Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006 and Certain Provisions Related to the Competitive Acquisition Program of Outpatient Drugs and Biologicals Under Part B; Correcting Amendment, 9458-9466 [06-1711]
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Federal Register / Vol. 71, No. 37 / Friday, February 24, 2006 / Rules and Regulations
paragraph (b) of this section. Other
acceptable monitoring approaches
include periodic testing approved by
EPA or the State or local permitting
authority or continuous parameter
monitoring as described in paragraph (f)
of this section.
(f) The owner or operator of a new
turbine that commences construction
after July 8, 2004, which does not use
water or steam injection to control NOX
emissions may, but is not required to,
perform continuous parameter
monitoring as follows:
*
*
*
*
*
(2) For any lean premix stationary
combustion turbine, the owner or
operator shall continuously monitor the
appropriate parameters to determine
whether the unit is operating in lowNOX mode.
*
*
*
*
*
(j) For each affected unit that elects to
continuously monitor parameters or
emissions, or to periodically determine
the fuel sulfur content or fuel nitrogen
content under this subpart, the owner or
operator shall submit reports of excess
emissions and monitor downtime, in
accordance with § 60.7(c). Excess
emissions shall be reported for all
periods of unit operation, including
startup, shutdown and malfunction. For
the purpose of reports required under
§ 60.7(c), periods of excess emissions
and monitor downtime that shall be
reported are defined as follows:
(1) * * *
(iv) For owners or operators that elect,
under paragraph (f) of this section, to
monitor combustion parameters or
parameters that document proper
operation of the NOX emission controls:
*
*
*
*
*
(5) All reports required under
§ 60.7(c) shall be postmarked by the
30th day following the end of each 6month period.
3. Section 60.335 is amended by
revising paragraph (b)(8) to read as
follows:
I
§ 60.335
Test methods and procedures.
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*
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(b) * * *
(8) If the owner or operator elects
under § 60.334(f) to monitor combustion
parameters or parameters indicative of
proper operation of NOX emission
controls, the appropriate parameters
shall be continuously monitored and
recorded during each run of the initial
performance test, to establish acceptable
operating ranges, for purposes of the
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parameter monitoring plan for the
affected unit, as specified in § 60.334(g).
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[FR Doc. 06–1743 Filed 2–23–06; 8:45 am]
BILLING CODE 6560–50–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 405, 410, 411, 413, 414,
424 and 426
[CMS–1502–F2 and CMS–1325–F]
RIN 0938–AN84 and 098–AN58
Medicare Program; Revisions to
Payment Policies Under the Physician
Fee Schedule for Calendar Year 2006
and Certain Provisions Related to the
Competitive Acquisition Program of
Outpatient Drugs and Biologicals
Under Part B; Correcting Amendment
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Correcting amendment to final
rule with comment.
AGENCY:
In the November 21, 2005
Federal Register (70 FR 70116), we
published a final rule with comment
period entitled ‘‘Medicare Program;
Revisions to Payment Policies Under the
Physician Fee Schedule for Calendar
Year 2006 and Certain Provisions
Related to the Competitive Acquisition
Program of Outpatient Drugs and
Biologicals Under Part B.’’ This
correcting amendment corrects
technical errors in the November 21,
2005 publication.
EFFECTIVE DATE: This correcting
amendment is effective January 1, 2006.
FOR FURTHER INFORMATION CONTACT:
Diane Milstead, (410) 786–3355.
SUPPLEMENTARY INFORMATION:
SUMMARY:
I. Background
FR Doc. 05–22160, entitled ‘‘Medicare
Program; Revisions to Payment Policies
Under the Physician Fee Schedule for
Calendar Year 2006 and Certain
Provisions Related to the Competitive
Acquisition Program of Outpatient
Drugs and Biologicals Under Part B’’
and appearing in the Federal Register
on November 21, 2005 (70 FR 70116),
addressed Medicare Part B payment
policy, including the physician fee
schedule, that is applicable for calendar
year (CY) 2006; and finalized certain
provisions of the interim final rule to
implement the Competitive Acquisition
Program (CAP) for Part B Drugs.
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It also revised Medicare Part B
payment and related policies regarding:
Physician work, practice expense and
malpractice relative value units (RVUs);
Medicare telehealth services; multiple
diagnostic imaging procedures; covered
outpatient drugs and biologicals;
supplemental payments to Federally
Qualified Health Centers (FQHCs); renal
dialysis services; coverage for glaucoma
screening services; National Coverage
Decision (NCD) timeframes; and
physician referrals for nuclear medicine
services and supplies to health care
entities with which physicians have
financial relationships.
In addition, the rule finalized the
interim RVUs for CY 2005 and issued
interim RVUs for new and revised
procedure codes for CY 2006. This rule
also updated the codes subject to the
physician self-referral prohibition and
discussed payment policies relating to
teaching anesthesia services, therapy
caps, private contracts and opt-out, and
chiropractic and oncology
demonstrations.
We have identified a number of
technical errors in that final rule with
comment period.
II. Summary of Errors
We are identifying and correcting
errors made to certain parts of the
preamble, regulations text and addenda
of the November 21, 2005 final rule with
comment (70 FR 70116). In addition,
addendum B, C, D, E and F are revised
under this correcting amendment,
although these addenda will not appear
in the Code of Federal Regulations.
A. Summary of Preamble Errors
In the preamble text, there were a
number of errors and omissions
beginning on pages 70150 through
70335.
1. On page 70150, in the first column,
in the last paragraph under Section m.
(Additional PE Issues Raised by
Commenters), in the second sentence,
the number of the CPT code referenced
is incorrect.
2. On page 70155, in the center
column, the last sentence of the second
paragraph under the discussion titled,
‘‘3. Cardiac Catheritization and
Angioplasty Exception,’’ there was an
error in one of the code ranges
referenced.
3. On page 70263, in the third
column; in last paragraph, the reference
to Table 26 is incorrect.
4. On page 70263, Table 26 was
numbered incorrectly.
5. On page 70274, in the first column;
in the second paragraph language
concerning the specific deleted practice
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expense items was inadvertently
omitted.
6. On page 70282, in the second
column; from the top of the column,
lines 8 through 11, the sentence, ‘‘We
are assigning a status indicator of N for
these services because they are
nonvcovered under Medicare.’’ reflects
an incorrect status indicator and will be
revised.
7. On page 70282, in the third
column; we inadvertently omitted a
paragraph before section F.
(Establishment of Interim PE RVUs for
New and Revised Physician’s Current
Procedural Terminology (CPT) Codes
and New Healthcare Common
Procedure Coding System (HCPCS)
Codes for 2006).
8. On page 70296, in the second
column; in the last paragraph, in line 6,
we incorrectly used the term ‘‘PFS’’, and
that term will be replaced.
9. On page 70302, in Table 35, the
figures for Annual Actual Expenditures
and the Cumulative Actual
Expenditures, for the period of 1/1/03–
12/31/03, are incorrect and will be
revised.
10. On page 70316, the first column,
the percentage adjustment referenced in
the third complete sentence is incorrect
and will be revised.
11. On page 70320, the second
footnote to Table 49 has incorrectly
listed the numerical scaler. This
footnote will be corrected.
These corrections are reflected in
Section III.A of this correcting
amendment.
B. Summary of Regulations Text Errors
In the regulation text, there were
technical errors and omissions in
§ 405.2469, § 414.190, § 414.904,
§ 414.906, and § 426.340.
1. On page 70329, in the third
column, under § 405.2469, paragraph
(a)(1) does not reflect the correct format
for amendatory language. Paragraph
(a)(1) will be restructured.
2. On page 70331, in the third
column, the reference to § 414.190 is
incorrect.
3. On page 70332, in the third
column, the title (Basis for payment.) for
§ 414.904 is incorrect.
4. On page 70333, in the first column,
under § 414.906, we inadvertently
omitted a change to bring the
regulations text into conformity with
our policy on updating CAP drug prices,
as described in the interim final rule
with comment period published July 6,
2005.
5. On page 70335, in the first column,
under § 426.340, the statutory references
in paragraphs (e)(2)(ii) and (f)(2)(ii) are
incorrect.
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The corrections are reflected in
section III.B. of this correcting
amendment.
C. Summary of Addendum B, C, D, E
and F Errors
1. In Addendum B, pages 70337
through 70463, we are making the
following corrections:
a. We assigned incorrect RVUs to the
following Physicians’ CPT or HCPCS
codes:
50000:
i. 52648;
60000:
ii. 61630, 61635;
80000:
iii. 88385–26, 88385–TC, 88385,
88386–26, 88386–TC, and 88386;
90000:
iv. 90760, 90761, 90765, 90766,
90767, 90768, 90772, 90773, 90774,
90775, 92626, 92627, 93514, 96401,
96402, 96405, 96406, 96409, 96411,
96413, 96415, 96416, 96417, 96420,
96440, 96450, 96521, 96522, 96542,
97606, 99300, 99324, 99325, 99326,
99327, 99328, 99334, 99335, 99336,
and 99337.
b. We assigned an incorrect global
period for CPT code 92627.
c. We assigned incorrect status
indicators to the following CPT or codes
0141T, 0142T, 0143T, 88385–26, 88385–
TC, 88385, 88386–26, 88386–TC, 88386,
96523, 98960, 98961, 98962 and 99340.
d. The following HCPCS codes were
inadvertently included: G9041, G9042,
G9043 and G9044. These numbers
should not have been included because
they were not in effect.
e. HCPCS code G0332 was
inadvertently omitted from the
addendum.
f. The first footnote to addendum B
should be corrected to read ‘‘1CPT codes
and descriptions only. Copyright 2005
American Medical Association. All
Rights Reserved. Applicable FARS/
DFARS apply.’’
These corrections are reflected in
Sections III.C.1. and 2. of this correcting
amendment.
2. In Addendum C, pages 70463
through 70466, we are making the
following corrections:
a. We assigned incorrect RVUs to the
following CPT or alphanumeric HCPCS
number for service codes:
60000:
i. 61630 and 61635.
80000:
ii. 88385–26 and 88386–26.
90000:
iii. 90760, 90761, 90765, 90766,
90767, 90768, 90772, 90773, 90774,
90775, 92626, 92627, 96401, 96402,
96409, 96411, 96413, 96415, 96416,
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9459
96417, 96450, 96521, 96522, 96523,
96542, 99300, 99324, 99325, 99326,
99327, 99328, 99334, 99335, 99336
and 99337.
b. We assigned incorrect status
indicators to the following CPT codes
88385–26, 88386–26, 98960, 98961,
98962 and 99340.
These corrections are reflected in
Section III.C.3 of this correcting
amendment.
3. In Addendum D, pages 70466
through 70467, we are correcting the
locality name ‘‘Kansas*’’ to read
‘‘Kansas’’.
These corrections are reflected in
Section III.C.4 of this correcting
amendment.
4. In Addendum E, pages 70468
through 70469, we are correcting the
locality name ‘‘Kansas*’’ to read
‘‘Kansas’’.
These corrections are reflected in
Section III.C.5 of this correcting
amendment.
5. In Addendum F, pages 70469
through 70471, we are correcting this
Addendum by replacing this Addendum
in its entirety to address two errors.
First, we inadvertently left a
discontinued HCPCS code, J1750, on
Addendum F. This code was replaced
by J1751 and J1752 which are found on
Addendum G ‘‘Revised New Drugs for
CAP Bidding for 2006’’. Second, we
included a new HCPCS code, J7318,
which we understood would replace
HCPCS codes J7317 and J7320. HCPCS
J7318 was not issued and HCPCS codes
J7317 & J3120 were retained. We have
reweighted and corrected Addendum F
to reflect these changes.
These corrections are reflected in
Section III.C.6 of this correcting
amendment.
III. Correction of Errors
In FR Doc. 05–22160, entitled
‘‘Medicare Program; Revisions to
Payment Policies Under the Physician
Fee Schedule for Calendar Year 2006
and Certain Provisions Related to the
Competitive Acquisition Program of
Outpatient Drugs and Biologicals Under
Part B,’’ which appeared in the Federal
Register on November 21, 2005 (70 FR
70116), make the following corrections:
A. Correction of Preamble Errors
1. On page 70150, in the first column;
in the last paragraph under Section m.
(Additional PE Issues Raised by
Commenters), in the second sentence,
the number ‘‘99755’’ is corrected to read
‘‘97755’’.
