158
G8159
G8160
G8161
G8162
erjones on PROD1PC68 with RULES
G8100
G8103
G8104
G8106
G8107
G8108
G8109
G8110
G8111
G8112
G8113
G8114
G8115
G8116
G8117
G8126
G8127
G8128
G8129
G8130
G8131
G8152
G8153
G8154
G8155
...............
...............
...............
...............
...............
...............
...............
G8163
G8164
G8165
G8166
G8167
G8170
G8171
G8172
...............
...............
...............
...............
...............
...............
...............
...............
VerDate Aug<31>2005
CI
AMI-CAD inelig antiplate mea
CAD pt w/LDL>100mg/dl .......
CAD pt w/LDL< or = 100mg/dl
CAD pt not eligible for LDL ....
Osteoporosis assess ..............
Osteopor pt not assess ..........
Pt inelig for osteopor meas ....
Falls assess w/ 12 mon .........
Not elig for falls assessmen ...
Hearing assess receive ..........
Pt w/o hearing assess ............
Pt inelig for hearing assess ....
Urinary incont pt assess .........
Pt not assess for urinary in ....
Pt not elig for urinary inco ......
ESRD pt w/ dialy of
URR> 65%.
ESRD pt w/ dialy of
URR< 65%.
ESRD pt not elig for URR/KtV
ESRD pt w/Hct> or = 33 .........
ESRD pt w/Hct< 33 ................
ESRD pt inelig for HCT/Hgb ..
ESRD pt w/ auto AV fistula ....
ESRD pt w other fistula ..........
COPD pt rec smoking cessat
COPD pt w/o smoke cessat
int.
Osteopo pt given Ca+VitD
sup.
Osteop pt inelig for Ca+VitD ..
New dx osteo pt w/antiresorp
Osteo pt inelig for antireso .....
Bone dens meas test perf ......
Bone dens meas test inelig ....
Pt receiv influenza vacc .........
Pt w/o influenza vacc .............
Pt inelig for influenza vacc .....
Pt receiv mammogram ...........
Pt not doc mammogram .........
Pt ineligible mammography ....
Care not provided for mamogr
Pt receiv pneumo vacc ...........
Pt did not rec pneumo vacc ...
Pt was inelig for pneumo vac
Pt treat w antidepress 12wks
Pt not treat w/antidepres 12w
Pt inelig for antidepres med ...
Pt treat w/antidepres for 6m ...
Pt not treat w/antidepres 6m ..
Pt inelig for antidepres med ...
Pt w/AB 1 hr prior to incisi .....
Pt not doc for AB 1 hr prior ....
Pt ineligi for AB therapy .........
Pt recd thromboemb
prophylax.
Pt did not rec thromboembo ..
Pt ineligi for thrombolism ........
Pt recd CABG w/ IMA ............
Pt w/CABG w/o IMA ...............
Pt inelig for CABG w/IMA .......
Iso CABG pt rec preop bblock
Iso CABG pt w/o preop
Bblock.
Iso CABG pt inelig for preo ....
Iso CABG pt w/prolng intub ...
Iso CABG pt w/o prolng intub
Iso CABG req surg rexpo .......
Iso CABG w/o surg explo .......
CEA/ext bypass pt on aspirin
Pt w/carot endarct/ext bypas ..
CEA/ext bypass pt not on asp
15:34 Dec 22, 2005
Jkt 208001
PO 00000
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
SI
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
M
M
M
M
M
M
M
M
NI ...................
M
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
NI
NI
NI
NI
NI
NI
NI
...................
...................
...................
...................
...................
...................
...................
M
M
M
M
M
M
M
NI
NI
NI
NI
NI
NI
NI
NI
...................
...................
...................
...................
...................
...................
...................
...................
Payment
rate
M
NI
NI
NI
NI
NI
NI
NI
NI
Relative
weight
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
NI ...................
APC
M
M
M
M
M
M
M
M
Frm 00055
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
National
unadjusted
copayment
76183
Minimum
unadjusted
copayment
76184
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
HCPCS/CPT
Short descriptor
G8182 ...............
G8183 ...............
G8184 ...............
G8185 ...............
G8186 ...............
J0882 ................
J0886 ................
J1675 ................
J7306 ................
J7341 ................
J7620 ................
J7627 ................
J8498 ................
J8515 ................
J8540 ................
L0491 ................
L0492 ................
L0621 ................
L0622 ................
L0623 ................
L0624 ................
L0625 ................
L0626 ................
L0627 ................
L0628 ................
L0629 ................
L0630 ................
L0631 ................
L0632 ................
L0633 ................
L0634 ................
L0635 ................
L0636 ................
L0637 ................
L0638 ................
CAD pt care not prov LDL .....
HF/atrial fib pt on warfarin ......
HF/atrial fib pt inelig warf .......
Osteoarth pt w/ assess pain ..
Osteoarth pt inelig assess ......
Darbepoetin alfa, esrd use .....
Epoetin alfa, esrd ...................
Histrelin acetate ......................
Levonorgestrel implant sys ....
Non-human, metabolic tissue
Albuterol non-compounded ....
Budesonide, compounded ......
Antiemetic rectal/supp NOS ...
Cabergoline, oral 0.25mg .......
Oral dexamethasone ..............
TLSO 2 piece rigid shell .........
TLSO 3 piece rigid shell .........
SIO flex pelvisacral prefab .....
SIO flex pelvisacral custom ....
SIO panel prefab ....................
SIO panel custom ...................
LO flexibl L1-below L5 pre .....
LO sag stays/panels pre-fab ..
LO sagitt rigid panel prefab ....
LO flex w/o rigid stays pre .....
LSO flex w/rigid stays cust .....
LSO post rigid panel pre ........
LSO sag-coro rigid frame pre
LSO sag rigid frame cust .......
LSO flexion control prefab .....
LSO flexion control custom ....
LSO sagit rigid panel prefab ..
LSO sagittal rigid panel cus ...
LSO sag-coronal panel prefab
LSO sag-coronal panel custom.
LSO s/c shell/panel prefab .....
LSO s/c shell/panel custom ...
MRI compatible system ..........
SO cap design w/o jnts CF ....
SO airplane w/o jnts CF .........
SO airplane w/joint CF ...........
EO w/o joints CF ....................
EWHO rigid w/o jnts CF .........
EWHO w/joint(s) CF ...............
EWHFO rigid w/o jnts CF .......
EWHFO w/joint(s) CF .............
WHO w/nontorsion jnt(s) CF ..
HFO w/o joints CF ..................
HO w/o joints CF ....................
HFO w/joint(s) CF ..................
FO w/o joints CF ....................
FO nontorsion joint CF ...........
SEWHO cap design w/o jnts
CF.
SEWHO airplane w/o jnts CF
SEWHO cap design w/jnt(s)
CF.
SEWHO airplane w/jnt(s) CF
SEWHFO cap design w/o jnt
CF.
SEWHFO airplane w/o jnts
CF.
SEWHFO cap desgn w/jnt(s)
CF.
SEWHFO airplane w/jnt(s) CF
Symes ankle w/o (SACH) foot
Stance phase only ..................
SACH foot, replacement ........
Flex/ext wrist w/wo friction .....
UE triple control harness ........
Replc sockt below e/w disa ....
L0639
L0640
L0859
L3671
L3672
L3673
L3702
L3763
L3764
L3765
L3766
L3905
L3913
L3919
L3921
L3933
L3935
L3961
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
................
L3967 ................
L3971 ................
L3973 ................
L3975 ................
L3976 ................
erjones on PROD1PC68 with RULES
L3977 ................
L3978
L5703
L5858
L5971
L6621
L6677
L6883
................
................
................
................
................
................
................
VerDate Aug<31>2005
17:01 Dec 22, 2005
Jkt 208001
CI
PO 00000
SI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
M
M
M
M
M
B
B
B
E
K
B
B
B
E
K
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
A
A
NI ...................
A
NI ...................
A
NI
NI
NI
NI
NI
NI
NI
Payment
rate
A
A
NI ...................
NI ...................
Relative
weight
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
NI ...................
NI ...................
APC
A
A
A
A
A
A
A
...................
...................
...................
...................
...................
...................
...................
Frm 00056
Fmt 4700
National
unadjusted
copayment
Minimum
unadjusted
copayment
1707
0.20
1708
Sfmt 4700
1.01
0.22
0.04
E:\FR\FM\23DER1.SGM
23DER1
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
HCPCS/CPT
Short descriptor
L6884 ................
L6885 ................
L7400 ................
L7401 ................
L7402 ................
L7403 ................
L7404 ................
L7405 ................
L7600 ................
L8623 ................
L8624 ................
L8680 ................
L8681 ................
L8683 ................
L8684 ................
L8685 ................
L8686 ................
L8687 ................
L8688 ................
L8689 ................
Q0510 ...............
Replc sockt above elbow disa
Replc sockt shldr dis/interc ....
Add UE prost be/wd, ultlite ....
Add UE prost a/e ultlite mat ...
Add UE prost s/d ultlite mat ...
Add UE prost b/e acrylic ........
Add UE prost a/e acrylic ........
Add UE prost s/d acrylic ........
Prosthetic donning sleeve ......
Lith ion batt CID, non-earlvl ...
Lith ion batt CID, ear level .....
Implt neurostim elctr each ......
Pt prgrm for implt neurostim ..
Radiofq trsmtr for implt neu ...
Radiof trsmtr implt scrl neu ....
Implt nrostm pls gen sng rec
Implt nrostm pls gen sng non
Implt nrostm pls gen dua rec
Implt nrostm pls gen dua non
External recharging system ....
Dispens fee
immunosupressive.
Sup fee antiem, antica,
immuno.
Px sup fee anti-can sub pres
Disp fee inhal drugs/30 days
Disp fee inhal drugs/90 days
Presbyopia-correct function ....
Q0511 ...............
Q0512 ...............
Q0513 ...............
Q0514 ...............
V2788 ................
CI
D. Corrections to Addendum L
Addendum L represents all hospitals
that are eligible to have their wage index
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
NI
SI
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
...................
Payment
rate
increased by the out-migration
adjustment. In the final rule with
comment period, we inadvertently did
not list all hospitals eligible for the
erjones on PROD1PC68 with RULES
010005
010008
010009
010010
010012
010022
010025
010029
010035
010038
010045
010047
010054
010061
010072
010078
010083
010085
010100
010101
010109
010115
010129
010143
010146
010150
010158
010164
013027
014008
014009
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
........................
*
........................
........................
*
*
*
*
*
........................
*
........................
........................
........................
*
........................
*
........................
*
*
........................
........................
........................
*
........................
*
*
*
........................
........................
........................
0.0259
0.0212
0.0092
0.0259
0.0205
0.0714
0.0235
0.0107
0.0375
0.0062
0.0160
0.0155
0.0092
0.0506
0.0310
0.0062
0.0121
0.0092
0.0121
0.0310
0.0451
0.0093
0.0121
0.0375
0.0062
0.0155
0.0093
0.0310
0.0121
0.0121
0.0092
15:34 Dec 22, 2005
Jkt 208001
PO 00000
Minimum
unadjusted
copayment
M
B
B
E
...................
...................
...................
...................
adjustment. We correct this in this
notice by replacing Addendum L in its
entirety; however we retain the footnote
language as published in the final rule.