2. On page 70155, in the center
column; the last sentence of the second
paragraph under the discussion titled,
‘‘3. Cardiac Catheterization and
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Angioplasty Exception,’’ the number
‘‘93617’’ is corrected to read ‘‘93618’’.
3. On page 70263, in the third
column; in the last paragraph, the
phrase ‘‘Table 26’’ is corrected to read
‘‘Table 26A’’.
4. On page 70263, the table heading
‘‘Table 26.—Example of Payments’’ is
corrected to read ‘‘Table 26A.—Example
of Payments’’.
5. On page 70274, in the first column;
in the second paragraph, the paragraph
is corrected by adding a new sentence
at the end of the paragraph to read as
follows: ‘‘Because payment for the
supplies and equipment for both of
these procedures is provided under a
separate DMERC policy, we have
deleted the following practice expense
items from these codes: Supplies
deleted include dressings, both Adaptic
and microporous, the drainage canister,
and the sharp debridement kit—which
was identified as not being needed for
the typical scenario; and, the vacuum
pump was deleted from the equipment.’’
6. On page 70282, in the second
column; lines 8 through 11, the
sentence, ‘‘We are assigning a status
indicator of N for these services because
they are noncovered under Medicare.’’
is corrected to read, ‘‘We are assigning
a status indicator of B for these services
because payment for these services is
bundled into payment for other
Medicare services.’’
7. On page 70282, in the third
column; we are adding a new paragraph
before section F. (Establishment of
Interim PE RVUs for New and Revised
Physician’s Current Procedural
Terminology (CPT) Codes and New
Healthcare Common Procedure Coding
System (HCPCS) Codes for 2006). The
new paragraph reads as follows: ‘‘CPT
code 99339 Individual physician
supervision of patient (patient not
present) in home, domiciliary or rest
home (e.g., assisted living facility)
requiring complex and
multidisciplinary care modalities
involving regular physician
development and/or revision of care
plans, review of subsequent reports of
patient status, review of related
laboratory and other studies,
communication (including telephone
calls) for purposes of assessment care
decisions with health care
professional(s), family member(s),
surrogate decision maker(s) (e.g., legal
guardian) and/or key caregiver(s)
involved in patient’s care, integration of
new information into the medical
treatment plan and/or adjustment of
medical therapy, within a calendar
month; 15–29 minutes.
CPT code 99340 Individual physician
supervision of patient (patient not
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present) in home, domiciliary or rest
home (e.g., assisted living facility)
requiring complex and
multidisciplinary care modalities
involving regular physician
development and/or revision of care
plans, review of subsequent reports of
patient status, review of related
laboratory and other studies,
communication (including telephone
calls) for purposes of assessment care
decisions with health care
professional(s), family member(s),
surrogate decision maker(s) (e.g., legal
guardian) and/or key caregiver(s)
involved inpatient’s care, integration of
new information into the medical
treatment plan and/or adjustment of
medical therapy, within a calendar
month; 30 minutes or more. We are
assigning a status indicator of B for
these codes because payment for these
services is bundled into payment for
other services.’’
8. On page 70296, in the second
column; in the last paragraph, in line 6,
the term ‘‘PFS’’ is corrected to read
‘‘Code List’’.
9. On page 70302, in Table 35; in the
third column titled ‘‘Annual Actual
Expenditures’’, in line 10 (1/1/03–12/
31/03) of that column, ‘‘76.8’’ is
corrected to read ‘‘78.2’’; and in the fifth
column titled ‘‘Cumulative Actual
Expenditures’’, in line 10 (1/1/03–12/
31/03) of that column, ‘‘460.6’’ is
corrected to read ‘‘462.0’’.
10. On page 70316, in the first
column; in the third complete sentence,
the figure ‘‘¥0.6’’ is corrected to read
‘‘¥0.15’’.
11. On page 70320, in the second
footnote to Table 49, the figure ‘‘0.9984’’
is corrected to read ‘‘0.9985’’.
B. Correction of Regulation Text Errors
List of Subjects
42 CFR Part 405
Administrative practice and
procedure, Health facilities, Health
professions, Kidney diseases, Medical
devices, Medicare, Reporting and
recordkeeping requirements, Rural
areas, X-rays.
42 CFR Part 414
Administrative practice and
procedure, Health facilities, Health
professions, Kidney diseases, Medicare,
Reporting and recordkeeping
requirements.
42 CFR Part 426
Administrative practice and
procedure, Medicare, Reporting and
recordkeeping requirements.
Given the errors summarized in
section II.B. of this correcting
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amendment, we are making the
following correcting amendments to 42
CFR parts 405, 414, and 426:
PART 405—FEDERAL HEALTH
INSURANCE FOR THE AGED AND
DISABLED
1. The authority citation for part 405
continues to read as follows:
I
Authority: Secs. 1102, 1861, 1862(a), 1871,
1874, 1881, and 1886(k) of the Social
Security Act (42 U.S.C. 1302, 1395x,
1395y(a), 1395hh, 1395kk, 1395rr, and
1395ww(k)), and sec. 353 of the Public
Health Service Act (42 U.S.C. 263a).
2. Section 405.2469 is amended by
revising paragraph (a)(1) to read as
follows:
I
§ 405.2469 Federally Qualified Health
Centers supplemental payments.
*
*
*
*
*
(a) Calculation of supplemental
payment. (1) The supplemental payment
for Federally Qualified Health Center
covered services provided to Medicare
patients enrolled in Medicare
Advantage plans is based on the
difference between—
(i) Payments received by the center
from the Medicare Advantage plan as
determined on a per visit basis; and
(ii) The Federally Qualified Health
Center’s all-inclusive cost-based per
visit rate as set forth in this subpart, less
any amount the FQHC may charge as
described in section 1857(e)(3)(B) of the
Act.
*
*
*
*
*
PART 414—PAYMENT FOR PART B
MEDICAL AND OTHER HEALTH
SERVICES
3. The authority citation for part 414
continues to read as follows:
I
Authority: Secs. 1102, 1871, and 1881(b)(1)
of the Social Security Act (42 U.S.C. 1302,
1395hh, and 1395rr(b)(1)).
4. Section 414.906 is amended by
revising paragraph (c)(1) introductory
text to read as follows:
I
§ 414.906 Competitive acquisition program
as the basis of payment.
*
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*
*
*
(c) Computation of payment amount.
(1) Except as specified in paragraph
(c)(2) of this section, payment for CAP
drugs is based on bids submitted, as a
result of the bidding process as
described in § 414.910. Based on these
bids, a single payment amount for each
CAP drug in the competitive acquisition
area is determined on the basis of the
bids submitted and accepted and
updated from the bidding period to the
payment year. This single payment
amount is then updated on an annual
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basis based on the approved CAP
vendor’s reasonable net acquisition
costs for that category as determined by
CMS, based, in part, on information
disclosed to CMS and limited by the
weighted payment amount established
under section 1847A of the Act across
all drugs for which a composite bid is
required in the category, and limited by
the payment amount established under
section 1847A of the Act for each other
drug for which the approved CAP
vendor submits a bid in accordance
with § 414.910. Adjustment to the
payment amounts may be made more
often than annually, but no more often
than quarterly, in any of the following
cases:
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PART 426—REVIEW OF NATIONAL
COVERAGE DETERMINATIONS AND
LOCAL COVERAGE
DETERMINATIONS
5. The authority citation for part 426
continues to read as follows:
I
Authority: Secs. 1102 and 1871 of the
Social Security Act (42 U.S.C. 1302 and
1395hh).
6. Section 426.340 is amended by
revising paragraphs (e)(2)(ii) and
(f)(2)(ii) to read as follows:
I
§ 426.340 Procedures for review of new
evidence.
*
*
*
*
*
(e) * * *
(2) * * *
(ii) For NCDs, in compliance with the
timeframes specified in section 1862(1)
9461
of the Act, by which CMS completes the
reconsideration.
(f) * * *
(2) * * *
(ii) For NCDs, the reconsideration
timeframe specified by the Board, in
compliance with section 1862(l) of the
Act.
*
*
*
*
*
C. Correction of Addendum Errors
Given the errors summarized in
Section II.C of this correcting
amendment, we are making the
following corrections to Addendum B,
C, D, E, and F. These addenda will not
appear in the Code of Federal
Regulations.
I 1. On pages 70337 through 70463, the
following entries to Addendum B are
corrected to read as follows:
I
ADDENDUM B.—RELATIVE VALUE UNITS (RVUS) AND RELATED INFORMATION—CONTINUED
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CPT 1/
HCPCS 2
0141T .....
0142T .....
0143T .....
................
52648 .....
................
61630 .....
61635 .....
................
88385 .....
88385 .....
88385 .....
88386 .....
88386 .....
88386 .....
................
90760 .....
90761 .....
90765 .....
90766 .....
90767 .....
90768 .....
90772 .....
90773 .....
90774 .....
90775 .....
92626 .....
92627 .....
................
93514 .....
................
96401 .....
96402 .....
96405 .....
96406 .....
96409 .....
96411 .....
96413 .....
96415 .....
96416 .....
96417 .....
96420 .....
................
96440 .....
................
96450 .....
96521 .....
96522 .....
96523 .....
96542 .....
................
97606 .....
................
Status
Mod
........
........
........
26
TC
26
TC
........
........
........
........
........
........
........
VerDate Aug<31>2005
Description
Physician
work RVUs 3
Nonfacility
PE RVUs
Facility PE
RVUs
Malpractice
RVUs
Nonfacility
total
Facility total
Global
I ..........
I ..........
I ..........
............
A ........
............
N ........
N ........
............
A ........
A ........
A ........
A ........
A ........
A ........
............
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
............
C ........
............
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
............
A ........
............
A ........
A ........
A ........
A ........
A ........
............
A ........
............
Perq islet transplant .........................
Open islet transplant ........................
Laparoscopic islet transplant ...........
..........................................................
Laser surgery of prostate .................
..........................................................
Intracranial angioplasty ....................
Intracran angioplasty w/stent ...........
..........................................................
Eval molecul probes, 51–250 ..........
Eval molecul probes, 51–250 ..........
Eval molecul probes, 51–250 ..........
Eval molecul probes, 251–500 ........
Eval molecul probes, 251–500 ........
Eval molecul probes, 251–500 ........
..........................................................
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, sc/im ................
Ther/proph/diag inj, ia ......................
Ther/proph/diag inj, iv push .............
Ther/proph/diag inj add-on ...............
Eval aud status rehab ......................
Evallaud status rehab add-on ..........
..........................................................
Left heart catheterization .................
..........................................................
Chemo, anti-neopl, sq/im .................
Chemo hormon antineopl sq/im .......
Chemo intralesional, up to 7 ............
Chemo intralesional over 7 ..............
Chemo, iv push, sngl drug ...............
Chemo, iv push, addl drug ..............
Chemo, iv infusion, 1 hr ...................
Chemo, iv infusion, addl hr ..............
Chemo prolong infuse w/pump ........
Chemo iv infuse each addl seq .......
Chemo, ia, push technique ..............
..........................................................
Chemotherapy, intracavitary ............
..........................................................
Chemotherapy, into CNS .................
Refill/maint, portable pump ..............
Refill/maint pump/resvr syst .............
Irrig drug delivery device .................
Chemotherapy injection ...................
..........................................................
Neg press wound tx, >50 cm ..........
..........................................................
0.00
0.00
0.00
....................
11.19
....................
+21.08
+23.08
....................
1.50
0.00
1.50
1.88
0.00
1.88
....................
0.17
0.09
0.2
0.18
0.19
0.17
0.17
0.17
0.18
0.10
0.00
0.00
....................
0.00
....................
0.2
0.19
0.52
0.80
0.24
0.20
0.28
0.19
0.21
0.2
0.17
....................
2.37
....................
1.53
0.21
0.21
0.04
0.75
....................
0.60
....................
0.00
0.00
0.00
....................
74.15
....................
NA
NA
....................
0.65
6.45
7.10
0.82
6.23
7.05
....................
1.43
0.40
11.76
0.46
0.89
0.44
0.31
0.31
1.30
0.57
2.20
0.55
....................
0.00
....................
11.17
1.01
2.44
3.02
2.93
1.61
4.20
0.77
4.61
11.95
2.67
....................
8.15
....................
6.97
3.77
2.65
0.69
4.26
....................
0.35
....................
0.00
0.00
0.00
....................
4.80
....................
12.53
13.58
....................
NA
NA
NA
NA
NA
NA
....................
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
....................
0.00
....................
NA
NA
0.24
0.29
NA
NA
NA
NA
NA
NA
NA
....................
1.23
....................
1.29
NA
NA
NA
0.66
....................
0.24
....................
0.00
0.00
0.00
....................
0.79
....................
2.01
2.20
....................
0.06
0.06
0.12
0.08
0.08
0.16
....................
0.07
0.04
0.07
0.04
0.04
0.04
0.01
0.02
0.04
0.04
0.06
.02
....................
0.00
....................
0.01
0.01
0.03
0.03
0.06
0.06
0.08
0.07
0.08
0.07
0.08
....................
0.17
....................
0.09
0.06
0.06
0.01
0.07
....................
0.03
....................
0.00
0.00
0.00
....................
86.07
....................
NA
NA
....................
2.21
6.51
8.72
2.78
6.31
9.09
....................
1.67
0.53
2.04
0.68
1.12
0.65
0.49
0.50
1.52
0.71
2.26
0.57
....................
0.00
....................
1.39
1.21
2.99
3.85
3.23
1.87
4.56
1.03
4.90
2.23
2.92
....................
10.693.77
....................
8.59
4.04
2.92
0.74
5.08
....................
0.98
....................
0.00
0.00
0.00
....................
16.78
....................
35.62
38.86
....................
NA
NA
NA
NA
NA
NA
....................
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
....................
0.00
....................
NA
NA
0.79
1.12
NA
NA
NA
NA
NA
NA
NA
....................
000
....................
2.91
NA
NA
NA
1.48
....................
0.87
....................
XXX
XXX
XXX
18:05 Feb 23, 2006
Jkt 208001
PO 00000
Frm 00035
Fmt 4700
Sfmt 4700
E:\FR\FM\24FER1.SGM
24FER1
090
090
090
XXX
XXX
XXX
XXX
XXX
XXX
XXX
ZZZ
XXX
ZZZ
ZZZ
ZZZ
XXX
XXX
XXX
ZZZ
XXX
ZZZ
000
XXX
XXX
000
000
XXX
ZZZ
XXX
ZZZ
XXX
ZZZ
XXX
000
XXX
XXX
XXX
XXX
XXX
9462
Federal Register / Vol. 71, No. 37 / Friday, February 24, 2006 / Rules and Regulations
ADDENDUM B.—RELATIVE VALUE UNITS (RVUS) AND RELATED INFORMATION—CONTINUED
CPT 1/
98960 .....
98961 .....
98962 .....
................
99300 .....
................
99324 .....
99325 .....
99326 .....
99327 .....
99328 .....
99334 .....
99335 .....
99336 .....
99337 .....
................
99340 .....
................
G0332 ....
Status
Mod
HCPCS 2
........
........
........
........
Description
Physician
work RVUs 3
Nonfacility
PE RVUs
Facility PE
RVUs
Malpractice
RVUs
Nonfacility
total
Facility total
Global
B ........
B ........
B ........
............
A ........
............
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
............
B ........
............
A ........
Self-mgmt educ & train, 1 pt ............
Self-mgmt educ/train, 2–4 pt ...........
Self-mgmt educ/train, 5–8 pt ...........
..........................................................
lc, infant pbw 2501–5000 gm ..........
..........................................................
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 ..........
..........................................................
Preadmin IV immunoglobulin ...........
0.00
0.00
0.00
....................
2.40
....................
1.01
1.52
2.27
3.03
3.78
0.76
1.26
2.02
3.03
....................
0.00
....................
0.00
0.00
0.00
0.00
....................
NA
....................
0.49
0.68
0.92
1.17
1.42
0.40
0.58
0.82
1.15
....................
0.00
....................
1.91
0.00
0.00
0.00
....................
0.84
....................
NA
NA
NA
NA
NA
NA
NA
NA
NA
....................
0.00
....................
NA
0.00
0.00
0.00
....................
0.15
....................
0.05
0.07
0.10
0.13
0.16
0.04
0.06
0.09
0.13
....................
0.00
....................
0.00
0.00
0.00
0.00
....................
NA
....................
1.55
2.27
3.29
4.33
5.36
1.20
1.90
2.93
4.31
....................
0.00
....................
1.91
0.00
0.00
0.00
....................
3.35
....................
NA
NA
NA
NA
NA
NA
NA
NA
NA
....................
0.00
....................
NA
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
1 CPT
codes and descriptions only. Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
2 Copyright 2005 American Dental Association. All Rights Reserved.
3 Indicates RVUs are not used for Medicare payment.
2. On page 70463, the following
entries to Addendum B, G9041, G9042,
G9043, and G9044 are removed.
ADDENDUM B.—RELATIVE VALUE UNITS (RVUS) AND RELATED INFORMATION—CONTINUED
CPT 1/
HCPCS 2
Mod
Status
G9041
G9042
G9043
G9044
........
........
........
........
X
X
X
X
.....
.....
.....
.....
1 CPT
........
........
........
........
Physician
work
RVUs 3
Description
Low
Low
Low
Low
vision
vision
vision
vision
rehab occupationa ........
rehab orient/mobi ..........
lowvision therapy ..........
rehabilate teache ..........
0.00
0.00
0.00
0.00
Nonfacility
PE RVUs
Facility PE
RVUs
0.00
0.00
0.00
0.00
Malpractice
RVUs
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Nonfacility
total
0.00
0.00
0.00
0.00
Facility total
0.00
0.00
0.00
0.00
Global
XXX
XXX
XXX
XXX
codes and descriptions only. Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
2005 American Dental Association. All Rights Reserved.
RVUs are not used for Medicare payment.
2 Copyright
3 +Indicates
3. On pages 70463 through 70466, the
following entries to Addendum C are
corrected to read as follows:
I
ADDENDUM C.—CODES WITH INTERIM RVUS
wwhite on PROD1PC61 with RULES
CPT 1/
HCPCS 2
61630
61635
88385
88386
90760
90761
90765
90766
90767
90768
90772
90773
90774
90775
92626
92627
96401
96402
96409
96411
96413
96415
96416
96417
96450
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
Mod
Status
26
26
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
N
N
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
VerDate Aug<31>2005
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
Physician
work
RVUs 3
Description
Intracranial angioplasty ...................
Intracran angioplasty w/stent ..........
Eval Molecul probes, 51–250 .........
Eval Molecul probes, 251–500 .......
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, sc/im ...............
Ther/proph/diag inj, ia .....................
Ther/proph/diag inj, iv push ............
Ther/proph/diag inj add-on ..............
Eval aud status rehab .....................
Evalaud status rehab add-on ..........
Chemo, anti-neopl, sq/im ................
Chemo hormone antineopl sq/im ....
Chemo, iv push, sngl drug ..............
Chemo, iv push, addl drug .............
Chemo, iv infusion, 1 hr ..................
Chemo, iv infusion, addl hr .............
Chemo prolong infuse w/pump .......
Chemo iv infuse each addl seq ......
Chemotherapy, into CNS ................
18:05 Feb 23, 2006
Jkt 208001
PO 00000
Frm 00036
+21.08
+23.08
1.50
1.88
0.17
0.09
0.21
0.18
0.19
0.17
0.17
0.17
0.18
0.10
0.00
0.00
0.21
0.19
0.24
0.20
0.28
0.19
0.21
0.21
1.53
Fmt 4700
Nonfacility
PE RVUs
Facility PE
RVUs
NA
NA
0.65
0.82
1.43
0.40
1.76
0.46
0.89
0.44
0.31
0.31
1.30
0.57
2.20
0.55
1.17
1.01
2.93
1.61
4.20
0.77
4.61
1.95
6.97
Sfmt 4700
Malpractice
RVUs
12.53
13.58
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
1.29
2.01
2.20
0.06
0.08
0.07
0.04
0.07
0.04
0.04
0.04
0.01
0.02
0.04
0.04
0.06
0.02
0.01
0.01
0.06
0.06
0.08
0.07
0.08
0.07
0.09
E:\FR\FM\24FER1.SGM
24FER1
Nonfacility
Total
NA
NA
2.21
2.78
1.67
0.53
2.04
0.68
1.12
0.65
0.49
0.50
1.52
0.71
2.26
0.57
1.39
1.21
3.23
1.87
4.56
1.03
4.90
2.23
8.59
Facility
Total
35.62
30.66
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
2.91
Global
090
090
XXX
XXX
XXX
ZZZ
XXX
ZZZ
ZZZ
ZZZ
XXX
XXX
XXX
ZZZ
XXX
ZZZ
XXX
XXX
XXX
ZZZ
XXX
ZZZ
XXX
ZZZ
000
9463
Federal Register / Vol. 71, No. 37 / Friday, February 24, 2006 / Rules and Regulations
ADDENDUM C.—CODES WITH INTERIM RVUS—Continued
CPT 1/
HCPCS 2
Mod
Status
Description
Physician
work
RVUs 3
Nonfacility
PE RVUs
Facility PE
RVUs
Malpractice
RVUs
Nonfacility
Total
Facility
Total
96521 ......
96522 ......
96523 ......
96542 ......
.................
98960 ......
98961 ......
98962 ......
.................
99300 ......
99324 ......
99325 ......
99326 ......
99327 ......
99328 ......
99334 ......
99335 ......
99336 ......
99337 ......
.................
99340 ......
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
........
A ........
A ........
A ........
A ........
............
B ........
B ........
B ........
............
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
A ........
............
B ........
Refill/maint, portable pump .............
Refil/maint pump/resvr syst ............
Irrig drug delivery device ................
Chemotherapy injection ..................
.........................................................
Self-mgmt educ & train, 1 pt ...........
Self-mgmt educ/train, 2–4 pt ..........
Self-mgmt educ/train 5–8 pt ...........
.........................................................
Ic, infant pbw 2501–5000 gm .........
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 .........
0.21
0.21
0.04
0.75
....................
0.00
0.00
0.00
....................
2.40
1.01
1.52
2.27
3.03
3.78
0.76
1.26
2.02
3.03
....................
0.00
3.77
2.65
0.69
4.26
....................
0.00
0.00
0.00
....................
NA
0.49
0.68
0.92
1.17
1.42
0.40
0.58
0.82
1.15
....................
0.00
NA
NA
NA
0.66
....................
0.00
0.00
0.00
....................
0.84
NA
NA
NA
NA
NA
NA
NA
NA
NA
....................
0.00
0.06
0.06
0.01
0.07
....................
0.00
0.00
0.00
....................
0.15
0.05
0.07
0.10
0.13
0.16
0.04
0.06
0.09
0.13
....................
0.00
4.04
2.92
0.74
5.08
....................
0.00
0.00
0.00
....................
NA
1.55
2.27
3.29
4.33
5.36
1.20
1.90
2.93
4.31
....................
0.00
NA
NA
NA
1.48
....................
0.00
0.00
0.00
....................
3.35
NA
NA
NA
NA
NA
NA
NA
NA
NA
....................
0.00
Global
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
XXX
1 CPT
codes and descriptions only. Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
2 Copyright 2005 American Dental Association. All Rights Reserved.
3 +Indicates RVUs are not used for Medicare payment.
4. On page 70467, in Addendum D, in
the 11th entry, in the third column, the
I
locality ‘‘Kansas*’’ is corrected to read
‘‘Kansas’’ as follows:
ADDENDUM D.—2006 GEOGRAPHIC PRACTICE COST INDICES BY MEDICARE CARRIER AND LOCALITY—CONTINUED
Carrier
Locality
00650 ........................................................
00
5. On page 70469, in Addendum E, in
the fourth entry, in the third column,
I
Locality name
Work GPCI
Kansas ......................................................
1.000
PE GPCI
0.878
MP GPCI
0.721
the locality ‘‘Kansas*’’ is corrected to
read ‘‘Kansas’’ as follows:
ADDENDUM E.—2006 GAFS—CONTINUED
Carrier
Locality
00650 ................................................................................
Locality name
00
Kansas .............................................................................
2006 GAF
0.0936
6. On pages 70469 through 70471,
Addendum F, in its entirety, is
corrected to read as follows:
I
ADDENDUM F.—REVISED SINGLE DRUG CATEGORY LIST
wwhite on PROD1PC61 with RULES
HCPCS
J0150
J0152
J0170
J0207
J0215
J0280
J0290
J0475
J0540
J0550
J0570
J0585
J0587
J0600
J0637
J0640
J0670
Long description
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
VerDate Aug<31>2005
18:05 Feb 23, 2006
Jkt 208001
Weight
Injection, adenosine for therapeutic use, 6 mg ...........................................................