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1
Provider no.
National
unadjusted
copayment
B
NI
NI
NI
NI
Relative
weight
A
A
A
A
A
A
A
A
A
A
A
B
A
A
A
B
B
B
B
A
B
NI ...................
APC
76185
Qualifying county name
Marshall.
Crenshaw.
Morgan.
Marshall.
De Kalb.
Cherokee.
Chambers.
Lee.
Cullman.
Calhoun.
Fayette.
Butler.
Morgan.
Jackson.
Talladega.
Calhoun.
Baldwin.
Morgan.
Baldwin.
Talladega.
Pickens.
Franklin.
Baldwin.
Cullman.
Calhoun.
Butler.
Franklin.
Talladega.
Baldwin.
Baldwin.
Morgan.
Frm 00057
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
76186
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
erjones on PROD1PC68 with RULES
Provider no.
040014
040019
010047
010069
010071
040076
040100
042007
050008
050009
050013
050014
050016
050042
050046
050047
050055
050065
050069
050073
050076
050082
050084
050089
050090
050099
050101
050117
050118
050122
050129
050133
050136
050140
050150
050152
050159
050167
050168
050173
050174
050177
050193
050224
050226
050228
050230
050232
050236
050245
050272
050279
050291
050298
050300
050313
050325
050327
050331
050335
050336
050348
050367
050385
050394
050407
050426
050444
050454
050457
050469
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
*
*
*
*
........................
*
*
........................
........................
*
*
*
........................
*
........................
........................
........................
*
*
*
*
........................
........................
*
*
*
........................
........................
*
........................
*
........................
*
*
*
........................
........................
........................
*
*
*
........................
*
*
*
*
*
........................
........................
*
*
*
*
*
*
........................
........................
*
*
........................
........................
*
........................
*
........................
........................
*
........................
........................
........................
*
0.0159
0.0697
0.0090
0.0140
0.0026
0.1075
0.0159
0.0026
0.0026
0.0478
0.0478
0.0131
0.0103
0.0219
0.0156
0.0026
0.0026
0.0029
0.0029
0.0269
0.0026
0.0156
0.0555
0.0152
0.0308
0.0152
0.0269
0.0463
0.0555
0.0555
0.0152
0.0170
0.0308
0.0152
0.0316
0.0026
0.0156
0.0555
0.0029
0.0029
0.0308
0.0156
0.0029
0.0029
0.0029
0.0026
0.0029
0.0103
0.0156
0.0152
0.0152
0.0152
0.0308
0.0152
0.0152
0.0555
0.0176
0.0152
0.0308
0.0176
0.0555
0.0029
0.0269
0.0308
0.0156
0.0026
0.0029
0.0463
0.0026
0.0026
0.0152
15:34 Dec 22, 2005
Jkt 208001
PO 00000
Qualifying county name
White.
St. Francis.
Randolph.
Mississippi.
Jefferson.
Hot Spring.
White.
Jefferson.
San Francisco
NAPA.
NAPA.
Amador.
San Luis Obispo.
Tehama.
Ventura.
San Francisco.
San Francisco.
Orange.
Orange.
Solano.
San Francisco.
Ventura.
San Joaquin.
San Bernardino.
Sonoma.
San Bernardino.
Solano.
Merced.
San Joaquin.
San Joaquin.
San Bernardino.
Yuba.
Sonoma.
San Bernardino.
Nevada
San Francisco.
Ventura.
San Joaquin.
Orange.
Orange.
Sonoma.
Ventura.
Orange.
Orange.
Orange.
San Francisco.
Orange.
San Luis Obispo.
Ventura.
San Bernardino.
San Bernardino.
San Bernardino.
Sonoma.
San Bernardino.
San Bernardino.
San Joaquin.
Tuolumne.
San Bernardino.
Sonoma.
Tuolumne.
San Joaquin.
Orange.
Solano.
Sonoma.
Ventura.
San Francisco.
Orange.
Merced.
San Francisco.
San Francisco.
San Bernardino.
Frm 00058
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
erjones on PROD1PC68 with RULES
Provider no.
050476
050494
050506
050517
050526
050528
050535
050539
050543
050547
050548
050549
050550
050551
050567
050568
050570
050580
050584
050585
050586
050589
050592
050594
050603
050609
050616
050618
050633
050667
050668
050678
050680
050690
050693
050695
050720
050728
050731
052035
052037
052039
052040
053034
053037
053304
053306
053308
054020
054074
054077
054089
054093
054106
054111
054122
054123
054135
054141
054144
060001
060003
060027
060103
064007
070003
070006
070010
070018
070020
070021
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
........................
*
........................
........................
*
*
*
........................
*
*
*
*
*
*
*
........................
*
*
*
*
*
*
*
*
*
*
........................
*
........................
*
*
*
........................
*
*
........................
*
*
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
*
*
*
*
........................
*
*
*
*
........................
*
0.0257
0.0316
0.0103
0.0152
0.0029
0.0463
0.0029
0.0257
0.0029
0.0308
0.0029
0.0156
0.0029
0.0029
0.0029
0.0062
0.0029
0.0029
0.0152
0.0029
0.0152
0.0029
0.0029
0.0029
0.0029
0.0029
0.0156
0.0152
0.0103
0.0478
0.0026
0.0029
0.0269
0.0308
0.0029
0.0555
0.0029
0.0308
0.0152
0.0029
0.0152
0.0029
0.0152
0.0029
0.0152
0.0029
0.0029
0.0029
0.0026
0.0269
0.0156
0.0026
0.0152
0.0156
0.0152
0.0478
0.0555
0.0029
0.0269
0.0026
0.0294
0.0203
0.0203
0.0203
0.0203
0.0009
0.0047
0.0047
0.0047
0.0073
0.0009
15:34 Dec 22, 2005
Jkt 208001
PO 00000
Qualifying county name
Lake.
Nevada.
San Luis Obispo.
San Bernardino.
Orange.
Merced.
Orange.
Lake.
Orange.
Sonoma.
Orange.
Ventura.
Orange.
Orange.
Orange.
Madera.
Orange.
Orange.
San Bernardino.
Orange.
San Bernardino.
Orange.
Orange.
Orange.
Orange.
Orange.
Ventura.
San Bernardino.
San Luis Obispo.
Napa.
San Francisco.
Orange.
Solano.
Sonoma.
Orange.
San Joaquin.
Orange.
Sonoma.
San Bernardino.
Orange.
San Bernardino.
Orange.
San Bernardino.
Orange.
San Bernardino.
Orange.
Orange.
Orange.
San Francisco.
Solano.
Ventura.
San Francisco.
San Bernardino.
Ventura.
San Bernardino.
Napa.
San Joaquin.
Orange.
Solano.
San Francisco.
Weld.
Boulder.
Boulder.
Boulder.
Boulder.
Windham.
Fairfield.
Fairfield.
Fairfield.
Middlesex.
Windham.
Frm 00059
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
76187
76188
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
erjones on PROD1PC68 with RULES
Provider no.
070028
070033
070034
073026
074000
074003
074008
074012
074014
080001
080003
082000
083300
084001
084002
084003
100014
100017
100045
100047
100062
100068
100072
100077
100102
100118
100156
100175
100212
100232
100236
100252
100290
110023
110027
110029
110041
110069
110124
110136
110150
110153
110187
110189
110190
110205
114018
130003
130024
130049
130066
140012
140026
140033
140043
140058
140084
140100
140110
140130
140155
140160
140161
140186
140202
140205
140234
140291
150022
150030
150035
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
*
*
*
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
*
........................
........................
........................
........................
........................
........................
*
........................
........................
........................
........................
........................
*
........................
*
........................
*
*
*
........................
........................
*
*
*
*
........................
*
........................
*
........................
*
........................
*
........................
........................
*
*
........................
........................
*
........................
........................
*
*
........................
........................
........................
*
*
........................
*
........................
0.0047
0.0047
0.0047
0.0009
0.0047
0.0073
0.0009
0.0047
0.0047
0.0063
0.0063
0.0063
0.0063
0.0063
0.0063
0.0063
0.0118
0.0118
0.0118
0.0021
0.0060
0.0118
0.0118
0.0021
0.0125
0.0398
0.0125
0.0231
0.0060
0.0347
0.0021
0.0233
0.0582
0.0500
0.0387
0.0063
0.0777
0.0474
0.0428
0.0261
0.0261
0.0474
0.1172
0.0031
0.0182
0.0779
0.0261
0.0095
0.0275
0.0349
0.0349
0.0220
0.0346
0.0147
0.0046
0.0081
0.0147
0.0147
0.0346
0.0147
0.0027
0.0286
0.0138
0.0027
0.0147
0.0163
0.0346
0.0147
0.0249
0.0201
0.0083
15:34 Dec 22, 2005
Jkt 208001
PO 00000
Qualifying county name
Fairfield.
Fairfield.
Fairfield.
Windham.
Fairfield.
Middlesex.
Windham.
Fairfield.
Fairfield.
New Castle.
New Castle.
New Castle.
New Castle.
New Castle.
New Castle.
New Castle.
Volusia.
Volusia.
Volusia.
Charlotte.
Marion.
Volusia.
Volusia.
Charlotte.
Columbia.
Flagler.
Columbia.
De Soto.
Marion.
Putnam.
Charlotte.
Okeechobee.
Sumter.
Gordon.
Franklin.
Hall.
Habersham.
Houston.
Wayne.
Baldwin.
Baldwin.
Houston.
Lumpkin.
Fannin.
Macon.
Gilmer.
Baldwin.
Nez Perce.
Bonner.
Kootenai.
Kootenai.
Lee.
La Salle.
Lake.
Whiteside.
Morgan.
Lake.
Lake.
La Salle.
Lake.
Kankakee.
Stephenson.
Livingston.
Kankakee.
Lake.
Boone.
La Salle.
Lake.
Montgomery.
Henry.
Porter.
Frm 00060
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
erjones on PROD1PC68 with RULES
Provider no.
150045
150060
150062
150065
150076
150088
150091
150102
150113
150122
154047
154050
160013
160026
160030
160032
160080
170137
180012
180066
180127
180128
183028
184012
190001
190003
190010
190015
190017
190054
190078
190088
190099
190106
190133
190144
190184
190190
190191
190246
192034
192036
192040
192046
193044
193055
193063
193068
193073
193091
194047
200002
200013
200024
200032
200034
200050
210001
210004
210016
210018
210022
210023
210043
210048
210057
212002
213029
214001
214003
214013
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
........................
........................
........................
*
*
*
........................
*
*
........................
........................
........................
........................
*
........................
........................
*
*
*
*
*
........................
........................
........................
*
*
........................
*
........................
........................
........................
........................
*
*
........................
........................
........................
........................
*
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
*
........................
*
........................