Injection, adenosine for diagnostic use, 30 mg ...........................................................
Injection, adrenalin, epinephrine, 1 ml ampule ............................................................
Injection, amifostine, 500 mg .......................................................................................
Injection, alefacept, 0.5 mg ..........................................................................................
Injection, aminophyllin, 250 mg ...................................................................................
Injection, ampicillin sodium, 500 mg ............................................................................
Injection, baclofen, 10 mg ............................................................................................
Injection, penicillin g benzathine and penicillin g procaine, 1,200,000 units ...............
Injection, penicillin g benzathine and penicillin g procaine, 2,400,000 units ...............
Injection, penicillin g benzathine, 1,200,000 units .......................................................
Botulinum toxin type A, per unit ...................................................................................
Botulinum toxin type B, per 100 units ..........................................................................
Injection, edetate calcium disodium, 1000 mg ............................................................
Injection, caspofungin acetate, 5 mg ...........................................................................
Injection, leucovorin calcium, per 50 mg .....................................................................
Injection, mepivacaine hydrochloride, per 10 ml .........................................................
PO 00000
Frm 00037
Fmt 4700
Sfmt 4700
E:\FR\FM\24FER1.SGM
24FER1
0.00070000
0.00459478
0.00007897
0.00016099
0.00083383
0.00082088
0.00012657
0.00024643
0.00007209
0.00001831
0.00004605
0.03743206
0.00150704
0.00004459
0.00008483
0.01064503
0.00038398
9464
Federal Register / Vol. 71, No. 37 / Friday, February 24, 2006 / Rules and Regulations
ADDENDUM F.—REVISED SINGLE DRUG CATEGORY LIST—Continued
wwhite on PROD1PC61 with RULES
HCPCS
J0690
J0692
J0696
J0698
J0702
J0704
J0735
J0800
J0881
J0885
J0895
J1000
J1020
J1030
J1040
J1051
J1094
J1100
J1190
J1200
J1212
J1245
J1250
J1260
J1335
J1440
J1441
J1450
J1580
J1600
J1626
J1631
J1642
J1644
J1645
J1650
J1655
J1720
J1745
J1756
J1885
J1940
J1956
J2001
J2010
J2150
J2260
J2300
J2325
J2353
J2354
J2405
J2430
J2505
J2550
J2680
J2765
J2780
J2820
J2912
J2916
J2920
J2930
J2997
J3260
J3301
J3302
J3303
J3315
J3370
J3396
J3410
Long description
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
........................................................
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Jkt 208001
Weight
Injection, cefazolin sodium, 500 mg ............................................................................
Injection, cefepime hydrochloride, 500 mg ..................................................................
Injection, ceftriaxone sodium, per 250 mg ...................................................................
Injection, cefotaxime sodium, per gm ..........................................................................
Injection, betamethasone acetate & betamethasone sodium phosphate, per 3 mg ...
Injection, betamethasone sodium phosphate, per 4 mg .............................................
Injection, clonidine hydrochloride, 1 mg ......................................................................
Injection, corticotropin, 40 units ...................................................................................
Injection, darbepoetin alfa, 1 mcg (non-ESRD use) ....................................................
Injection, epoetin alpha, (for non ESRD use), per 1000 units ....................................
Injection, deferoxamine mesylate, 500 mg ..................................................................
Injection, depo-estradiol cypionate, 5 mg ....................................................................
Injection, methylprednisolone acetate, 20 mg .............................................................
Injection, methylprednisolone acetate, 40 mg .............................................................
Injection, methylprednisolone acetate, 80 mg .............................................................
Injection, medroxyprogesterone acetate, 50 mg .........................................................
Injection, dexamethasone acetate, 1 mg .....................................................................
Injection, dexamethasone sodium phosphate, 1 mg ...................................................
Injection, dexrazoxane hydrochloride, per 250 mg ......................................................
Injection, diphenhydramine hcl, 50 mg ........................................................................
Injection, DMSO, dimethyl sulfoxide, 50%, 50 ml .......................................................
Injection, dipyridamole, per 10 mg ...............................................................................
Injection, dobutamine hydrochloride, per 250 mg .......................................................
Injection, dolasetron mesylate, 10 mg .........................................................................
Injection, ertapenem sodium, 500 mg .........................................................................
Injection, filgrastim (G–CSF), 300 mcg ........................................................................
Injection, filgrastim (G–CSF), 480 mcg ........................................................................
Injection fluconazole, 200 mg ......................................................................................
Injection, garamycin, gentamicin, 80 mg .....................................................................
Injection, gold sodium thiomalate, 50 mg ....................................................................
Injection, granisetron hydrochloride, 100 mcg .............................................................
Injection, haloperidol decanoate, per 50 mg ...............................................................
Injection, heparin sodium, (heparin lock flush), per 10 units .......................................
Injection, heparin sodium, per 1000 units ....................................................................
Injection, dalteparin sodium, per 2500 iu .....................................................................
Injection, enoxaparin sodium, 10 mg ...........................................................................
Injection, tinzaparin sodium, 1000 iu ...........................................................................
Injection, hydrocortisone sodium succinate, 100 mg ...................................................
Injection infliximab, 10 mg ...........................................................................................
Injection, iron sucrose, 1 mg ........................................................................................
Injection, ketorolac tromethamine, per 15 mg .............................................................
Injection, furosemide, 20 mg ........................................................................................
Injection, levofloxacin, 250 mg .....................................................................................
Injection, lidocaine hcl for intravenous infusion, 10 mg ...............................................
Injection, lincomycin hcl, 300 mg .................................................................................
Injection, mannitol, 25% in 50 ml .................................................................................
Injection, milrinone lactate, 5 mg .................................................................................
Injection, nalbuphine hydrochloride, per 10 mg ...........................................................
Injection, nesiritide, 0.1 mg ..........................................................................................
Injection, octreotide, depot form for intramuscular injection, 1 mg .............................
Injection, octreotide, non-depot subcutaneous or intravenous injection, 25 mcg .......
Injection, ondansetron hydrochloride, per 1 mg ..........................................................
Injection, pamidronate disodium, per 30 mg ...............................................................
Injection, pegfilgrastim, 6 mg .......................................................................................
Injection, promethazine hcl, 50 mg ..............................................................................
Injection, fluphenazine decanoate, 25 mg ...................................................................
Injection, metoclopramide hCL, 10 mg ........................................................................
Injection, ranitidine hydrochloride, 25 mg ....................................................................
Injection, sargramostim (GM–CSF), 50 mcg ...............................................................
Injection, sodium chloride, 0.9%, per 2 ml ..................................................................
Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg ..................
Injection, methylprednisolone sodium succinate, 40 mg .............................................
Injection, methylprednisolone sodium succinate, 125 mg ...........................................
Injection, alteplase recombinant, 1 mg ........................................................................
Injection, tobramycin sulfate, 80 mg ............................................................................
Injection, triamcinolone acetonide, per 10 mg .............................................................
Injection, triamcinolone diacetate, per 5 mg ................................................................
Injection, triamcinolone hexacetonide, per 5 mg .........................................................
Injection, triptorelin pamoate, 3.75 mg ........................................................................
Injection, vancomycin hCL, 500 mg .............................................................................
Injection, verteporfin, 0.1 mg .......................................................................................
Injection, hydroxyzine hCL, 25 mg ..............................................................................
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0.00195107
0.00008412
0.01373037
0.00156790
0.00065114
0.00068681
0.00015113
0.00011134
0.00088550
0.00217910
0.00680009
0.00061134
0.00031230
0.00077199
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0.05438624
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Federal Register / Vol. 71, No. 37 / Friday, February 24, 2006 / Rules and Regulations
9465
ADDENDUM F.—REVISED SINGLE DRUG CATEGORY LIST—Continued
wwhite on PROD1PC61 with RULES
HCPCS
J3420
J3475
J3480
J3487
J7030
J7040
J7042
J7050
J7060
J7070
J7120
J7317
J7320
J9000
J9001
J9031
J9040
J9045
J9050
J9060
J9062
J9065
J9070
J9080
J9090
J9091
J9092
J9093
J9094
J9095
J9096
J9097
J9098
J9100
J9110
J9130
J9140
J9150
J9170
J9178
J9181
J9182
J9185
J9190
J9200
J9201
J9202
J9206
J9208
J9209
J9211
J9213
J9214
J9219
J9245
J9250
J9260
J9263
J9265
J9268
J9280
J9290
J9291
J9293
J9310
J9320
J9340
J9350
J9355
J9360
J9370
J9375
Long description
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Weight
Injection, vitamin B–12 cyanocobalamin, up to 1000 mcg ..........................................
Injection, magnesium sulfate, per 500 mg ...................................................................
Injection, potassium chloride, per 2 meq .....................................................................
Injection, zoledronic acid, 1 mg ...................................................................................
Infusion, normal saline solution, 1000 cc ....................................................................
Infusion, normal saline solution, sterile (500 ml = 1 unit) ............................................
5% dextrose/normal saline (500 ml = 1 unit) ...............................................................
Infusion, normal saline solution, 250 cc ......................................................................
5% dextrose/water (500 ml = 1 unit) ...........................................................................
Infusion, D5W, 1000 cc ................................................................................................
Ringers lactate infusion, 1000 cc .................................................................................
Sodium hyaluronate, per 20 to 25 mg dose for intra-articular injection ......................
Hylan G–F 20, 16 mg, for intra articular injection .......................................................
Doxorubicin hCL, 10 mg ..............................................................................................
Doxorubicin hydrochloride, all lipid formulations, 10 mg .............................................
BCG (Intravesical) per instillation ................................................................................
Bleomycin sulfate, 15 units ..........................................................................................
Carboplatin, 50 mg .......................................................................................................
Carmustine, 100 mg .....................................................................................................
Cisplatin, powder or solution, per 10 mg .....................................................................
Cisplatin, 50 mg ...........................................................................................................
Injection, cladribine, per 1 mg ......................................................................................
Cyclophosphamide, 100 mg ........................................................................................
Cyclophosphamide, 200 mg ........................................................................................
Cyclophosphamide, 500 mg ........................................................................................
Cyclophosphamide, 1.0 gram ......................................................................................
Cyclophosphamide, 2.0 gram ......................................................................................
Cyclophosphamide, lyophilized, 100 mg .....................................................................
Cyclophosphamide, lyophilized, 200 mg .....................................................................
Cyclophosphamide, lyophilized, 500 mg .....................................................................
Cyclophosphamide, lyophilized, 1.0 gram ...................................................................
Cyclophosphamide, lyophilized, 2.0 gram ...................................................................
Cytarabine liposome, 10 mg ........................................................................................
Cytarabine, 100 mg ......................................................................................................
Cytarabine, 500 mg ......................................................................................................
Dacarbazine, 100 mg ...................................................................................................
Dacarbazine, 200 mg ...................................................................................................
Daunorubicin, 10 mg ....................................................................................................
Docetaxel, 20 mg .........................................................................................................
Injection, epirubicin hCL, 2 mg ....................................................................................
Etoposide, 10 mg .........................................................................................................
Etoposide, 100 mg .......................................................................................................
Fludarabine phosphate, 50 mg ....................................................................................
Fluorouracil, 500 mg ....................................................................................................
Floxuridine, 500 mg .....................................................................................................
Gemcitabine hCL, 200 mg ...........................................................................................
Goserelin acetate implant, per 3.6 mg ........................................................................
Irinotecan, 20 mg .........................................................................................................
Ifosfamide, 1 gm ..........................................................................................................
Mesna, 200 mg ............................................................................................................
Idarubicin hydrochloride, 5 mg .....................................................................................
Interferon, ALFA–2A, recombinant, 3 million units ......................................................
Interferon, ALFA–2B, recombinant, 1 million units ......................................................
Leuprolide acetate implant, 65 mg ..............................................................................
Injection, melphalan hydrochloride, 50 mg ..................................................................
Methotrexate sodium, 5 mg .........................................................................................
Methotrexate sodium, 50 mg .......................................................................................
Injection, oxaliplatin, 0.5 mg ........................................................................................
Paclitaxel, 30 mg ..........................................................................................................
Pentostatin, per 10 mg .................................................................................................
Mitomycin, 5 mg ...........................................................................................................
Mitomycin, 20 mg .........................................................................................................
Mitomycin, 40 mg .........................................................................................................
Injection, mitoxantrone hydrochloride, per 5 mg .........................................................
Rituximab, 100 mg .......................................................................................................