*
*
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
0.0416
0.0051
0.0153
0.0139
0.0189
0.0196
0.0573
0.0160
0.0196
0.0199
0.0189
0.0416
0.0218
0.0496
0.0040
0.0272
0.0049
0.0336
0.0083
0.0567
0.0352
0.0282
0.0083
0.0083
0.0645
0.0107
0.0401
0.0401
0.0235
0.0107
0.0235
0.0705
0.0390
0.0238
0.0238
0.0705
0.0161
0.0161
0.0235
0.0161
0.0235
0.0401
0.0401
0.0645
0.0401
0.0161
0.0401
0.0401
0.0235
0.0107
0.0705
0.0129
0.0186
0.0071
0.0466
0.0071
0.0140
0.0129
0.0040
0.0040
0.0040
0.0040
0.0209
0.0209
0.0287
0.0040
0.0129
0.0040
0.0209
0.0129
0.0040
17:01 Dec 22, 2005
Jkt 208001
PO 00000
Qualifying county name
De Kalb.
Vermillion.
Decatur.
Jackson.
Marshall.
Madison.
Huntington.
Starke.
Madison.
Ripley.
Marshall.
De Kalb.
Muscatine.
Boone.
Story.
Jasper.
Clinton.
Douglas.
Hardin.
Logan.
Franklin.
Lawrence.
Hardin.
Hardin.
Washington.
Iberia.
Tangipahoa.
Tangipahoa.
St. Landry.
Iberia.
St. Landry.
Webster.
Avoyelles.
Allen.
Allen.
Webster.
Caldwell.
Caldwell.
St. Landry.
Caldwell.
St. Landry.
Tangipahoa.
Tangipahoa.
Washington.
Tangipahoa.
Caldwell.
Tngipahoa.
Tangipahoa.
St. Landry.
Iberia.
Webster.
Lincoln.
Waldo.
Androscoggin.
Oxford.
Androscoggin.
Hancock.
Washington.
Montgomery.
Montgomery.
Montgomery.
Montgomery.
Ann Arundel.
Ann Arundel.
Howard.
Montgomery.
Washington.
Montgomery.
Ann Arundel.
Washington.
Montgomery.
Frm 00061
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
76189
76190
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
erjones on PROD1PC68 with RULES
Provider no.
220001
220002
220003
220006
220010
220011
220019
220025
220028
220029
220033
220035
220049
220058
220062
220063
220070
220080
220082
220084
220089
220090
220095
220098
220101
220105
220163
220171
220174
222000
222003
222026
222044
222047
222048
223026
223028
223029
223033
224007
224002
224026
224032
224033
224038
230003
230013
230015
230019
230021
230022
230029
230037
230041
230042
230047
230069
230071
230072
230075
230078
230092
230093
230096
230099
230106
230121
230130
230151
230174
230184
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
*
........................
*
........................
*
........................
*
*
*
*
*
*
........................
*
*
........................
........................
*
........................
........................
........................
*
*
........................
........................
........................
*
........................
*
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
*
*
........................
*
........................
*
*
*
........................
*
*
*
*
*
........................
*
........................
*
*
*
*
*
*
*
*
........................
0.0056
0.0249
0.0056
0.0306
0.0306
0.0249
0.0056
0.0056
0.0056
0.0306
0.0306
0.0306
0.0249
0.0056
0.0056
0.0249
0.0249
0.0306
0.0249
0.0249
0.0249
0.0056
0.0056
0.0249
0.0249
0.0249
0.0056
0.0240
0.0306
0.0249
0.0249
0.0306
0.0306
0.0306
0.0056
0.0249
0.0306
0.0056
0.0056
0.0249
0.0249
0.0056
0.0056
0.0306
0.0249
0.0035
0.0091
0.0359
0.0091
0.0136
0.0113
0.0091
0.0178
0.0099
0.0685
0.0082
0.0487
0.0091
0.0035
0.0145
0.0136
0.0389
0.0079
0.0359
0.0339
0.0030
0.0691
0.0091
0.0091
0.0035
0.0389
15:34 Dec 22, 2005
Jkt 208001
PO 00000
Qualifying county name
Worcester.
Middlesex.
Worcester.
Essex.
Essex.
Middlesex.
Worcester.
Worcester.
Worcester.
Essex.
Essex.
Essex.
Middlesex.
Worcester.
Worcester.
Middlesex.
Middlesex.
Essex.
Middlesex.
Middlesex.
Middlesex.
Worcester.
Worcester.
Middlesex.
Middlesex.
Middlesex.
Worcester.
Middlesex.
Essex.
Middlesex.
Middlesex.
Essex.
Essex.
Essex.
Worcester.
Middlesex.
Essex.
Worcester.
Worcester.
Middlesex.
Middlesex.
Worcester.
Worcester.
Essex.
Middlesex.
Ottawa.
Oakland.
St. Joseph.
Oakland.
Berrien.
Branch.
Oakland.
Hillsdale.
Bay.
Allegan.
MACOMB.
Livingston.
Oakland.
Ottawa.
Calhoun.
Berrien.
Jackson.
Mecosta.
St. Joseph.
Monroe.
Newaygo.
Shiawassee.
Oakland.
Oakland.
Ottawa.
Jackson.
Frm 00062
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
erjones on PROD1PC68 with RULES
Provider no.
230195
230204
230207
230217
230222
230223
230227
230254
230257
230264
230269
230277
230279
232020
232023
232025
232028
232034
232036
233025
233028
233031
234011
234021
234023
234024
234037
240013
240018
240021
240044
240064
240069
240071
240152
240154
240187
240211
250040
250045
254009
260011
260025
260047
260074
260097
260127
280054
280077
280123
290019
290049
293029
300011
300012
300017
300020
300023
300029
300034
303026
304001
310002
310009
310010
310011
310013
310018
310021
310038
310039
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
*
*
*
*
........................
*
*
*
*
*
*
*
*
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
*
*
........................
........................
*
*
*
*
........................
*
*
*
........................
........................
........................
*
*
*
........................
........................
........................
*
........................
*
........................
........................
*
*
........................
*
........................
........................
*
........................
........................
*
*
........................
........................
*
*
*
*
........................
0.0082
0.0082
0.0091
0.0145
0.0228
0.0091
0.0082
0.0091
0.0082
0.0082
0.0091
0.0091
0.0487
0.0099
0.0082
0.0136
0.0145
0.0685
0.0389
0.0145
0.0091
0.0082
0.0091
0.0082
0.0091
0.0082
0.0145
0.0226
0.1196
0.0920
0.0868
0.0138
0.0419
0.0454
0.0735
0.0138
0.0506
0.0705
0.0294
0.0042
0.0294
0.0007
0.0078
0.0007
0.0158
0.0425
0.0158
0.0137
0.0089
0.0137
0.0026
0.0026
0.0026
0.0069
0.0069
0.0361
0.0069
0.0361
0.0361
0.0069
0.0361
0.0361
0.0351
0.0351
0.0092
0.0115
0.0351
0.0351
0.0092
0.0350
0.0350
15:34 Dec 22, 2005
Jkt 208001
PO 00000
Qualifying county name
Macomb.
Macomb.
Oakland.
Calhoun.
Midland.
Oakland.
Macomb.
Oakland.
Macomb.
Macomb.
Oakland.
Oakland.
Livingston.
Bay.
Macomb.
Berrien.
Calhoun.
Allegan.
Jackson.
Calhoun.
Oakland.
Macomb.
Oakland.
Macomb.
Oakland.
Macomb.
Calhoun.
Morrison.
Goodhue.
Le Sueur.
Winona.
Itasca.
Steele.
Rice.
Kanabec.
Itasca.
Mc Leod.
Pine.
Jackson.
Hancock.
Jackson.
Cole.
Marion.
Cole.
Randolph.
Johnson.
Pike.
Gage.
Dodge.
Gage.
Carson City.
Carson City.
Carson City.
Hillsborough.
Hillsborough.
Rockingham.
Hillsborough.
Rockingham.
Rockingham.
Hillsborough.
Rockingham.
Rockingham.
Essex.
Essex.
Mercer.
Cape May.
Essex.
Essex.
Mercer.
Middlesex.
Middlesex.
Frm 00063
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
76191
76192
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
erjones on PROD1PC68 with RULES
Provider no.
310044
310054
310070
310076
310078
310083
310092
310093
310096
310108
310110
310119
310123
310124
312018
313025
313027
314010
314011
314013
314020
314025
320003
320011
320018
320085
322001
323025
323032
324007
324009
324010
324011
324012
330004
330008
330027
330094
330106
330126
330135
330167
330181
330182
330191
330198
330205
330209
330224
330225
330235
330259
330264
330276
330331
330332
330372
330386
334017
334061
340015
340020
340021
340037
340039
340069
340070
340073
340085
340096
340104
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
........................
*
*
*
*
*
........................
*
*
........................
........................
*
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
*
*
*
*
*
*
*
........................
*
*
*
........................
*
*
........................
........................
*
........................
*
........................
........................
........................
........................
*
........................
........................
........................
........................
*
........................
*
*
........................
*
........................
........................
........................
0.0092
0.0351
0.0350
0.0351
0.0351
0.0351
0.0092
0.0351
0.0351
0.0350
0.0092
0.0351
0.0351
0.0350
0.0350
0.0351
0.0092
0.0351
0.0350
0.0092
0.0351
0.0092
0.0629
0.0442
0.0063
0.0063
0.0629
0.0629
0.0063
0.0063
0.0063
0.0063
0.0442
0.0063
0.0959
0.0470
0.0137
0.0778
0.0137
0.0560
0.0560
0.0137
0.0137
0.0137
0.0026
0.0137
0.0560
0.0560
0.0959
0.0137
0.0270
0.0137
0.0560
0.0063
0.0137
0.0137
0.0137
0.1139
0.0560
0.0560
0.0267
0.0207
0.0216
0.0216
0.0144
0.0053
0.0448
0.0053
0.0377
0.0377
0.0216
15:34 Dec 22, 2005
Jkt 208001
PO 00000
Qualifying county name
Mercer.
Essex.
Middlesex.
Essex.
Essex.
Essex.
Mercer.
Essex.
Essex.
Middlesex.
Mercer.
Essex.
Essex.
Middlesex.
Middlesex.
Essex.
Mercer.
Essex.
Middlesex.
Mercer.
Essex.
Mercer.
San Miguel.
Rio Arriba.
Dona Ana.
Dona Ana.
San Miguel.
San Miguel.
Dona Ana.
Dona Ana.
Dona Ana.
Dona Ana.
Rio Arriba.
Dona Ana.
Ulster.
Wyoming.
Nassau.
Columbia.
Nassau.
Orange.
Orange.
Nassau.
Nassau.
Nassau.
Warren.
Nassau.
Orange.
Orange.
Ulster.
Nassau.
Cayuga.
Nassau.
Orange.
Fulton.
Nassau.
Nassau.
Nassau.
Sullivan.
Orange.
Orange.
Rowan.
Lee.
Cleveland.
Cleveland.
Iredell.
Wake.
Alamance.
Wake.
Davidson.
Davidson.
Cleveland.
Frm 00064
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
erjones on PROD1PC68 with RULES
Provider no.
340114
340126
340127
340129
340133
340138
340144
340145
340173
344001
344004
344011
344014
360013
360025
360036
360065
360070
360078
360084
360086
360095
360100
360107
360131
360151
360156
360175
360187
360197
360267
362007
362032
364031
364040
370004
370014
370015
370023
370065
370113
370149
370179
374017
380002
380008
380022
380029
380051
380056
384008
390011
390044
390046
390056
390065
390066
390096
390101
390110
390130
390138
390146
390150
390151
390162
390201
390233
392031
392034
393026
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
*
*
*
*
........................
*
*
*
*
........................
........................
........................
........................
*
*
*
*
........................
*
........................
*
*
........................
*
........................
........................
........................
*
*
*
........................
........................
........................
........................
........................
*
*
*
........................
........................
*
........................
*
........................
........................
*
........................
........................
........................
........................
........................
........................
........................
........................
........................
*
*
........................
........................
*
........................
*
........................
*
*
........................
........................
........................
........................
........................
........................
0.0053
0.0161
0.0961
0.0144
0.0308
0.0053
0.0144
0.0563
0.0053
0.0053
0.0961
0.0053
0.0053
0.0166
0.0087
0.0263
0.0141
0.0028
0.0159
0.0028
0.0168
0.0087
0.0028
0.0213
0.0028
0.0028
0.0213
0.0159
0.0168
0.0092
0.0028
0.0213
0.0028
0.0028
0.0168
0.0193
0.0831
0.0463
0.0084
0.0121
0.0205
0.0356
0.0314
0.0193
0.0130
0.0201
0.0201
0.0075
0.0075
0.0075
0.0075
0.0012
0.0200
0.0098
0.0042
0.0501
0.0259
0.0200
0.0098
0.0012
0.0012
0.0325
0.0053
0.0206
0.0325
0.0200
0.1127
0.0098
0.0102
0.0200
0.0200
15:34 Dec 22, 2005
Jkt 208001
PO 00000
Qualifying county name
Wake.
Wilson.
Granville.
Iredell.
Martin.
Wake.
Iredell.
Lincoln.
Wake.
Wake.
Granville.
Wake.
Wake.
Shelby.
Erie.
Wayne.
Huron.
Stark.
Portage.
Stark.
Clark.
Hancock.
Stark.
Sandusky.
Stark.
Stark.
Sandusky.
Clinton.
Clark.
Logan.
Stark.
Sandusky.
Stark.
Stark.
Clark.
Ottawa.
Bryan.
Mayes.
Stephens.
Craig.
Delaware.
Pottawatomie.
Okfuskee.
Ottawa.
Josephine.
Linn.
Linn.
Marion.
Marion.
Marion.
Marion.
Cambria.
Berks.
York.
Huntingdon.
Adams.
Lebanon.
Berks.
York.
Cambria.
Cambria.
Franklin.
Warren.
Greene.
Franklin.
Northampton.
Monroe.
York.
Cambria.
Northampton.
Berks.
Frm 00065
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
76193
76194
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
erjones on PROD1PC68 with RULES
Provider no.
393037
394014
394016
394020
420007
420020
420027
420030
420039
420043
420068
420070
420083
420093
420098
423029
424011
440008
440024
440030
440035
440047
440056
440060
420063
440067
440073
440105
440114
440115
440148
440153
440174
440181
440184
440185
444006
444008
450032
450039
450050
450059
450064
450087
450099
450121
450135
450137
450144
450163
450187
450194
450214
450224
450347
450362
450370
450389
450395
450419
450438
450447
450451
450465
450547
450563
450565
450596
450597
450623
450626
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
........................
........................
........................
........................
........................
*
........................
*
*
........................
*
*
........................
........................
........................
........................
........................
*
........................
........................
*
........................
........................
*
........................
*
*
........................
........................
........................
*
........................
........................
........................
........................
*
........................
........................
*
*
........................
*
*
*
*
*
*
*
*
........................
*
*
*
*
*
........................
........................
*
........................
*
*
*
*
........................
*
*
........................
........................
........................
*
........................
0.0098
0.0200
0.0053
0.0259
0.0001
0.0035
0.0210
0.0103
0.0153
0.0177
0.0097
0.0101
0.0001
0.0001
0.0035
0.0210
0.0210
0.0663
0.0387
0.0056
0.0441
0.0499
0.0321
0.0499
0.0011
0.0056
0.0513
0.0011
0.0523
0.0499
0.0568
0.0007
0.0372
0.0407
0.0011
0.0387
0.0011
0.0407
0.0416
0.0097
0.0750
0.0073
0.0097
0.0097
0.0180
0.0097
0.0097
0.0097
0.0573
0.0134
0.0264
0.0328
0.0368
0.0411
0.0427
0.0486
0.0258
0.0881
0.0484
0.0097
0.0258
0.0358
0.0551
0.0435
0.0411
0.0097
0.0486
0.0808
0.0077
0.0492
0.0294
15:34 Dec 22, 2005
Jkt 208001
PO 00000
Qualifying county name
York.
Berks.
Warren.
Lebanon.
Spartanburg.
Georgetown.
Anderson.
Colleton.
Union.
Cherokee.
Orangeburg.
Sumter.
Spartanburg.
Spartanburg.
Georgetown.
Anderson.
Anderson.
Henderson.
Bradley.
Hamblen.
Montgomery.
Gibson.
Jefferson.
Gibson.
Washington.
Hamblen.
Maury.
Washington.
Lauderdale.
Gibson.
De Kalb.
Cocke.
Haywood.
Hardeman.
Washington.
Bradley.
Washington.
Hardeman.
Harrison.
Tarrant.
Ward.
Comal.
Tarrant.
Tarrant.
Gray.
Tarrant.
Tarrant.
Tarrant.
Andrews.
Kleberg.
Washington.
Cherokee.
Wharton.
Wood.
Walker.
Burnet.
Colorado.
Henderson.
Polk.
Tarrant.
Colorado.
Navarro.
Somervell.
Matagorda.
WOOD.
Tarrant.
Palo Pinto.
Hood.
De Witt.
Fannin.
Jackson.
Frm 00066
Fmt 4700
Sfmt 4700
E:\FR\FM\23DER1.SGM
23DER1
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
erjones on PROD1PC68 with RULES
Provider no.
450639
450672
450675
450677
450694
450747
450755
450763
450779
450813
450858
450872
450880
452018
452019
452028
452088
453040
453041
453042
453089
453300
453303
454009
454012
454019
454051
454052
454061
454086
460017
460036
460039
470018
490019
490038
490047
490084
490105
490110
494029
500003
500007
500019
500021
500024
500039
500041
500079
500108
500122
500129
500139
500143
503301
504003
504010
510018
510028
510039
510047
510050
510077
513025
520028
520035
520044
520057
520059
520071
520095
VerDate Aug<31>2005
Redesignation
indicator
Out-migration
adjustment
*
*
*
*
*
*
*
........................
*
........................
*
*
*
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
........................
*
*
........................
........................
........................
*
........................
*
........................
........................
*
........................
........................
........................
........................
*
*
........................
........................
*
........................
........................
........................
........................
........................
........................
*
*
........................
*
........................
*
........................
*
........................
........................
........................
*
*
*
0.0097
0.0097
0.0097
0.0097
0.0368
0.0195
0.0484
0.0236
0.0097
0.0195
0.0097
0.0097
0.0097
0.0097
0.0097
0.0097
0.0097
0.0097
0.0097
0.0097
0.0195
0.0097
0.0097
0.0328
0.0097
0.0097
0.0097
0.0097
0.0097
0.0097
0.0392
0.0700
0.0392
0.0287
0.1240
0.0022
0.0198
0.0167
0.0022
0.0082
0.0022
0.0208
0.0208
0.0213
0.0055
0.0023
0.0174
0.0118
0.0055
0.0055
0.0459
0.0055
0.0023
0.0023
0.0055
0.0055
0.0055
0.0209
0.0141
0.0112
0.0275
0.0112
0.0021
0.0112
0.0157
0.0077
0.0077
0.0118
0.0200
0.0239
0.0118
15:34 Dec 22, 2005
Jkt 208001
PO 00000
Qualifying county name
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Wharton.
Anderson.
Hockley.
Hutchinson.
Tarrant.
Anderson.
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Anderson.
Tarrant.
Tarrant.
Cherokee.
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Tarrant.
Box Elder.
Wasatch.
Box Elder.
Windsor
Culpeper.
Smyth.
Page.
Essex.
Smyth.
Montgomery.
Smyth.
Skagit.
Skagit.
Lewis.
Pierce.
Thurston.
Kitsap.
Cowlitz.
Pierce.
Pierce.
Island.
Pierce.
Thurston.
Thurston.
Pierece.
Pierce.
Pierce.
Jackson.
Fayette.
Ohio.
Marion.
Ohio.
Mingo.
Ohio.
Green.
Sheboygan.
SHeboygan.
Sauk.
Racine.
Jefferson.
Sauk.
Frm 00067
Fmt 4700
Sfmt 4700
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23DER1
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Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Rules and Regulations
ADDENDUM L.—OUT-MIGRATION WAGE ADJUSTMENT CY 2006 1—Continued
Redesignation
indicator
520096
520102
520116
520132
522005
523026
524020
524021
Out-migration
adjustment
*
*
*
........................
........................
........................
........................
........................
Provider no.
0.0200
0.0298
0.0239
0.0077
0.0200
0.0200
0.0118
0.0298
Qualifying county name
Racine.
Walworth.
Jefferson.
Sheboygan.
Racine.
Racine.
Sauk.
Walworth.
* Hospitals that have been reclassified under section 1886(d)(10) of the Act, reclassified under section 508 Pub. L. 108–173, or redesignated
under section 1886(d)(8) of the Act.
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare—Hospital
Insurance; and Program No. 93.774,
Medicare—Supplementary Medical
Insurance Program)
Dated: December 20, 2005.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. 05–24447 Filed 12–22–05; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Part 422
[CMS–4069–F4]
RIN 0938–AN06
Medicare Program; Establishment of
the Medicare Advantage Program
erjones on PROD1PC68 with RULES
SUMMARY: This document corrects
technical errors that appeared in the
final rule published in the Federal
Register on January 28, 2005 entitled
‘‘Establishment of the Medicare
Advantage Program.’’
DATES: Except amendments to
§§ 422.316 and 422.503, this final rule is
effective March 22, 2005. Section
422.316(a), which was stayed from
September 1, 2005, until January 1,
2006, by FR Doc. 05–17280 published
on September 1, 2005 (70 FR 52023), is
effective January 1, 2006. Section
422.503(b)(4)(ii) is effective December
23, 2005.
FOR FURTHER INFORMATION CONTACT:
Christopher McClintick, (410) 786–
4682.
VerDate Aug<31>2005
15:34 Dec 22, 2005
Jkt 208001
In FR Doc. 05–1322 of January 28,
2005 (70 FR 4588), there were several
errors that we identified and corrected
in a correcting amendment published
September 1, 2005 (FR Doc. 05–17285,
70 FR 52023). Based on further review
of the January 28, 2005, final rule, we
are making additional typographical and
conforming changes. We identify these
changes in the ‘‘Summary of Errors’’
section and correct these errors in the
‘‘Correction of Errors’’ section below.
The provisions in this correcting
amendment are effective as if they were
included in the final rule published on
January 28, 2005. Accordingly, with the
exception of the revisions to
§ 422.316(a), which are stayed until
January 1, 2006, and § 422.503(b)(4)(ii),
which are effective December 23, 2005,
the corrections are effective retroactive
to March 22, 2005, the effective date of
most of the provisions of the January 28,
2005 final rule.
II. Summary of Errors
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final rule; correcting
amendment.