Streptozocin, 1 gm .......................................................................................................
Thiotepa, 15 mg ...........................................................................................................
Topotecan, 4 mg ..........................................................................................................
Trastuzumab, 10 mg ....................................................................................................
Vinblastine sulfate, 1 mg ..............................................................................................
Vincristine sulfate, 1 mg ...............................................................................................
Vincristine sulfate, 2 mg ...............................................................................................
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0.00243166
0.00049872
0.00993344
0.00102860
0.00015894
0.00016980
0.00191598
0.00149854
0.00235846
0.00032536
0.00049267
0.00003728
0.00570096
0.00000890
0.00095393
0.00025430
0.00008142
0.00062691
0.00004968
0.00008125
0.00005049
0.00000530
0.00092680
0.00009190
0.00017696
0.00013977
0.00001360
0.00000817
0.00013010
0.00002076
0.00009429
0.00007024
0.00000490
0.00257221
0.00121917
0.00231466
0.00053112
0.00030647
0.00396193
0.00000409
0.00496182
0.00288597
0.00319095
0.00007892
0.00036868
0.00000318
0.00008082
0.00675198
0.00006526
0.00000159
0.00186700
0.00051449
0.07318565
0.00556692
0.00000645
0.00004077
0.00003481
0.00006143
0.00025120
0.00409565
0.00000673
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0.00018268
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0.00019751
0.00011515
9466
Federal Register / Vol. 71, No. 37 / Friday, February 24, 2006 / Rules and Regulations
ADDENDUM F.—REVISED SINGLE DRUG CATEGORY LIST—Continued
HCPCS
Long description
J9390 ........................................................
J9395 ........................................................
J9600 ........................................................
Q3025 .......................................................
Vinorelbine tartrate, per 10 mg ....................................................................................
Injection, fulvestrant, 25 mg .........................................................................................
Porfimer sodium, 75 mg ...............................................................................................
Injection, interferon BETA–1A, 11 mcg for intramuscular use ....................................
wwhite on PROD1PC61 with RULES
IV. 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 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 the notice and comment
procedures if the Secretary finds, for
good cause, 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 rule. We can also waive the 30-day
delay in effective date under the APA (5
U.S.C. 553(d)) when there is good cause
to do so and we publish in the rule an
explanation of our good cause.
This correcting amendment addresses
technical errors and omissions made in
FR Doc. 05–22160, entitled ‘‘Medicare
Program; Revisions to Payment Policies
Under the Physician Fee Schedule for
Calendar Year 2006 and Certain
Provisions Related to the Competitive
Acquisition Program of Outpatient
Drugs and Biologicals Under Part B,’’
which appeared in the Federal Register
on November 21, 2005 (70 FR 70116)
and was made effective January 1, 2006.
The provisions of this final rule with
comment period have been previously
subjected to notice and comment
procedures. These corrections are
consistent with the discussion and text
and do not make substantive changes to
the CY 2006 published rule. As such,
this correcting amendment is intended
to ensure the CY 2006 final rule with
comment accurately reflects the policy
adopted. Therefore, we find that
undertaking further notice and comment
procedures to incorporate these
corrections into the final rule with
comment is unnecessary and contrary to
the public interest.
For the same reasons, we are also
waiving the 30-day delay in effective
date for this correcting amendment. We
believe that it is in the public interest
to ensure that the CY 2006 final rule
with comment accurately states our
policy on physician fee schedule and
other Part B payment policies, and
provisions related to the competitive
VerDate Aug<31>2005
18:05 Feb 23, 2006
Jkt 208001
acquisition program of outpatient drugs
and biologicals under Part B. Therefore,
delaying the effective date of these
corrections beyond the January 1, 2006
effective date of the final rule with
comment period would be contrary to
the public interest. In so doing, we find
good cause to waive the 30-day delay in
the effective date.
(Catalog of Federal Domestic Assistance
Program No. 93.774, Medicare—
Supplementary Medical Insurance Program)
Dated: February 7, 2006.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. 06–1711 Filed 2–23–06; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
42 CFR Parts 411 and 489
[CMS–6272–IFC]
RIN 0938–AN27
Medicare Program; Medicare
Secondary Payer Amendments
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Interim final rule with comment
period.
AGENCY:
SUMMARY: This interim final rule with
comment period implements
amendments to the Medicare Secondary
Payer (MSP) provisions under Title III of
the Medicare Prescription Drug,
Improvement, and Modernization Act of
2003 (MMA). The MMA amendments
clarify the MSP provisions regarding the
obligations of primary plans and
primary payers, the nature of the
insurance arrangements subject to the
MSP rules, the circumstances under
which Medicare may make conditional
payments, and the obligations of
primary payers to reimburse Medicare.
DATES: Effective date: These regulations
are effective on April 25, 2006.
Comment date: To be assured
consideration, comments must be
received at one of the addresses
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provided below, no later than 5 p.m. on
April 25, 2006.
ADDRESSES: In commenting, please refer
to file code CMS–6272–IFC. Because of
staff and resource limitations, we cannot
accept comments by facsimile (FAX)
transmission.
You may submit comments in one of
four ways (no duplicates, please):
1. Electronically. You may submit
electronic comments on specific issues
in this regulation to https://
www.cms.hhs.gov/eRulemaking. Click
on the link ‘‘Submit electronic
comments on CMS regulations with an
open comment period.’’ (Attachments
should be in Microsoft Word,
WordPerfect, or Excel; however, we
prefer Microsoft Word.)
2. By regular mail. You may mail
written comments (one original and two
copies) to the following address ONLY:
Centers for Medicare & Medicaid
Services, Department of Health and
Human Services, Attention: CMS–6272–
IFC, g1P.O. Box 8017, Baltimore, MD
21244–8017.
Please allow sufficient time for mailed
comments to be received before the
close of the comment period.
3. By express or overnight mail. You
may send written comments (one
original and two copies) to the following
address ONLY: Centers for Medicare &
Medicaid Services, Department of
Health and Human Services, Attention:
CMS–6272–IFC, Mail Stop C4–26–05,
7500 Security Boulevard, Baltimore, MD
21244–1850.
4. By hand or courier. If you prefer,
you may deliver (by hand or courier)
your written comments (one original
and two copies) before the close of the
comment period to one of the following
addresses. If you intend to deliver your
comments to the Baltimore address,
please call telephone number (410) 786–
7195 in advance to schedule your
arrival with one of our staff members.
Room 445–G, Hubert H. Humphrey
Building, 200 Independence Avenue,
SW., Washington, DC 20201; or 7500
Security Boulevard, Baltimore, MD
21244–1850.
(Because access to the interior of the
HHH Building is not readily available to
persons without Federal Government
identification, commenters are
encouraged to leave their comments in
E:\FR\FM\24FER1.SGM
24FER1
Agencies
[Federal Register Volume 71, Number 37 (Friday, February 24, 2006)]
[Rules and Regulations]
[Pages 9458-9466]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 06-1711]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 405, 410, 411, 413, 414, 424 and 426
[CMS-1502-F2 and CMS-1325-F]
RIN 0938-AN84 and 098-AN58
Medicare Program; Revisions to Payment Policies Under the
Physician Fee Schedule for Calendar Year 2006 and Certain Provisions
Related to the Competitive Acquisition Program of Outpatient Drugs and
Biologicals Under Part B; Correcting Amendment
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Correcting amendment to final rule with comment.
-----------------------------------------------------------------------
SUMMARY: In the November 21, 2005 Federal Register (70 FR 70116), we
published a final rule with comment period entitled ``Medicare Program;
Revisions to Payment Policies Under the Physician Fee Schedule for
Calendar Year 2006 and Certain Provisions Related to the Competitive
Acquisition Program of Outpatient Drugs and Biologicals Under Part B.''
This correcting amendment corrects technical errors in the November 21,
2005 publication.
EFFECTIVE DATE: This correcting amendment is effective January 1, 2006.
FOR FURTHER INFORMATION CONTACT: Diane Milstead, (410) 786-3355.
SUPPLEMENTARY INFORMATION:
I. Background
FR Doc. 05-22160, entitled ``Medicare Program; Revisions to Payment
Policies Under the Physician Fee Schedule for Calendar Year 2006 and
Certain Provisions Related to the Competitive Acquisition Program of
Outpatient Drugs and Biologicals Under Part B'' and appearing in the
Federal Register on November 21, 2005 (70 FR 70116), addressed Medicare
Part B payment policy, including the physician fee schedule, that is
applicable for calendar year (CY) 2006; and finalized certain
provisions of the interim final rule to implement the Competitive
Acquisition Program (CAP) for Part B Drugs.
It also revised Medicare Part B payment and related policies
regarding: Physician work, practice expense and malpractice relative
value units (RVUs); Medicare telehealth services; multiple diagnostic
imaging procedures; covered outpatient drugs and biologicals;
supplemental payments to Federally Qualified Health Centers (FQHCs);
renal dialysis services; coverage for glaucoma screening services;
National Coverage Decision (NCD) timeframes; and physician referrals
for nuclear medicine services and supplies to health care entities with
which physicians have financial relationships.
In addition, the rule finalized the interim RVUs for CY 2005 and
issued interim RVUs for new and revised procedure codes for CY 2006.
This rule also updated the codes subject to the physician self-referral
prohibition and discussed payment policies relating to teaching
anesthesia services, therapy caps, private contracts and opt-out, and
chiropractic and oncology demonstrations.
We have identified a number of technical errors in that final rule
with comment period.
II. Summary of Errors
We are identifying and correcting errors made to certain parts of
the preamble, regulations text and addenda of the November 21, 2005
final rule with comment (70 FR 70116). In addition, addendum B, C, D, E
and F are revised under this correcting amendment, although these
addenda will not appear in the Code of Federal Regulations.
A. Summary of Preamble Errors
In the preamble text, there were a number of errors and omissions
beginning on pages 70150 through 70335.
1. On page 70150, in the first column, in the last paragraph under
Section m. (Additional PE Issues Raised by Commenters), in the second
sentence, the number of the CPT code referenced is incorrect.
2. On page 70155, in the center column, the last sentence of the
second paragraph under the discussion titled, ``3. Cardiac
Catheritization and Angioplasty Exception,'' there was an error in one
of the code ranges referenced.
3. On page 70263, in the third column; in last paragraph, the
reference to Table 26 is incorrect.
4. On page 70263, Table 26 was numbered incorrectly.
5. On page 70274, in the first column; in the second paragraph
language concerning the specific deleted practice
[[Page 9459]]
expense items was inadvertently omitted.
6. On page 70282, in the second column; from the top of the column,
lines 8 through 11, the sentence, ``We are assigning a status indicator
of N for these services because they are nonvcovered under Medicare.''
reflects an incorrect status indicator and will be revised.
7. On page 70282, in the third column; we inadvertently omitted a
paragraph before section F. (Establishment of Interim PE RVUs for New
and Revised Physician's Current Procedural Terminology (CPT) Codes and
New Healthcare Common Procedure Coding System (HCPCS) Codes for 2006).
8. On page 70296, in the second column; in the last paragraph, in
line 6, we incorrectly used the term ``PFS'', and that term will be
replaced.
9. On page 70302, in Table 35, the figures for Annual Actual
Expenditures and the Cumulative Actual Expenditures, for the period of
1/1/03-12/31/03, are incorrect and will be revised.
10. On page 70316, the first column, the percentage adjustment
referenced in the third complete sentence is incorrect and will be
revised.
11. On page 70320, the second footnote to Table 49 has incorrectly
listed the numerical scaler. This footnote will be corrected.
These corrections are reflected in Section III.A of this correcting
amendment.
B. Summary of Regulations Text Errors
In the regulation text, there were technical errors and omissions
in Sec. 405.2469, Sec. 414.190, Sec. 414.904, Sec. 414.906, and
Sec. 426.340.
1. On page 70329, in the third column, under Sec. 405.2469,
paragraph (a)(1) does not reflect the correct format for amendatory
language. Paragraph (a)(1) will be restructured.
2. On page 70331, in the third column, the reference to Sec.
414.190 is incorrect.
3. On page 70332, in the third column, the title (Basis for
payment.) for Sec. 414.904 is incorrect.
4. On page 70333, in the first column, under Sec. 414.906, we
inadvertently omitted a change to bring the regulations text into
conformity with our policy on updating CAP drug prices, as described in
the interim final rule with comment period published July 6, 2005.
5. On page 70335, in the first column, under Sec. 426.340, the
statutory references in paragraphs (e)(2)(ii) and (f)(2)(ii) are
incorrect.