AGENCY:
SUPPLEMENTARY INFORMATION:
I. Background
The errors we are correcting in this
correcting amendment pertain to the
regulations text only. The changes
follow the sequence of the CFR sections
affected.
In § 422.2 of the final rule, in the
definition of ‘‘Provider network,’’ we
inadvertently did not include a
reference to a ‘‘network Private Fee-forService (PFFS) plan,’’ a new option
made possible by the Medicare
Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA).
In § 422.101, in paragraph (b)(4), we
inadvertently referenced paragraph
(b)(3) when specifying an exception to
the requirements concerning the review
of uniform local coverage policies,
instead of (b)(3)(ii), the paragraph upon
which the exception is based.
In § 422.112, we are revising
paragraph (c)(5), which specifies the
requirements for designation as an
essential hospital, to clarify that the
requirement applies to hospitals that are
PO 00000
Frm 00068
Fmt 4700
Sfmt 4700
already designated as an essential
hospital.
In § 422.216, we are revising
paragraphs (b)(1)(i) and (b)(1)(iii) to
conform to the changes we made in
§ 422.114(c) as a result of the changes to
section 1852(j) of the Social Security
Act (the Act), which explicitly allows
PFFS plans to charge differential cost
sharing in certain instances.
Also, in § 422.216, which concerns
provider credentialing requirements, in
paragraph (i) we are correcting
typographical errors that resulted in the
reference to two non-existent
regulations text sections.
In § 422.256, we are revising
paragraph (b)(3) to remove a confusing
and inadvertent reference to Medicare
Savings Account (MSA) plans.
In § 422.316, we are revising
paragraph (a) to more clearly indicate
that, consistent with section
1833(a)(3)(B) of the Act, the
supplemental payment CMS will make
directly to the Federally Qualified
Health Center (FQHC) is net of what the
FQHC may charge as cost sharing under
its contract with the Medicare
Advantage (MA) organization, not the
cost sharing amounts that the FQHC
actually collects.
In § 422.503, we are revising
paragraph (b)(4)(ii) to revert to a
paragraph concerning the administrative
and management arrangements
necessary to qualify as an MA
organization that was inadvertently
replaced in the final rule. We are
making one technical change to the
provision, to refer to ‘‘quality
improvement’’ instead of ‘‘quality
assurance,’’ to conform to the change in
terminology implemented as part of the
MMA.
III. Waiver of Proposed Rulemaking
We ordinarily publish a notice of
proposed rulemaking in the Federal
Register to provide a period for public
comment before the provisions of a rule
take effect in accordance with section
553(b) of the Administrative Procedure
E:\FR\FM\23DER1.SGM
23DER1
]]>Agencies
[Federal Register Volume 70, Number 246 (Friday, December 23, 2005)]
[Rules and Regulations]
[Pages 76176-76196]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-24447]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 419 and 485
[CMS-1501-CN2]
RIN 0938-AN46
Medicare Program; Changes to the Hospital Outpatient Prospective
Payment System and Calendar Year 2006 Payment Rates; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Correction of final rule with comment period.
-----------------------------------------------------------------------
SUMMARY: This document corrects technical errors that appeared in the
final rule with comment period published in the Federal Register on
November 10, 2005 entitled ``Changes to the Hospital Outpatient
Prospective Payment System and Calendar Year 2006 Payment Rates; Final
Rule.''
EFFECTIVE DATE: January 1, 2006.
FOR FURTHER INFORMATION CONTACT: Rebecca Kane, (410) 786-0378.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 05-22136 (70 FR 68515), we have identified a number of
technical errors that we have described in the ``Summary of Errors''
section and corrected in the ``Correction of Errors'' section below.
The provisions in this correction notice are effective as if they had
been included in the CY 2006 final rule with comment period.
Accordingly, the corrections are effective January 1, 2006.
II. Summary of Errors
On November 10, 2005, we published the CY 2006 Hospital Outpatient
Prospective Payment System (OPPS) final rule with comment period.
Included in that document were several
[[Page 76177]]
technical and typographical errors that we are correcting in section
III of this notice.
A. Correction of Technical Errors
We are correcting the following technical errors that were included
in the CY 2006 OPPS final rule with comment period affecting drug
administration code C8596, estimated expenditures, regulation text,
hospital coding for sodium hyaluronate products, and Addendum L.
On page 68680, we neglected to remove the first row, referencing
HCPCS code C8956, from Table 31 and the accompanying discussion
regarding C8956 from the response to the comment included in the third
column, third paragraph. We are correcting these errors in this notice.
On page 68726, we referred to the transfer from the Federal
government to Medicare providers in billions rather than millions in
the accounting table. We are correcting the error in this notice.
On page 68728, we omitted a reference to pass-through devices in
the regulation text as stated in the preamble text at 68559. We correct
this omission in this notice.
On page 68643 and in Addendum B we erroneously referred to the
creation of a code by the National HCPCS Panel, specifically the
creation of HCPCS code J7318. This was incorrect as this code was not
created by the National HCPCS Panel. Our error was discovered after
publication, and we are taking this opportunity to revise Addendum B to
reflect the CY 2006 payment for Sodium Hyaluronate products using HCPCS
codes J7317 and J7320, as originally included in the CY 2006 OPPS
proposed rule.
On pages 68752-68913 we published Addendum B--Payment Status by
HCPCS Code and Related Information--CY 2006. We excluded several codes
from this table. In section III of this correction notice we correct
this error by publishing the omitted codes.
On pages 68964 through 68980, we published Addendum L--Out-
Migration Wage Adjustment CY 2006. We excluded several providers from
this table. In Section III of this correction notice, we republish
Addendum L.
B. Other Corrections
We are also correcting typographical, formatting, and other
technical errors that were contained in the CY 2006 OPPS final rule
with comment period.
III. Waiver of Proposed Rulemaking and Delay in Effective Date
We ordinarily publish a notice of proposed rulemaking in the
Federal Register to provide a period for public comment before the
provisions of a notice such as this takes effect in accordance with
section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C.
553(b)). We also ordinarily provide a 30-day delay in the effective
date of the provisions of a notice in accordance with section 553(d) of
the APA (5 U.S.C. 553(d)). However, we can waive both the notice and
comment procedure and the 30-day delay in effective date if the
Secretary finds, for good cause, that it is impracticable, unnecessary
or contrary to the public interest, and incorporates a statement of the
finding and the reasons therefore in the notice.
The policies and payment methodology finalized in the CY 2006 OPPS
final rule with comment period have previously been subjected to notice
and comment procedures. This correction notice merely provides
technical corrections to the CY 2006 OPPS final rule with comment
period that was promulgated through notice and comment rulemaking, and
does not make substantive changes to the policies or payment
methodology that were finalized in the final rule with comment period.
For example, this notice corrects typographical errors, makes
clarifications to the preamble and regulations text, and revises
inaccurate tabular data. Therefore, we find it unnecessary to undertake
further notice and comment procedures with respect to this correction
notice. We also believe it is in the public interest to waive notice
and comment procedures and the 30-day delay in effective date for this
notice. This correction notice is intended to ensure that the CY 2006
OPPS final rule with comment period accurately reflects the policies
expressed in the final rule, and that the corrected information is made
available to the public prior to January 1, 2006, the date on which the
final rule becomes effective.
For the reasons stated above, we find that both notice and comment
and the 30-day delay in effective date for this correction notice are
unnecessary and that it is in the public interest to make this notice
effective in conjunction with the final rule to which the corrections
apply. Therefore, we find there is good cause to waive notice and
comment procedures and the 30-day delay in effective date for this
correction notice.
IV. Correction of Errors
In FR Doc. 05-22136 (70 FR 68515), make the following corrections:
A. Corrections to Preamble Text
1. On page 68516, in column 3, in the second full paragraph, line
3, the term ``OPPA'' is corrected to read ``OPPS.''
2. On page 68517, in column 1, in the 15th paragraph, line 1, the
phrase ``(Cost center specific)'' is removed.
3. On page 68518, in column 1, in the 11th paragraph, line 2, the
phrase ``and0651'' is corrected to read ``and 0651.''
4. On page 68537,
a. In column 3, in the first full paragraph, lines 5 to 6, the
phrase ``of the proposed rule (76 FR 42690)'' is removed.
b. In column 3, in the first full paragraph, line 6, the word
``contained'' is corrected to read ``contains.''
5. On page 68549,
a. In column 2, in the first full paragraph, line 7, the amount
``$246.04'' is corrected to read ``$245.91.''
b. In column 2, in the first full paragraph, line 8, the amount
``$49.21'' is corrected to read ``$49.18.''
6. On page 68551, in column 3; in the second full paragraph, line
12, the term ``TEFRA'' is removed.
7. On page 68552,
a. In column 1, in the second partial paragraph, line 32, the term
``TEFRA'' is removed.
b. In column 2, in the first partial paragraph carried over from
column 1, line 14, the term ``TEFRA'' is removed.
c. In column 2, in the first partial paragraph carried over from
column 1, line 15, the line is corrected by inserting the phrase ``paid
under the OPPS but not under the IPPS'' between the words ``hospitals''
and ``will.''
d. In column 3, in the first partial paragraph carried over from
column 2, line 3, the term ``TEFRA'' is removed.
e. In column 3 in the first partial paragraph carried over from
column 2, line 5, the term ``TEFRA'' is corrected to read ``these.''
f. In column 3, in the first partial paragraph carried over from
column 2, line 10, the term ``TEFRA'' is corrected to read ``these.''
g. In column 3, in the first partial paragraph carried over from
column 2, line 17, the term ``TEFRA'' is removed.
h. In column 3, in the first partial paragraph carried over from
column 2, line 18, the line is corrected by inserting the phrase term
``not paid under the IPPS'' between the words ``hospitals'' and
``that''.
8. On page 68556, in column 2, in the second full paragraph, in
line 20, the
[[Page 76178]]
sentence is corrected by adding the following bolded text ``payments,
brachytherapy seeds, and any service''.
9. On page 68559,
a. In column 1, below the table footnotes, line 14, following
``biologicals'' the word ``and'' is removed.
b. In column 1, below the table footnotes, line 16 is corrected
adding, ``, and brachytherapy seeds.'' after ``payment policy''.
10. On page 68561,
a. In column 1, line 7, add a ``,'' after term ``rural hospitals''.
b. In column 1, in the last partial paragraph, line 7, remove the
word ``because'' and add ``as'' in its place.
c. In column 2, in the first partial paragraph carried over from
column 1, line 11, ``2 percent'' is corrected to read ``-2 percent''.
11. On page 68565, column 1, in the fifth full paragraph, line 5,
``2005'' is corrected to read ``2006''.
12. On page 68578, column 1, in the last partial paragraph, line 2,
the number ``0042'' is corrected to read ``0429.''
13. On page 68596, column 2, in the first full paragraph,
a. Line 8, the amount ``$2,662.62'' is corrected to read
``$2,709.14.''
b. Line 12, the amount ``$2,975.50'' is corrected to read
``$3,051.67.''
14. On page 68606, in column 1, in the first full paragraph, line
10, the number ``0442'' is corrected to read ``0422.''
15. On page 68628,
a. In column 2, in the first partial paragraph carried over from
column 1, line 5, the word ``where'' is corrected to read ``when.''
b. In column 2, in the third full paragraph, line 17, the phrase
``November 13, 2000 final rule'' is corrected to read ``November 13,
2000 interim final rule with comment period.''
16. On page 68630,
a. In column 1, in the first partial paragraph carried over from
page 68629, line 4, the date ``August 3'' is corrected to read
``November 13.''
b. In column 2, in the first full paragraph, line 13, the date
``August 3'' is corrected to read ``November 13.''
c. In column 2, in the first full paragraph, line 13, the line is
corrected by inserting ``with comment period'' at the end of the
sentence.
d. In column 2, in the first full paragraph, line 33, the date
``August 3'' is corrected to read ``November 13.''
17. On page 68637, in Table 22, the footnote is removed from the
column one heading.
18. On page 68679, in column 1; in the first partial paragraph at
the bottom of the page, line 6, the number ``31'' is corrected to read
``30.''
19. On page 68680,
a. In column 3, in the third paragraph, line 3, the term ``codes''
is corrected to read ``code.''
b. In column 3, in the third paragraph, lines 3 through 8, the
sentence is corrected by removing the phrase ``C8956 (Refilling and
maintenance of portable or implantable pump or reservoir for drug
delivery for therapy/diagnosis, systemic (e.g., intravenous, intra-
arterial)) and.''
c. In Table 31, the table is corrected by removing row 1.
20. On page 68717, in column 1, first partial paragraph continued
from the previous page, line 24, the line is corrected by inserting the
phrase ``brachytherapy seeds,'' after the word ``* * * biologicals,''.
21. On page 68719, in column 1, the third partial paragraph, line
9, the sentence is corrected by inserting the phrase ``at least''
between the word ``of'' and the number ``0.2.''
22. On page 68720, in column 3, in the second full paragraph, line
30, the number ``3.2'' is corrected to read ``3.0.''
23. On page 68726, in table 41, in column 2, row 2, ``$660
Billion.'' is corrected to read ``$660 Million.''
Sec. 419.43 [Amended]
0
24. On page 68728,
0
a. In column 1, in the first partial paragraph carried over from page
68727, line 1, the phrase ``APC and devices of'' is corrected to read
``APC, devices of.''
0
b. In column 1, in the first partial paragraph carried over from page
68727, line 3, the sentence is corrected by inserting the phrase, ``,
and devices paid under Sec. 419.66'' after the phrase ``(including a
radioactive source).''
B. Corrections to Addendum A
1. On page 68736, for APC 0339, row 22, column 3, ``Q'' is
corrected to read ``S.''
2. On page 68738, for APC 0430, row 27, is removed.
3. On page 68743, for APC 1491, row 23, column 6, ``$2.00'' is
removed.
4. On page 68746, APC 1611 is added in numerical order as follows:
a. Column 2 reads ``Hylan G-F 20 injection,''
b. Column 3 reads ``K,''
c. Column 4 is blank,
d. Column 5 reads ``$199.09,''
e. Column 6 is blank,
f. Column 7 reads ``$39.82.''
5. On page 68748,
a. APC 1706, row 18, is removed.
b. For APC 1713, row 25, column 2, ``Inj Fe-based MR contrast, ml''
is corrected to read ``Inj Fe-base MR contrast, 1m1.''
6. On page 68749, APC 7316 is added as follows:
a. Column 2 reads ``Sodium hyaluronate injection,''
b. Column 3 reads ``K,''
c. Column 4 is blank,
d. Column 5 reads ``$106.70,''
e. Column 6 is blank,
f. Column 7 reads ``$21.34.''
7. On page 68750,
a. For APC 9119, row 19, column 2, ``Pentastarch 10% solution'' is
corrected to read ``Injection, pegfilgrastim 6mg.''
b. For APC 9126, row 25, column 2, ``Injection, Natalizumab, 1mg''
is corrected to read ``Natalizumab injection.''
8. On page 68751, for APC 9164, row 7, column 2, ``Inj Gad-base MR
contrast, ml'' is corrected to read ``Inj Gad-base MR contrast, 1ml.''
C. Corrections to Addendum B
1. On page 68876,
a. For HCPCS code 95965, row 9,
i. In column 4, ``T'' is corrected to read ``S,''
ii. In column 5, ``0430'' is corrected to read ``1523,''
iii. In column 6, ``10.8452'' is removed,
iv. In column 7, ``$645.41'' is corrected to read ``$2,750.00,''
v. In column 9, ``$129.08'' is corrected to read ``$550.00.''
b. For HCPCS code 95966, row 10,
i. In column 4, ``T'' is corrected to read ``S,''
ii. In column 5, ``0430'' is corrected to read ``1514,''
iii. In column 6, ``10.8452'' is deleted,
iv. In column 7, ``$645.41'' is corrected to read ``$1,250.00,''
v. In column 9, ``$129.08'' is corrected to read ``$250.00.''
c. For HCPCS code 95967, row 11,
i. In column 4, ``T'' is corrected to read ``S,''
ii. In column 5, ``0430'' is corrected to read ``1510,''
iii. In column 6, ``10.8452'' is deleted,
iv. In column 7, ``$645.41'' is corrected to read ``$850.00,''
v. In column 9, ``$129.06'' is corrected to read ``$170.00.''
2. On page 68880,
a. For HCPCS code 0001F, row 1, column 4, ``D'' is corrected to
read ``E.''
b. For HCPCS code 0005F, row 7, column 4, ``D'' is corrected to
read ``E.''
3. On page 68888, for HCPCS code C8956, row 14,
a. In column 4, ``T'' is corrected to read ``D,''
b. In column 5, ``0125'' is removed,
c. In column 6, ``1.9021'' is removed,
d. In column 7, ``$113.20'' is removed,
e. In column 9, ``$22.64'' is removed.
4. On page 68895,
[[Page 76179]]
a. For HCPCS code G0375, row 36, column 8, ``$2.00'' is removed.
b. For HCPCS code G0376, row 37, column 8, ``$2.00'' is removed.
5. On page 68901,
a. For HCPCS code J2505, row 20, column 2, ``Pentastarch 10%
solution'' is corrected to read ``Injection, pegfilgrastim 6mg.''
b. For HCPCS code J2510, row 21, column 2, ``Sincalide injection''
is corrected to read ``Penicillin g procaine inj.''
6. On page 68902, for HCPCS code J3070, row 26, column 2,
``Pentazocine hcl injection'' is corrected to read ``Pentazocine
injection.''
7. On page 68904,
a. For HCPCS code J7317, row 12, column 4,
i. ``D'' is corrected to read ``K,''
ii. In column 5, ``7316'' is added,
iii. In column 7, ``$106.70'' is added,
iv. In column 9, ``$21.34'' is added.
b. For HCPCS code J7318, row 13,
i. In column 4, ``K'' is corrected to read ``D,''
ii. In column 5, ``1706'' is removed,
iii. In column 7, ``$7.20'' is removed,
iv. In column 9, ``$1.44'' is removed,
c. For HCPCS code J7320, row 14,
i. In column 4, ``D'' is corrected to read ``K,''
ii. In column 5, ``1611'' is added,
iii. In column 7, ``$199.09'' is added,
iv. In column 9, ``$39.82'' is added.
8. On page 68907, for HCPCS code K0105, row 8, column 4, ``D'' is
corrected to read ``Y.''
9. On page 68912,
a. For HCPCS code Q4079, row 15, column 2, ``Injection,
Natalizumab, 1 MG'' is corrected to read ``Natalizumab injection.''
b. For HCPCS code Q9946, row 21, column 2, ``LOCM <=149 mg/ml
iodine, 1ml'' is corrected to read ``LOCM 150-199 mg/ml iodine, 1ml.''
c. For HCPCS code Q9952, row 27, column 2, ``Inj Gad-base MR
contrast, ml'' is corrected to read ``Inj Gad-base MR contrast, 1ml.''
d. For HCPCS code Q9953, row 28, column 2, ``Inj Fe-based MR
contrast, ml'' is corrected to read ``Inj Fe-based MR contrast, 1ml.''
10. The following HCPCS codes were inadvertently omitted from the
Addendum B. We correct this error by listing the omitted codes below.
--------------------------------------------------------------------------------------------------------------------------------------------------------
National Minimum
HCPCS/CPT Short descriptor CI SI APC Relative Payment unadjusted unadjusted
weight rate copayment copayment
--------------------------------------------------------------------------------------------------------------------------------------------------------
22010.............................. I&d, p-spine, c/t/cerv- NI................... C
thor.
22015.............................. I&d, p-spine, l/s/ls.. NI................... C
32503.............................. Resect apical lung NI................... C
tumor.
32504.............................. Resect apical lung tum/ NI................... C
chest.
33507.............................. Repair art, intramural NI................... C
33548.............................. Restore/remodel, NI................... C
ventricle.
33768.............................. Cavopulmonary shunting NI................... C
33880.............................. Endovasc taa repr incl NI................... C
subcl.
33881.............................. Endovasc taa repr w/o NI................... C
subcl.
33883.............................. Insert endovasc NI................... C
prosth, taa.
33884.............................. Endovasc prosth, taa, NI................... C
add-on.
33886.............................. Endovasc prosth, NI................... C
delayed.
33889.............................. Artery transpose/ NI................... C
endovas taa.
33891.............................. Car-car bp grft/ NI................... C
endovas taa.
33925.............................. Rpr pul art unifocal w/ NI................... C
o cpb.
33926.............................. Repr pul art, unifocal NI................... C
w/cpb.
43770.............................. Lap, place gastr NI................... C
adjust band.
43771.............................. Lap, revise adjust NI................... C
gast band.
43772.............................. Lap, remove adjust NI................... C
gast band.
43773.............................. Lap, change adjust NI................... C
gast band.
43774.............................. Lap remov adj gast NI................... C
band/port.
44187.............................. Lap, ileo/jejuno-stomy NI................... C
44188.............................. Lap, colostomy........ NI................... C
44227.............................. Lap, close enterostomy NI................... C
45395.............................. Lap, removal of rectum NI................... C
45397.............................. Lap, remove rectum w/ NI................... C
pouch.
45400.............................. Laparoscopic NI................... C
proctopexy.
45402.............................. Lap proctopexy w/sig NI................... C
resect.
46710.............................. Repr per/vag pouch NI................... C
sngl proc.
46712.............................. Repr per/vag pouch dbl NI................... C
proc.
50250.............................. Cryoablate renal mass NI................... C
open.
61630.............................. Intracranial NI................... B
angioplasty.
61635.............................. Intracran angioplsty w/ NI................... B
stent.
61640.............................. Dilate ic vasospasm, NI................... B
init.
61641.............................. Dilate ic vasospasm NI................... B
add-on.
61642.............................. Dilate ic vasospasm NI................... B
add-on.
75956.............................. Xray, endovasc thor ao NI................... C
repr.
75957.............................. Xray, endovasc thor ao NI................... C
repr.
75958.............................. Xray, place prox ext NI................... C
thor ao.
75959.............................. Xray, place dist ext NI................... C
thor ao.
80195.............................. Assay of sirolimus.... NI................... A
82271.............................. Occult blood, feces, NI................... A
single.
82272.............................. Blood occult NI................... A
peroxidase.
83037.............................. Glycosylated hb, home NI................... A
device.
83631.............................. Lactoferrin, fecal NI................... A
(quant).
83695.............................. Assay of NI................... A
lipoprotein(a).