The corrections are reflected in section III.B. of this correcting
amendment.
C. Summary of Addendum B, C, D, E and F Errors
1. In Addendum B, pages 70337 through 70463, we are making the
following corrections:
a. We assigned incorrect RVUs to the following Physicians' CPT or
HCPCS codes:
50000:
i. 52648;
60000:
ii. 61630, 61635;
80000:
iii. 88385-26, 88385-TC, 88385, 88386-26, 88386-TC, and 88386;
90000:
iv. 90760, 90761, 90765, 90766, 90767, 90768, 90772, 90773, 90774,
90775, 92626, 92627, 93514, 96401, 96402, 96405, 96406, 96409, 96411,
96413, 96415, 96416, 96417, 96420, 96440, 96450, 96521, 96522, 96542,
97606, 99300, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336,
and 99337.
b. We assigned an incorrect global period for CPT code 92627.
c. We assigned incorrect status indicators to the following CPT or
codes 0141T, 0142T, 0143T, 88385-26, 88385-TC, 88385, 88386-26, 88386-
TC, 88386, 96523, 98960, 98961, 98962 and 99340.
d. The following HCPCS codes were inadvertently included: G9041,
G9042, G9043 and G9044. These numbers should not have been included
because they were not in effect.
e. HCPCS code G0332 was inadvertently omitted from the addendum.
f. The first footnote to addendum B should be corrected to read
``\1\CPT codes and descriptions only. Copyright 2005 American Medical
Association. All Rights Reserved. Applicable FARS/DFARS apply.''
These corrections are reflected in Sections III.C.1. and 2. of this
correcting amendment.
2. In Addendum C, pages 70463 through 70466, we are making the
following corrections:
a. We assigned incorrect RVUs to the following CPT or alphanumeric
HCPCS number for service codes:
60000:
i. 61630 and 61635.
80000:
ii. 88385-26 and 88386-26.
90000:
iii. 90760, 90761, 90765, 90766, 90767, 90768, 90772, 90773, 90774,
90775, 92626, 92627, 96401, 96402, 96409, 96411, 96413, 96415, 96416,
96417, 96450, 96521, 96522, 96523, 96542, 99300, 99324, 99325, 99326,
99327, 99328, 99334, 99335, 99336 and 99337.
b. We assigned incorrect status indicators to the following CPT
codes 88385-26, 88386-26, 98960, 98961, 98962 and 99340.
These corrections are reflected in Section III.C.3 of this
correcting amendment.
3. In Addendum D, pages 70466 through 70467, we are correcting the
locality name ``Kansas*'' to read ``Kansas''.
These corrections are reflected in Section III.C.4 of this
correcting amendment.
4. In Addendum E, pages 70468 through 70469, we are correcting the
locality name ``Kansas*'' to read ``Kansas''.
These corrections are reflected in Section III.C.5 of this
correcting amendment.
5. In Addendum F, pages 70469 through 70471, we are correcting this
Addendum by replacing this Addendum in its entirety to address two
errors. First, we inadvertently left a discontinued HCPCS code, J1750,
on Addendum F. This code was replaced by J1751 and J1752 which are
found on Addendum G ``Revised New Drugs for CAP Bidding for 2006''.
Second, we included a new HCPCS code, J7318, which we understood would
replace HCPCS codes J7317 and J7320. HCPCS J7318 was not issued and
HCPCS codes J7317 & J3120 were retained. We have reweighted and
corrected Addendum F to reflect these changes.
These corrections are reflected in Section III.C.6 of this
correcting amendment.
III. Correction of Errors
In FR Doc. 05-22160, entitled ``Medicare Program; Revisions to
Payment Policies Under the Physician Fee Schedule for Calendar Year
2006 and Certain Provisions Related to the Competitive Acquisition
Program of Outpatient Drugs and Biologicals Under Part B,'' which
appeared in the Federal Register on November 21, 2005 (70 FR 70116),
make the following corrections:
A. Correction of Preamble Errors
1. On page 70150, in the first column; in the last paragraph under
Section m. (Additional PE Issues Raised by Commenters), in the second
sentence, the number ``99755'' is corrected to read ``97755''.
2. On page 70155, in the center column; the last sentence of the
second paragraph under the discussion titled, ``3. Cardiac
Catheterization and
[[Page 9460]]
Angioplasty Exception,'' the number ``93617'' is corrected to read
``93618''.
3. On page 70263, in the third column; in the last paragraph, the
phrase ``Table 26'' is corrected to read ``Table 26A''.
4. On page 70263, the table heading ``Table 26.--Example of
Payments'' is corrected to read ``Table 26A.--Example of Payments''.
5. On page 70274, in the first column; in the second paragraph, the
paragraph is corrected by adding a new sentence at the end of the
paragraph to read as follows: ``Because payment for the supplies and
equipment for both of these procedures is provided under a separate
DMERC policy, we have deleted the following practice expense items from
these codes: Supplies deleted include dressings, both Adaptic and
microporous, the drainage canister, and the sharp debridement kit--
which was identified as not being needed for the typical scenario; and,
the vacuum pump was deleted from the equipment.''
6. On page 70282, in the second column; lines 8 through 11, the
sentence, ``We are assigning a status indicator of N for these services
because they are noncovered under Medicare.'' is corrected to read,
``We are assigning a status indicator of B for these services because
payment for these services is bundled into payment for other Medicare
services.''
7. On page 70282, in the third column; we are adding a new
paragraph before section F. (Establishment of Interim PE RVUs for New
and Revised Physician's Current Procedural Terminology (CPT) Codes and
New Healthcare Common Procedure Coding System (HCPCS) Codes for 2006).
The new paragraph reads as follows: ``CPT code 99339 Individual
physician supervision of patient (patient not present) in home,
domiciliary or rest home (e.g., assisted living facility) requiring
complex and multidisciplinary care modalities involving regular
physician development and/or revision of care plans, review of
subsequent reports of patient status, review of related laboratory and
other studies, communication (including telephone calls) for purposes
of assessment care decisions with health care professional(s), family
member(s), surrogate decision maker(s) (e.g., legal guardian) and/or
key caregiver(s) involved in patient's care, integration of new
information into the medical treatment plan and/or adjustment of
medical therapy, within a calendar month; 15-29 minutes.
CPT code 99340 Individual physician supervision of patient (patient
not present) in home, domiciliary or rest home (e.g., assisted living
facility) requiring complex and multidisciplinary care modalities
involving regular physician development and/or revision of care plans,
review of subsequent reports of patient status, review of related
laboratory and other studies, communication (including telephone calls)
for purposes of assessment care decisions with health care
professional(s), family member(s), surrogate decision maker(s) (e.g.,
legal guardian) and/or key caregiver(s) involved inpatient's care,
integration of new information into the medical treatment plan and/or
adjustment of medical therapy, within a calendar month; 30 minutes or
more. We are assigning a status indicator of B for these codes because
payment for these services is bundled into payment for other
services.''
8. On page 70296, in the second column; in the last paragraph, in
line 6, the term ``PFS'' is corrected to read ``Code List''.
9. On page 70302, in Table 35; in the third column titled ``Annual
Actual Expenditures'', in line 10 (1/1/03-12/31/03) of that column,
``76.8'' is corrected to read ``78.2''; and in the fifth column titled
``Cumulative Actual Expenditures'', in line 10 (1/1/03-12/31/03) of
that column, ``460.6'' is corrected to read ``462.0''.
10. On page 70316, in the first column; in the third complete
sentence, the figure ``-0.6'' is corrected to read ``-0.15''.
11. On page 70320, in the second footnote to Table 49, the figure
``0.9984'' is corrected to read ``0.9985''.
B. Correction of Regulation Text Errors
List of Subjects
42 CFR Part 405
Administrative practice and procedure, Health facilities, Health
professions, Kidney diseases, Medical devices, Medicare, Reporting and
recordkeeping requirements, Rural areas, X-rays.
42 CFR Part 414
Administrative practice and procedure, Health facilities, Health
professions, Kidney diseases, Medicare, Reporting and recordkeeping
requirements.
42 CFR Part 426
Administrative practice and procedure, Medicare, Reporting and
recordkeeping requirements.
Given the errors summarized in section II.B. of this correcting
amendment, we are making the following correcting amendments to 42 CFR
parts 405, 414, and 426:
PART 405--FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED
0
1. The authority citation for part 405 continues to read as follows:
Authority: Secs. 1102, 1861, 1862(a), 1871, 1874, 1881, and
1886(k) of the Social Security Act (42 U.S.C. 1302, 1395x, 1395y(a),
1395hh, 1395kk, 1395rr, and 1395ww(k)), and sec. 353 of the Public
Health Service Act (42 U.S.C. 263a).
0
2. Section 405.2469 is amended by revising paragraph (a)(1) to read as
follows:
Sec. 405.2469 Federally Qualified Health Centers supplemental
payments.
* * * * *
(a) Calculation of supplemental payment. (1) The supplemental
payment for Federally Qualified Health Center covered services provided
to Medicare patients enrolled in Medicare Advantage plans is based on
the difference between--
(i) Payments received by the center from the Medicare Advantage
plan as determined on a per visit basis; and
(ii) The Federally Qualified Health Center's all-inclusive cost-
based per visit rate as set forth in this subpart, less any amount the
FQHC may charge as described in section 1857(e)(3)(B) of the Act.
* * * * *
PART 414--PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES
0
3. The authority citation for part 414 continues to read as follows:
Authority: Secs. 1102, 1871, and 1881(b)(1) of the Social
Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1)).
0
4. Section 414.906 is amended by revising paragraph (c)(1) introductory
text to read as follows:
Sec. 414.906 Competitive acquisition program as the basis of payment.
* * * * *
(c) Computation of payment amount. (1) Except as specified in
paragraph (c)(2) of this section, payment for CAP drugs is based on
bids submitted, as a result of the bidding process as described in
Sec. 414.910. Based on these bids, a single payment amount for each
CAP drug in the competitive acquisition area is determined on the basis
of the bids submitted and accepted and updated from the bidding period
to the payment year. This single payment amount is then updated on an
annual
[[Page 9461]]
basis based on the approved CAP vendor's reasonable net acquisition
costs for that category as determined by CMS, based, in part, on
information disclosed to CMS and limited by the weighted payment amount
established under section 1847A of the Act across all drugs for which a
composite bid is required in the category, and limited by the payment
amount established under section 1847A of the Act for each other drug
for which the approved CAP vendor submits a bid in accordance with
Sec. 414.910. Adjustment to the payment amounts may be made more often
than annually, but no more often than quarterly, in any of the
following cases:
* * * * *
PART 426--REVIEW OF NATIONAL COVERAGE DETERMINATIONS AND LOCAL
COVERAGE DETERMINATIONS
0
5. The authority citation for part 426 continues to read as follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
0
6. Section 426.340 is amended by revising paragraphs (e)(2)(ii) and
(f)(2)(ii) to read as follows:
Sec. 426.340 Procedures for review of new evidence.
* * * * *
(e) * * *
(2) * * *
(ii) For NCDs, in compliance with the timeframes specified in
section 1862(1) of the Act, by which CMS completes the reconsideration.
(f) * * *
(2) * * *
(ii) For NCDs, the reconsideration timeframe specified by the
Board, in compliance with section 1862(l) of the Act.
* * * * *
C. Correction of Addendum Errors
0
Given the errors summarized in Section II.C of this correcting
amendment, we are making the following corrections to Addendum B, C, D,
E, and F. These addenda will not appear in the Code of Federal
Regulations.