83700.............................. Lipopro bld, NI................... A
electrophoretic.
83701.............................. Lipoprotein bld, hr NI................... A
fraction.
83704.............................. Lipoprotein, bld, by NI................... A
nmr.
[[Page 76180]]
83900.............................. Molecule nucleic ampli NI................... A
2 seq.
83907.............................. Lyse cells for nucleic NI................... A
ext.
83908.............................. Nucleic acid, signal NI................... A
ampli.
83909.............................. Nucleic acid, high NI................... A
resolute.
83914.............................. Mutation ident ola/ NI................... A
sbce/aspe.
86200.............................. Ccp antibody.......... NI................... A
86355.............................. B cells, total count.. NI................... A
86357.............................. Nk cells, total count. NI................... A
86367.............................. Stem cells, total NI................... A
count.
86480.............................. Tb test, cell immun NI................... A
measure.
87209.............................. Smear, complex stain.. NI................... A
87900.............................. Phenotype, infect NI................... A
agent drug.
90649.............................. H papilloma vacc 3 NI................... E
dose im.
90736.............................. Zoster vacc, sc....... NI................... E
90760.............................. Hydration iv infusion, NI................... B
init.
90761.............................. Hydrate iv infusion, NI................... B
add-on.
90765.............................. Ther/proph/diag iv NI................... B
inf, init.
90766.............................. Ther/proph/dg iv inf, NI................... B
add-on.
90767.............................. Tx/proph/dg addl seq NI................... B
iv inf.
90768.............................. Ther/diag concurrent NI................... B
inf.
90774.............................. Ther/proph/diag inj, NI................... B
iv push.
90775.............................. Ther/proph/diag inj NI................... B
add-on.
92630.............................. Aud rehab pre-ling NI................... E
hear loss.
92633.............................. Aud rehab postling NI................... E
hear loss.
95251.............................. Gluc monitor, cont, NI................... B
phys i&r.
96409.............................. Chemo, iv push, sngl NI................... B
drug.
96411.............................. Chemo, iv push, addl NI................... B
drug.
96413.............................. Chemo, iv infusion, 1 NI................... B
hr.
96415.............................. Chemo, iv infusion, NI................... B
addl hr.
96417.............................. Chemo iv infus each NI................... B
addl seq.
97760.............................. Orthotic mgmt and NI................... A
training.
97761.............................. Prosthetic training... NI................... A
97762.............................. C/o for orthotic/ NI................... A
prosth use.
98960.............................. Self-mgmt educ & NI................... E
train, 1 pt.
98961.............................. Self-mgmt educ/train, NI................... E
2-4 pt.
98962.............................. Self-mgmt educ/train, NI................... E
5-8 pt.
99051.............................. Med serv, eve/wkend/ NI................... B
holiday.
99053.............................. Med serv 10pm-8am, 24 NI................... B
hr fac.
99060.............................. Out of office emerg NI................... B
med serv.
99304.............................. Nursing facility care, NI................... B
init.
99305.............................. Nursing facility care, NI................... B
init.
99306.............................. Nursing facility care, NI................... B
init.
99307.............................. Nursing fac care, NI................... B
subseq.
99308.............................. Nursing fac care, NI................... B
subseq.
99309.............................. Nursing fac care, NI................... B
subseq.
99310.............................. Nursing fac care, NI................... B
subseq.
99318.............................. Annual nursing fac NI................... B
assessmnt.
99324.............................. Domicil/r-home visit NI................... B
new pat.
99325.............................. Domicil/r-home visit NI................... B
new pat.
99326.............................. Domicil/r-home visit NI................... B
new pat.
99327.............................. Domicil/r-home visit NI................... B
new pat.
99328.............................. Domicil/r-home visit NI................... B
new pat.
99334.............................. Domicil/r-home visit NI................... B
est pat.
99335.............................. Domicil/r-home visit NI................... B
est pat.
99336.............................. Domicil/r-home visit NI................... B
est pat.
99337.............................. Domicil/r-home visit NI................... B
est pat.
99339.............................. Domicil/r-home care NI................... B
supervis.
99340.............................. Domicil/r-home care NI................... B
supervis.
0090T.............................. Cervical artific disc. NI................... C
0091T.............................. Lumbar artific disc... NI................... C
0092T.............................. Artific disc addl..... NI................... C
0093T.............................. Cervical artific NI................... C
diskectomy.
0094T.............................. Lumbar artific NI................... C
diskectomy.
0095T.............................. Artific diskectomy NI................... C
addl.
0096T.............................. Rev cervical artific NI................... C
disc.
0097T.............................. Rev lumbar artific NI................... C
disc.
0098T.............................. Rev artific disc addl. NI................... C
0103T.............................. Holotranscobalamin.... NI................... A
0104T.............................. At rest cardio gas NI................... A
rebreathe.
0105T.............................. Exerc cardio gas NI................... A
rebreathe.
0111T.............................. Rbc membranes fatty NI................... A
acids.
[[Page 76181]]
0115T.............................. Med tx mngmt 15 min... NI................... B
0116T.............................. Med tx mngmt subsqt... NI................... B
0117T.............................. Med tx mngmt addl 15 NI................... B
min.
0130T.............................. Chron care drug NI................... B
investigatn.
0140T.............................. Exhaled breath NI................... A
condensate ph.
0141T.............................. Perq islet transplant. NI................... E
0142T.............................. Open islet transplant. NI................... E
0143T.............................. Laparoscopic islet NI................... E
transplnt.
0153T.............................. Implant aneur sensor NI................... C
add-on.
1003F.............................. Level of activity NI................... E
assess.
1004F.............................. Clin symp vol ovrld NI................... E
assess.
1005F.............................. Asthma symptoms NI................... E
evaluate.
1006F.............................. Osteoarthritis assess. NI................... E
1007F.............................. Anti-inflm/anlgsc otc NI................... E
assess.
1008F.............................. Gi/renal risk assess.. NI................... E
2000F.............................. Blood pressure measure NI................... E
2001F.............................. Weight record......... NI................... E
2002F.............................. Clin sign vol ovrld NI................... E
assess.
2003F.............................. Auscultation heart NI................... E
perform.
2004F.............................. Initial exam involved NI................... E
joints.
3000F.............................. Blood press 140/ NI................... E
90 mmhg.
4003F.............................. Pt ed write/oral, pts NI................... E
w/ hf.
4012F.............................. Warfarin therapy rx... NI................... E
4014F.............................. Written discharge NI................... E
instr prvd.
4015F.............................. Persist asthma NI................... E
medicine ctrl.
4016F.............................. Anti-inflm/anlgsc NI................... E
agent rx.
4017F.............................. Gi prophylaxis for NI................... E
nsaid rx.
4018F.............................. Therapy exercise joint NI................... E
rx.
A0998.............................. Ambulance response/ NI................... E
treatment.
A4233.............................. Alkalin batt for NI................... Y
glucose mon.
A4234.............................. J-cell batt for NI................... Y
glucose mon.
A4235.............................. Lithium batt for NI................... Y
glucose mon.
A4236.............................. Silvr oxide batt NI................... Y
glucose mon.
A4363.............................. Ostomy clamp, NI................... A
replacement.
A4411.............................. Ost skn barr extnd =4 NI................... A
sq.
A4412.............................. Ost pouch drain high NI................... A
output.
A4604.............................. Tubing with heating NI................... Y
element.
A5120.............................. Skin barrier, wipe or NI................... A
swab.
A5512.............................. Multi den insert NI................... B
direct form.
A5513.............................. Multi den insert NI................... B
custom mold.
A6457.............................. Tubular dressing...... NI................... A
A6513.............................. Compress burn mask NI................... B
face/neck.
A6530.............................. Compression stocking NI................... E
BK18-30.
A6531.............................. Compression stocking NI................... A
BK30-40.
A6532.............................. Compression stocking NI................... A
BK40-50.
A6533.............................. Gc stocking thighlngth NI................... E
18-30.
A6534.............................. Gc stocking thighlngth NI................... E
30-40.
A6535.............................. Gc stocking thighlngth NI................... E
40-50.
A6536.............................. Gc stocking full lngth NI................... E
18-30.
A6537.............................. Gc stocking full lngth NI................... E
30-40.
A6538.............................. Gc stocking full lngth NI................... E
40-50.
A6539.............................. Gc stocking waistlngth NI................... E
18-30.
A6540.............................. Gc stocking waistlngth NI................... E
30-40.
A6541.............................. Gc stocking waistlngth NI................... E
40-50.
A6542.............................. Gc stocking custom NI................... E
made.
A6543.............................. Gc stocking lymphedema NI................... E
A6544.............................. Gc stocking garter NI................... E
belt.
A6549.............................. G compression stocking NI................... E
A9275.............................. Disp home glucose NI................... E
monitor.
A9281.............................. Reaching/grabbing NI................... E
device.
A9282.............................. Wig any type.......... NI................... E
B4185.............................. Parenteral sol 10 gm NI................... B
lipids.
E0170.............................. Commode chair electric NI................... Y
E0171.............................. Commode chair non- NI................... Y
electric.
[[Page 76182]]
E0172.............................. Seat lift mechanism NI................... E
toilet.
E0485.............................. Oral device/appliance NI................... Y
prefab.
E0486.............................. Oral device/appliance NI................... Y
cusfab.
E0641.............................. Multi-position stnd NI................... E
fram sys.
E0642.............................. Dynamic standing frame NI................... E
E0705.............................. Transfer board or NI................... B
device.
E0762.............................. Trans elec jt stim dev NI................... B
sys.
E0764.............................. Functional NI................... Y
neuromuscularstim.
E0911.............................. HD trapeze bar attach NI................... Y
to bed.
E0912.............................. HD trapeze bar free NI................... Y
standing.
E1392.............................. Portable oxygen NI................... Y
concentrator.
E1812.............................. Knee ext/flex w act NI................... Y
res ctrl.
E2207.............................. Crutch and cane holder NI................... Y
E2208.............................. Cylinder tank carrier. NI................... Y
E2209.............................. Arm trough each....... NI................... Y
E2210.............................. Wheelchair bearings... NI................... Y
E2211.............................. Pneumatic propulsion NI................... Y
tire.
E2212.............................. Pneumatic prop tire NI................... Y
tube.
E2213.............................. Pneumatic prop tire NI................... Y
insert.
E2214.............................. Pneumatic caster tire NI................... Y
each.
E2215.............................. Pneumatic caster tire NI................... Y
tube.
E2216.............................. Foam filled propulsion NI................... Y
tire.
E2217.............................. Foam filled caster NI................... Y
tire each.
E2218.............................. Foam propulsion tire NI................... Y
each.
E2219.............................. Foam caster tire any NI................... Y
size ea.
E2220.............................. Solid propulsion tire NI................... Y
each.
E2221.............................. Solid caster tire each NI................... Y
E2222.............................. Solid caster NI................... Y
integrated whl.
E2223.............................. Valve replacement only NI................... Y
each.
E2224.............................. Propulsion whl NI................... Y
excludes tire.
E2225.............................. Caster wheel excludes NI................... Y
tire.
E2226.............................. Caster fork NI................... Y
replacement only.
E2371.............................. Gr27 sealed leadacid NI................... Y
battery.
E2372.............................. Gr27 non-sealed NI................... Y
leadacid.
G0333.............................. Dispense fee initial NI................... M
30 day.
G0372.............................. MD service required NI................... M
for PMD.
G8006.............................. AMI pt recd aspirin at NI................... M
arriv.
G8007.............................. AMI pt did not receiv NI................... M
aspiri.
G8008.............................. AMI pt ineligible for NI................... M
aspiri.
G8009.............................. AMI pt recd Bblock at NI................... M
arr.
G8010.............................. AMI pt did not rec NI................... M
bblock.
G8011.............................. AMI pt inelig Bbloc at NI................... M
arriv.
G8012.............................. Pneum pt recv NI................... M
antibiotic 4 h.
G8013.............................. Pneum pt w/o NI................... M
antibiotic 4 hr.
G8014.............................. Pneum pt not elig NI................... M
antibiotic.
G8015.............................. Diabetic pt w/ NI................... M
HBA1c>9%.
G8016.............................. Diabetic pt w/ HBA1c < NI................... M
or = 9%.
G8017.............................. DM pt inelig for HBA1c NI................... M
measu.
G8018.............................. Care not provided for NI................... M
HbA1c.
G8019.............................. Diabetic pt w/LDL> NI................... M
100mg/dl.
G8020.............................. Diab pt w/LDL < or = NI................... M
100mg/dl.
G8021.............................. Diab pt inelig for LDL NI................... M
meas.
G8022.............................. Care not provided for NI................... M
LDL.
G8023.............................. DM pt w BP> 140/80.... NI................... M
G8024.............................. Diabetic pt wBP< 140/ NI................... M
80.
G8025.............................. Diabetic pt inelig for NI................... M
BP me.
G8026.............................. Diabet pt w no care re NI................... M
BP me.
G8027.............................. HF p w/LVSD on ACE-I/ NI................... M
ARB.
G8028.............................. HF pt w/LVSD not on NI................... M
ACE-I/AR.
G8029.............................. HF pt not elig for ACE- NI................... M
I/ARB.
G8030.............................. HF pt w/LVSD on NI................... M
Bblocker.
G8031.............................. HF pt w/LVSD not on NI................... M
Bblocker.
G8032.............................. HF pt not elig for NI................... M
Bblocker.
G8033.............................. AMI-CAD pt on Bblocker NI................... M
G8034.............................. AMI-CAD pt not on NI................... M
Bblocker.
G8035.............................. AMI-CAD pt inelig NI................... M
Bblocker.
G8036.............................. AMI-CAD pt doc on NI................... M
antiplatel.
G8037.............................. AMI-CAD pt not docu on NI................... M
antip.
[[Page 76183]]
G8038.............................. AMI-CAD inelig NI................... M
antiplate mea.
G8039.............................. CAD pt w/LDL>100mg/dl. NI................... M
G8040.............................. CAD pt w/LDL< or = NI................... M
100mg/dl.
G8041.............................. CAD pt not eligible NI................... M
for LDL.
G8051.............................. Osteoporosis assess... NI................... M
G8052.............................. Osteopor pt not assess NI................... M
G8053.............................. Pt inelig for osteopor NI................... M
meas.
G8055.............................. Falls assess w/ 12 mon NI................... M
G8056.............................. Not elig for falls NI................... M
assessmen.
G8057.............................. Hearing assess receive NI................... M
G8058.............................. Pt w/o hearing assess. NI................... M
G8059.............................. Pt inelig for hearing NI................... M
assess.
G8060.............................. Urinary incont pt NI................... M
assess.
G8061.............................. Pt not assess for NI................... M
urinary in.
G8062.............................. Pt not elig for NI................... M
urinary inco.
G8075.............................. ESRD pt w/ dialy of NI................... M
URR> 65%.
G8076.............................. ESRD pt w/ dialy of NI................... M
URR< 65%.
G8077.............................. ESRD pt not elig for NI................... M
URR/KtV.
G8078.............................. ESRD pt w/Hct> or = 33 NI................... M
G8079.............................. ESRD pt w/Hct< 33..... NI................... M
G8080.............................. ESRD pt inelig for HCT/ NI................... M
Hgb.
G8081.............................. ESRD pt w/ auto AV NI................... M
fistula.
G8082.............................. ESRD pt w other NI................... M
fistula.
G8093.............................. COPD pt rec smoking NI................... M
cessat.
G8094.............................. COPD pt w/o smoke NI................... M
cessat int.
G8099.............................. Osteopo pt given NI................... M
Ca+VitD sup.
G8100.............................. Osteop pt inelig for NI................... M
Ca+VitD.
G8103.............................. New dx osteo pt w/ NI................... M
antiresorp.
G8104.............................. Osteo pt inelig for NI................... M
antireso.
G8106.............................. Bone dens meas test NI................... M
perf.
G8107.............................. Bone dens meas test NI................... M
inelig.
G8108.............................. Pt receiv influenza NI................... M
vacc.
G8109.............................. Pt w/o influenza vacc. NI................... M
G8110.............................. Pt inelig for NI................... M
influenza vacc.
G8111.............................. Pt receiv mammogram... NI................... M
G8112.............................. Pt not doc mammogram.. NI................... M
G8113.............................. Pt ineligible NI................... M
mammography.
G8114.............................. Care not provided for NI................... M
mamogr.
G8115.............................. Pt receiv pneumo vacc. NI................... M
G8116.............................. Pt did not rec pneumo NI................... M
vacc.
G8117.............................. Pt was inelig for NI................... M
pneumo vac.
G8126.............................. Pt treat w antidepress NI................... M
12wks.
G8127.............................. Pt not treat w/ NI................... M
antidepres 12w.
G8128.............................. Pt inelig for NI................... M
antidepres med.
G8129.............................. Pt treat w/antidepres NI................... M
for 6m.
G8130.............................. Pt not treat w/ NI................... M
antidepres 6m.
G8131.............................. Pt inelig for NI................... M
antidepres med.
G8152.............................. Pt w/AB 1 hr prior to NI................... M
incisi.
G8153.............................. Pt not doc for AB 1 hr NI................... M
prior.
G8154.............................. Pt ineligi for AB NI................... M
therapy.
G8155.............................. Pt recd thromboemb NI................... M
prophylax.
G8156.............................. Pt did not rec NI................... M
thromboembo.
G8157.............................. Pt ineligi for NI................... M
thrombolism.
G8158.............................. Pt recd CABG w/ IMA... NI................... M
G8159.............................. Pt w/CABG w/o IMA..... NI................... M
G8160.............................. Pt inelig for CABG w/ NI................... M
IMA.
G8161.............................. Iso CABG pt rec preop NI................... M
bblock.
G8162.............................. Iso CABG pt w/o preop NI................... M
Bblock.
G8163.............................. Iso CABG pt inelig for NI................... M
preo.
G8164.............................. Iso CABG pt w/prolng NI................... M
intub.
G8165.............................. Iso CABG pt w/o prolng NI................... M
intub.
G8166.............................. Iso CABG req surg NI................... M
rexpo.
G8167.............................. Iso CABG w/o surg NI................... M
explo.
G8170.............................. CEA/ext bypass pt on NI................... M
aspirin.
G8171.............................. Pt w/carot endarct/ext NI................... M
bypas.
G8172.............................. CEA/ext bypass pt not NI................... M
on asp.
[[Page 76184]]
G8182.............................. CAD pt care not prov NI................... M
LDL.
G8183.............................. HF/atrial fib pt on NI................... M
warfarin.
G8184.............................. HF/atrial fib pt NI................... M
inelig warf.
G8185.............................. Osteoarth pt w/ assess NI................... M
pain.
G8186.............................. Osteoarth pt inelig NI................... M
assess.
J0882.............................. Darbepoetin alfa, esrd NI................... B
use.
J0886.............................. Epoetin alfa, esrd.... NI................... B
J1675.............................. Histrelin acetate..... NI................... B
J7306.............................. Levonorgestrel implant NI................... E
sys.
J7341.............................. Non-human, metabolic NI................... K 1707 ........ 1.01 .......... 0.20
tissue.
J7620.............................. Albuterol non- NI................... B
compounded.
J7627.............................. Budesonide, compounded NI................... B
J8498.............................. Antiemetic rectal/supp NI................... B
NOS.
J8515.............................. Cabergoline, oral NI................... E
0.25mg.
J8540.............................. Oral dexamethasone.... NI................... K 1708 ........ 0.22 .......... 0.04
L0491.............................. TLSO 2 piece rigid NI................... A
shell.
L0492.............................. TLSO 3 piece rigid NI................... A
shell.
L0621.............................. SIO flex pelvisacral NI................... A
prefab.
L0622.............................. SIO flex pelvisacral NI................... A
custom.
L0623.............................. SIO panel prefab...... NI................... A
L0624.............................. SIO panel custom...... NI................... A
L0625.............................. LO flexibl L1-below L5 NI................... A
pre.
L0626.............................. LO sag stays/panels NI................... A
pre-fab.
L0627.............................. LO sagitt rigid panel NI................... A
prefab.
L0628.............................. LO flex w/o rigid NI................... A
stays pre.
L0629.............................. LSO flex w/rigid stays NI................... A
cust.
L0630.............................. LSO post rigid panel NI................... A
pre.
L0631.............................. LSO sag-coro rigid NI................... A
frame pre.
L0632.............................. LSO sag rigid frame NI................... A
cust.
L0633.............................. LSO flexion control NI................... A
prefab.
L0634.............................. LSO flexion control NI................... A
custom.
L0635.............................. LSO sagit rigid panel NI................... A
prefab.
L0636.............................. LSO sagittal rigid NI................... A
panel cus.
L0637.............................. LSO sag-coronal panel NI................... A
prefab.
L0638.............................. LSO sag-coronal panel NI................... A
custom.
L0639.............................. LSO s/c shell/panel NI................... A
prefab.
L0640.............................. LSO s/c shell/panel NI................... A
custom.
L0859.............................. MRI compatible system. NI................... A
L3671.............................. SO cap design w/o jnts NI................... A
CF.
L3672.............................. SO airplane w/o jnts NI................... A
CF.
L3673.............................. SO airplane w/joint CF NI................... A
L3702.............................. EO w/o joints CF...... NI................... A
L3763.............................. EWHO rigid w/o jnts CF NI................... A
L3764.............................. EWHO w/joint(s) CF.... NI................... A
L3765.............................. EWHFO rigid w/o jnts NI................... A
CF.
L3766.............................. EWHFO w/joint(s) CF... NI................... A
L3905.............................. WHO w/nontorsion NI................... A
jnt(s) CF.
L3913.............................. HFO w/o joints CF..... NI................... A
L3919.............................. HO w/o joints CF...... NI................... A
L3921.............................. HFO w/joint(s) CF..... NI................... A
L3933.............................. FO w/o joints CF...... NI................... A
L3935.............................. FO nontorsion joint CF NI................... A
L3961.............................. SEWHO cap design w/o NI................... A
jnts CF.
L3967.............................. SEWHO airplane w/o NI................... A
jnts CF.
L3971.............................. SEWHO cap design w/ NI................... A
jnt(s) CF.
L3973.............................. SEWHO airplane w/ NI................... A
jnt(s) CF.
L3975.............................. SEWHFO cap design w/o NI