0
1. On pages 70337 through 70463, the following entries to Addendum B
are corrected to read as follows:
Addendum B.--Relative Value Units (RVUs) and Related Information--Continued
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Physician Nonfacility Facility PE Malpractice Nonfacility Facility
CPT 1/HCPCS 2 Mod Status Description work RVUs 3 PE RVUs RVUs RVUs total total Global
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
0141T................................. ..... I................ Perq islet transplant........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
0142T................................. ..... I................ Open islet transplant........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
0143T................................. ..... I................ Laparoscopic islet transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
52648................................. ..... A................ Laser surgery of prostate.... 11.19 74.15 4.80 0.79 86.07 16.78 090
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
61630................................. ..... N................ Intracranial angioplasty..... +21.08 NA 12.53 2.01 NA 35.62 090
61635................................. ..... N................ Intracran angioplasty w/stent +23.08 NA 13.58 2.20 NA 38.86 090
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
88385................................. 26 A................ Eval molecul probes, 51-250.. 1.50 0.65 NA 0.06 2.21 NA XXX
88385................................. TC A................ Eval molecul probes, 51-250.. 0.00 6.45 NA 0.06 6.51 NA XXX
88385................................. ..... A................ Eval molecul probes, 51-250.. 1.50 7.10 NA 0.12 8.72 NA XXX
88386................................. 26 A................ Eval molecul probes, 251-500. 1.88 0.82 NA 0.08 2.78 NA XXX
88386................................. TC A................ Eval molecul probes, 251-500. 0.00 6.23 NA 0.08 6.31 NA XXX
88386................................. ..... A................ Eval molecul probes, 251-500. 1.88 7.05 NA 0.16 9.09 NA XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
90760................................. ..... A................ Hydration iv infusion init... 0.17 1.43 NA 0.07 1.67 NA XXX
90761................................. ..... A................ Hydrate iv infusion, add-on.. 0.09 0.40 NA 0.04 0.53 NA ZZZ
90765................................. ..... A................ Ther/proph/diag iv inf, init. 0.2 11.76 NA 0.07 2.04 NA XXX
90766................................. ..... A................ Ther/proph/dg iv inf, add-on. 0.18 0.46 NA 0.04 0.68 NA ZZZ
90767................................. ..... A................ Tx/proph/dg addl seq iv inf.. 0.19 0.89 NA 0.04 1.12 NA ZZZ
90768................................. ..... A................ Ther/diag concurrent inf..... 0.17 0.44 NA 0.04 0.65 NA ZZZ
90772................................. ..... A................ Ther/proph/diag inj, sc/im... 0.17 0.31 NA 0.01 0.49 NA XXX
90773................................. ..... A................ Ther/proph/diag inj, ia...... 0.17 0.31 NA 0.02 0.50 NA XXX
90774................................. ..... A................ Ther/proph/diag inj, iv push. 0.18 1.30 NA 0.04 1.52 NA XXX
90775................................. ..... A................ Ther/proph/diag inj add-on... 0.10 0.57 NA 0.04 0.71 NA ZZZ
92626................................. ..... A................ Eval aud status rehab........ 0.00 2.20 NA 0.06 2.26 NA XXX
92627................................. ..... A................ Evallaud status rehab add-on. 0.00 0.55 NA .02 0.57 NA ZZZ
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
93514................................. ..... C................ Left heart catheterization... 0.00 0.00 0.00 0.00 0.00 0.00 000
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
96401................................. ..... A................ Chemo, anti-neopl, sq/im..... 0.2 11.17 NA 0.01 1.39 NA XXX
96402................................. ..... A................ Chemo hormon antineopl sq/im. 0.19 1.01 NA 0.01 1.21 NA XXX
96405................................. ..... A................ Chemo intralesional, up to 7. 0.52 2.44 0.24 0.03 2.99 0.79 000
96406................................. ..... A................ Chemo intralesional over 7... 0.80 3.02 0.29 0.03 3.85 1.12 000
96409................................. ..... A................ Chemo, iv push, sngl drug.... 0.24 2.93 NA 0.06 3.23 NA XXX
96411................................. ..... A................ Chemo, iv push, addl drug.... 0.20 1.61 NA 0.06 1.87 NA ZZZ
96413................................. ..... A................ Chemo, iv infusion, 1 hr..... 0.28 4.20 NA 0.08 4.56 NA XXX
96415................................. ..... A................ Chemo, iv infusion, addl hr.. 0.19 0.77 NA 0.07 1.03 NA ZZZ
96416................................. ..... A................ Chemo prolong infuse w/pump.. 0.21 4.61 NA 0.08 4.90 NA XXX
96417................................. ..... A................ Chemo iv infuse each addl seq 0.2 11.95 NA 0.07 2.23 NA ZZZ
96420................................. ..... A................ Chemo, ia, push technique.... 0.17 2.67 NA 0.08 2.92 NA XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
96440................................. ..... A................ Chemotherapy, intracavitary.. 2.37 8.15 1.23 0.17 10.693.77 000
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
96450................................. ..... A................ Chemotherapy, into CNS....... 1.53 6.97 1.29 0.09 8.59 2.91 000
96521................................. ..... A................ Refill/maint, portable pump.. 0.21 3.77 NA 0.06 4.04 NA XXX
96522................................. ..... A................ Refill/maint pump/resvr syst. 0.21 2.65 NA 0.06 2.92 NA XXX
96523................................. ..... A................ Irrig drug delivery device... 0.04 0.69 NA 0.01 0.74 NA XXX
96542................................. ..... A................ Chemotherapy injection....... 0.75 4.26 0.66 0.07 5.08 1.48 XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
97606................................. ..... A................ Neg press wound tx, >50 cm... 0.60 0.35 0.24 0.03 0.98 0.87 XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
[[Page 9462]]
Addendum B.--Relative Value Units (RVUs) and Related Information--Continued
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Physician Nonfacility Facility PE Malpractice Nonfacility Facility
CPT 1/HCPCS 2 Mod Status Description work RVUs 3 PE RVUs RVUs RVUs total total Global
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
98960................................. ..... B................ Self-mgmt educ & train, 1 pt. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
98961................................. ..... B................ Self-mgmt educ/train, 2-4 pt. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
98962................................. ..... B................ Self-mgmt educ/train, 5-8 pt. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
99300................................. ..... A................ lc, infant pbw 2501-5000 gm.. 2.40 NA 0.84 0.15 NA 3.35 XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
99324................................. ..... A................ Domicil/r-home visit new pat. 1.01 0.49 NA 0.05 1.55 NA XXX
99325................................. ..... A................ Domicil/r-home visit new pat. 1.52 0.68 NA 0.07 2.27 NA XXX
99326................................. ..... A................ Domicil/r-home visit new pat. 2.27 0.92 NA 0.10 3.29 NA XXX
99327................................. ..... A................ Domicil/r-home visit new pat. 3.03 1.17 NA 0.13 4.33 NA XXX
99328................................. ..... A................ Domicil/r-home visit new pat. 3.78 1.42 NA 0.16 5.36 NA XXX
99334................................. ..... A................ Domicil/r-home visit est pat. 0.76 0.40 NA 0.04 1.20 NA XXX
99335................................. ..... A................ Domicil/r-home visit est pat. 1.26 0.58 NA 0.06 1.90 NA XXX
99336................................. ..... A................ Domicil/r-home visit est pat. 2.02 0.82 NA 0.09 2.93 NA XXX
99337................................. ..... A................ Domicil/r-home visit est pat. 3.03 1.15 NA 0.13 4.31 NA XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
99340................................. ..... B................ Domicil/r-home care supervis. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
G0332................................. ..... A................ Preadmin IV immunoglobulin... 0.00 1.91 NA 0.00 1.91 NA XXX
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only. Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
\2\ Copyright 2005 American Dental Association. All Rights Reserved.
\3\ Indicates RVUs are not used for Medicare payment.
2. On page 70463, the following entries to Addendum B, G9041,
G9042, G9043, and G9044 are removed.
Addendum B.--Relative Value Units (RVUs) and Related Information--Continued
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Physician
CPT \1\/HCPCS \2\ Mod Status Description work RVUs Nonfacility Facility PE Malpractice Nonfacility Facility Global
\3\ PE RVUs RVUs RVUs total total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
G9041................................. ..... X................ Low vision rehab occupationa. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G9042................................. ..... X................ Low vision rehab orient/mobi. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G9043................................. ..... X................ Low vision lowvision therapy. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G9044................................. ..... X................ Low vision rehabilate teache. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only. Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
\2\ Copyright 2005 American Dental Association. All Rights Reserved.
\3\ +Indicates RVUs are not used for Medicare payment.
0
3. On pages 70463 through 70466, the following entries to Addendum C
are corrected to read as follows:
Addendum C.--Codes With Interim RVUs
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Physician
CPT \1\/ HCPCS \2\ Mod Status Description work RVUs Nonfacility Facility PE Malpractice Nonfacility Facility Global
\3\ PE RVUs RVUs RVUs Total Total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
61630................................. ..... N................ Intracranial angioplasty..... +21.08 NA 12.53 2.01 NA 35.62 090
61635................................. ..... N................ Intracran angioplasty w/stent +23.08 NA 13.58 2.20 NA 30.66 090
88385................................. 26 A................ Eval Molecul probes, 51-250.. 1.50 0.65 NA 0.06 2.21 NA XXX
88386................................. 26 A................ Eval Molecul probes, 251-500. 1.88 0.82 NA 0.08 2.78 NA XXX
90760................................. ..... A................ Hydration iv infusion, init.. 0.17 1.43 NA 0.07 1.67 NA XXX
90761................................. ..... A................ Hydrate iv infusion, add-on.. 0.09 0.40 NA 0.04 0.53 NA ZZZ
90765................................. ..... A................ Ther/proph/diag iv inf, init. 0.21 1.76 NA 0.07 2.04 NA XXX
90766................................. ..... A................ Ther/proph/dg iv inf, add-on. 0.18 0.46 NA 0.04 0.68 NA ZZZ
90767................................. ..... A................ Tx/proph/dg addl seq iv inf.. 0.19 0.89 NA 0.04 1.12 NA ZZZ
90768................................. ..... A................ Ther/diag concurrent inf..... 0.17 0.44 NA 0.04 0.65 NA ZZZ
90772................................. ..... A................ Ther/proph/diag inj, sc/im... 0.17 0.31 NA 0.01 0.49 NA XXX
90773................................. ..... A................ Ther/proph/diag inj, ia...... 0.17 0.31 NA 0.02 0.50 NA XXX
90774................................. ..... A................ Ther/proph/diag inj, iv push. 0.18 1.30 NA 0.04 1.52 NA XXX
90775................................. ..... A................ Ther/proph/diag inj add-on... 0.10 0.57 NA 0.04 0.71 NA ZZZ
92626................................. ..... A................ Eval aud status rehab........ 0.00 2.20 NA 0.06 2.26 NA XXX
92627................................. ..... A................ Evalaud status rehab add-on.. 0.00 0.55 NA 0.02 0.57 NA ZZZ
96401................................. ..... A................ Chemo, anti-neopl, sq/im..... 0.21 1.17 NA 0.01 1.39 NA XXX
96402................................. ..... A................ Chemo hormone antineopl sq/im 0.19 1.01 NA 0.01 1.21 NA XXX
96409................................. ..... A................ Chemo, iv push, sngl drug.... 0.24 2.93 NA 0.06 3.23 NA XXX
96411................................. ..... A................ Chemo, iv push, addl drug.... 0.20 1.61 NA 0.06 1.87 NA ZZZ
96413................................. ..... A................ Chemo, iv infusion, 1 hr..... 0.28 4.20 NA 0.08 4.56 NA XXX
96415................................. ..... A................ Chemo, iv infusion, addl hr.. 0.19 0.77 NA 0.07 1.03 NA ZZZ
96416................................. ..... A................ Chemo prolong infuse w/pump.. 0.21 4.61 NA 0.08 4.90 NA XXX
96417................................. ..... A................ Chemo iv infuse each addl seq 0.21 1.95 NA 0.07 2.23 NA ZZZ
96450................................. ..... A................ Chemotherapy, into CNS....... 1.53 6.97 1.29 0.09 8.59 2.91 000
[[Page 9463]]
96521................................. ..... A................ Refill/maint, portable pump.. 0.21 3.77 NA 0.06 4.04 NA XXX
96522................................. ..... A................ Refil/maint pump/resvr syst.. 0.21 2.65 NA 0.06 2.92 NA XXX
96523................................. ..... A................ Irrig drug delivery device... 0.04 0.69 NA 0.01 0.74 NA XXX
96542................................. ..... A................ Chemotherapy injection....... 0.75 4.26 0.66 0.07 5.08 1.48 XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
98960................................. ..... B................ Self-mgmt educ & train, 1 pt. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
98961................................. ..... B................ Self-mgmt educ/train, 2-4 pt. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
98962................................. ..... B................ Self-mgmt educ/train 5-8 pt.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
99300................................. ..... A................ Ic, infant pbw 2501-5000 gm.. 2.40 NA 0.84 0.15 NA 3.35 XXX
99324................................. ..... A................ Domicil/r-home visit new pat. 1.01 0.49 NA 0.05 1.55 NA XXX
99325................................. ..... A................ Domicil/r-home visit new pat. 1.52 0.68 NA 0.07 2.27 NA XXX
99326................................. ..... A................ Domicil/r-home visit new pat. 2.27 0.92 NA 0.10 3.29 NA XXX
99327................................. ..... A............... Domicil/r-home visit new pat. 3.03 1.17 NA 0.13 4.33 NA XXX
99328................................. ..... A................ Domicil/r-home visit new pat. 3.78 1.42 NA 0.16 5.36 NA XXX
99334................................. ..... A................ Domicil/r-home visit est pat. 0.76 0.40 NA 0.04 1.20 NA XXX
99335................................. ..... A................ Domicil/r-home visit est pat. 1.26 0.58 NA 0.06 1.90 NA XXX
99336................................. ..... A................ Domicil/r-home visit est pat. 2.02 0.82 NA 0.09 2.93 NA XXX
99337................................. ..... A................ Domicil/r-home visit est pat. 3.03 1.15 NA 0.13 4.31 NA XXX
..... ................. ............................. ........... ........... ........... ........... ........... ........... .................
99340................................. ..... B................ Domicil/r-home care supervis. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only. Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
\2\ Copyright 2005 American Dental Association. All Rights Reserved.
\3\ +Indicates RVUs are not used for Medicare payment.
0
4. On page 70467, in Addendum D, in the 11th entry, in the third
column, the locality ``Kansas*'' is corrected to read ``Kansas'' as
follows:
Addendum D.--2006 Geographic Practice Cost Indices by Medicare Carrier and Locality--Continued
----------------------------------------------------------------------------------------------------------------
Carrier Locality Locality name Work GPCI PE GPCI MP GPCI
----------------------------------------------------------------------------------------------------------------
00650............................... 00 Kansas................ 1.000 0.878 0.721
----------------------------------------------------------------------------------------------------------------
0
5. On page 70469, in Addendum E, in the fourth entry, in the third
column, the locality ``Kansas*'' is corrected to read ``Kansas'' as
follows:
Addendum E.--2006 GAFs--Continued
------------------------------------------------------------------------
Carrier Locality Locality name 2006 GAF
------------------------------------------------------------------------
00650........................ 00 Kansas......... 0.0936
------------------------------------------------------------------------
0
6. On pages 70469 through 70471, Addendum F, in its entirety, is
corrected to read as follows:
Addendum F.--Revised Single Drug Category List
------------------------------------------------------------------------
HCPCS Long description Weight
------------------------------------------------------------------------
J0150.......................... Injection, adenosine 0.00070000
for therapeutic use, 6
mg.
J0152.......................... Injection, adenosine 0.00459478
for diagnostic use, 30
mg.
J0170.......................... Injection, adrenalin, 0.00007897
epinephrine, 1 ml
ampule.
J0207.......................... Injection, amifostine, 0.00016099
500 mg.
J0215.......................... Injection, alefacept, 0.00083383
0.5 mg.
J0280.......................... Injection, 0.00082088
aminophyllin, 250 mg.
J0290.......................... Injection, ampicillin 0.00012657
sodium, 500 mg.
J0475.......................... Injection, baclofen, 10 0.00024643
mg.
J0540.......................... Injection, penicillin g 0.00007209
benzathine and
penicillin g procaine,
1,200,000 units.
J0550.......................... Injection, penicillin g 0.00001831
benzathine and
penicillin g procaine,
2,400,000 units.
J0570.......................... Injection, penicillin g 0.00004605
benzathine, 1,200,000
units.
J0585.......................... Botulinum toxin type A, 0.03743206
per unit.
J0587.......................... Botulinum toxin type B, 0.00150704
per 100 units.
J0600.......................... Injection, edetate 0.00004459
calcium disodium, 1000
mg.
J0637.......................... Injection, caspofungin 0.00008483
acetate, 5 mg.
J0640.......................... Injection, leucovorin 0.01064503
calcium, per 50 mg.
J0670.......................... Injection, mepivacaine 0.00038398
hydrochloride, per 10
ml.
[[Page 9464]]
J0690.......................... Injection, cefazolin 0.00042410
sodium, 500 mg.
J0692.......................... Injection, cefepime 0.00024846
hydrochloride, 500 mg.
J0696.......................... Injection, ceftriaxone 0.00668833
sodium, per 250 mg.
J0698.......................... Injection, cefotaxime 0.00014878
sodium, per gm.
J0702.......................... Injection, 0.00287709
betamethasone acetate
& betamethasone sodium
phosphate, per 3 mg.
J0704.......................... Injection, 0.00057059
betamethasone sodium
phosphate, per 4 mg.
J0735.......................... Injection, clonidine 0.00034149
hydrochloride, 1 mg.
J0800.......................... Injection, 0.00363945
corticotropin, 40
units.
J0881.......................... Injection, darbepoetin 0.15953454
alfa, 1 mcg (non-ESRD
use).
J0885.......................... Injection, epoetin 0.25136609
alpha, (for non ESRD
use), per 1000 units.
J0895.......................... Injection, deferoxamine 0.00024448
mesylate, 500 mg.
J1000.......................... Injection, depo- 0.00021013
estradiol cypionate, 5
mg.
J1020.......................... Injection, 0.00127329
methylprednisolone
acetate, 20 mg.
J1030.......................... Injection, 0.00593138
methylprednisolone
acetate, 40 mg.
J1040.......................... Injection, 0.00527803
methylprednisolone
acetate, 80 mg.
J1051.......................... Injection, 0.00006526
medroxyprogesterone
acetate, 50 mg.
J1094.......................... Injection, 0.00351268
dexamethasone acetate,
1 mg.
J1100.......................... Injection, 0.05492057
dexamethasone sodium
phosphate, 1 mg.
J1190.......................... Injection, dexrazoxane 0.00002444
hydrochloride, per 250
mg.
J1200.......................... Injection, 0.00216491
diphenhydramine hcl,
50 mg.
J1212.......................... Injection, DMSO, 0.00008475
dimethyl sulfoxide,
50%, 50 ml.
J1245.......................... Injection, 0.00383178
dipyridamole, per 10
mg.
J1250.......................... Injection, dobutamine 0.00053182
hydrochloride, per 250
mg.
J1260.......................... Injection, dolasetron 0.01737101
mesylate, 10 mg.
J1335.......................... Injection, ertapenem 0.00013263
sodium, 500 mg.
J1440.......................... Injection, filgrastim 0.00193572
(G-CSF), 300 mcg.
J1441.......................... Injection, filgrastim 0.00407388
(G-CSF), 480 mcg.
J1450.......................... Injection fluconazole, 0.00001609
200 mg.
J1580.......................... Injection, garamycin, 0.00039937
gentamicin, 80 mg.
J1600.......................... Injection, gold sodium 0.00005613
thiomalate, 50 mg.
J1626.......................... Injection, granisetron 0.01483731
hydrochloride, 100 mcg.
J1631.......................... Injection, haloperidol 0.00020702
decanoate, per 50 mg.
J1642.......................... Injection, heparin 0.06422737
sodium, (heparin lock
flush), per 10 units.
J1644.......................... Injection, heparin 0.00354562
sodium, per 1000 units.
J1645.......................... Injection, dalteparin 0.00011526
sodium, per 2500 iu.
J1650.......................... Injection, enoxaparin 0.00135618
sodium, 10 mg.
J1655.......................... Injection, tinzaparin 0.00047170
sodium, 1000 iu.
J1720.......................... Injection, 0.00013327
hydrocortisone sodium
succinate, 100 mg.
J1745.......................... Injection infliximab, 0.02762721
10 mg.
J1756.......................... Injection, iron 0.01026994
sucrose, 1 mg.
J1885.......................... Injection, ketorolac 0.00330082
tromethamine, per 15
mg.
J1940.......................... Injection, furosemide, 0.00065369
20 mg.
J1956.......................... Injection, 0.00008629
levofloxacin, 250 mg.
J2001.......................... Injection, lidocaine 0.00077528
hcl for intravenous
infusion, 10 mg.
J2010.......................... Injection, lincomycin 0.00062461
hcl, 300 mg.
J2150.......................... Injection, mannitol, 0.00029211
25% in 50 ml.
J2260.......................... Injection, milrinone 0.00004959
lactate, 5 mg.
J2300.......................... Injection, nalbuphine 0.00026341
hydrochloride, per 10
mg.
J2325.......................... Injection, nesiritide, 0.00027406
0.1 mg.
J2353.......................... Injection, octreotide, 0.00195107
depot form for
intramuscular
injection, 1 mg.
J2354.......................... Injection, octreotide, 0.00008412
non-depot subcutaneous
or intravenous
injection, 25 mcg.
J2405.......................... Injection, ondansetron 0.01373037
hydrochloride, per 1
mg.
J2430.......................... Injection, pamidronate 0.00156790
disodium, per 30 mg.
J2505.......................... Injection, 0.00065114
pegfilgrastim, 6 mg.
J2550.......................... Injection, promethazine 0.00068681
hcl, 50 mg.
J2680.......................... Injection, fluphenazine 0.00015113
decanoate, 25 mg.
J2765.......................... Injection, 0.00011134
metoclopramide hCL, 10
mg.
J2780.......................... Injection, ranitidine 0.00088550
hydrochloride, 25 mg.
J2820.......................... Injection, sargramostim 0.00217910
(GM-CSF), 50 mcg.
J2912.......................... Injection, sodium 0.00680009
chloride, 0.9%, per 2
ml.
J2916.......................... Injection, sodium 0.00061134
ferric gluconate
complex in sucrose
injection, 12.5 mg.
J2920.......................... Injection, 0.00031230
methylprednisolone
sodium succinate, 40
mg.
J2930.......................... Injection, 0.00077199
methylprednisolone
sodium succinate, 125
mg.
J2997.......................... Injection, alteplase 0.00012239
recombinant, 1 mg.
J3260.......................... Injection, tobramycin 0.00018292
sulfate, 80 mg.
J3301.......................... Injection, 0.02166537
triamcinolone
acetonide, per 10 mg.
J3302.......................... Injection, 0.00173214
triamcinolone
diacetate, per 5 mg.
J3303.......................... Injection, 0.00094603
triamcinolone
hexacetonide, per 5 mg.
J3315.......................... Injection, triptorelin 0.00000713
pamoate, 3.75 mg.
J3370.......................... Injection, vancomycin 0.00084187
hCL, 500 mg.
J3396.......................... Injection, verteporfin, 0.05438624
0.1 mg.
J3410.......................... Injection, hydroxyzine 0.00041004
hCL, 25 mg.
[[Page 9465]]
J3420.......................... Injection, vitamin B-12 0.01203050
cyanocobalamin, up to
1000 mcg.
J3475.......................... Injection, magnesium 0.00108505
sulfate, per 500 mg.
J3480.......................... Injection, potassium 0.00215709
chloride, per 2 meq.
J3487.......................... Injection, zoledronic 0.00336479
acid, 1 mg.
J7030.......................... Infusion, normal saline 0.00102834
solution, 1000 cc.
J7040.......................... Infusion, normal saline 0.00243166
solution, sterile (500
ml = 1 unit).
J7042.......................... 5% dextrose/normal 0.00049872
saline (500 ml = 1
unit).
J7050.......................... Infusion, normal saline 0.00993344
solution, 250 cc.
J7060.......................... 5% dextrose/water (500 0.00102860
ml = 1 unit).
J7070.......................... Infusion, D5W, 1000 cc. 0.00015894
J7120.......................... Ringers lactate 0.00016980
infusion, 1000 cc.
J7317.......................... Sodium hyaluronate, per 0.00191598
20 to 25 mg dose for
intra-articular
injection.
J7320.......................... Hylan G-F 20, 16 mg, 0.00149854
for intra articular
injection.
J9000.......................... Doxorubicin hCL, 10 mg. 0.00235846
J9001.......................... Doxorubicin 0.00032536
hydrochloride, all
lipid formulations, 10
mg.
J9031.......................... BCG (Intravesical) per 0.00049267
instillation.
J9040.......................... Bleomycin sulfate, 15 0.00003728
units.
J9045.......................... Carboplatin, 50 mg..... 0.00570096
J9050.......................... Carmustine, 100 mg..... 0.00000890
J9060.......................... Cisplatin, powder or 0.00095393
solution, per 10 mg.
J9062.......................... Cisplatin, 50 mg....... 0.00025430
J9065.......................... Injection, cladribine, 0.00008142
per 1 mg.
J9070.......................... Cyclophosphamide, 100 0.00062691
mg.
J9080.........................