Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015; Corrections, 14853-14870 [2015-06427]
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Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
period as corrected by this correction
document are available on the CMS Web
site at www.cms.gov/
PhysicianFeeSched/.
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
II. Summary of Errors
42 CFR Parts 403, 405, 410, 411, 412,
413, 414, 425, 489, 495, and 498
A. Summary of Errors in the Preamble
[CMS–1612–F2]
RIN 0938–AS12
Medicare Program; Revisions to
Payment Policies Under the Physician
Fee Schedule, Clinical Laboratory Fee
Schedule, Access to Identifiable Data
for the Center for Medicare and
Medicaid Innovation Models & Other
Revisions to Part B for CY 2015;
Corrections
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final rule; correcting
amendment.
AGENCY:
This document corrects
technical errors that appeared in the
final rule with comment period
published in the November 13, 2014
Federal Register (79 FR 67547–68092)
entitled, ‘‘Medicare Program; Revisions
to Payment Policies under the Physician
Fee Schedule, Clinical Laboratory Fee
Schedule, Access to Identifiable Data for
the Center for Medicare and Medicaid
Innovation Models & Other Revisions to
Part B for CY 2015.’’ The effective date
for the rule was January 1, 2015.
DATES: Effective date: This correcting
document is effective March 19, 2015.
Applicability date: The corrections
indicated in this document are
applicable beginning January 1, 2015.
FOR FURTHER INFORMATION CONTACT:
Christine Estella, (410) 786–0485, for
issues related to the physician quality
reporting system. Donta Henson, (410)
786–1947 for all other issues.
SUPPLEMENTARY INFORMATION:
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SUMMARY:
I. Background
In FR Doc. 2014–26183 (79 FR 67547
through 68092) the final rule entitled,
‘‘Medicare Program; Revisions to
Payment Policies under the Physician
Fee Schedule, Clinical Laboratory Fee
Schedule, Access to Identifiable Data for
the Center for Medicare and Medicaid
Innovation Models & Other Revisions to
Part B for CY 2015’’ (hereinafter referred
to as the CY 2015 PFS final rule with
comment period), there were a number
of technical errors that are identified
and corrected in section IV., Correction
of Errors. These corrections are
applicable as of January 1, 2015. We
note that the Addenda B and C to the
CY 2015 PFS final rule with comment
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On page 67559, due to errors made in
ratesetting, many of the values
contained in Table 4: Calculation of PE
RVUs Under Methodology for Selected
Codes, are incorrect.
On page 67562, in Table 8: Codes
Affected by Removal of Film Inputs, we
inadvertently included CPT codes
93320, 93321, and 93325.
On page 67591, we incorrectly stated
that in section II. G. of the rule, we
address the interim final values and
establish CY 2015 inputs for the lower
gastrointestinal procedures.
On page 67612, in Table 14: Codes
Reviewed by the 2014 Multi-Specialty
Refinement Panel, the work RVUs for
CPT codes 43204, 43205, and 43233 are
incorrect.
On page 67633, due to a typographical
error we referred to CPT code 41391
rather than CPT code 43391.
On page 67636, due to a technical
error, the final work RVU for code
43278 is incorrect.
On pages 67651 through 67663, in
Table 25: CY 2015 Interim Final Work
RVUS For New/Revised or Potentially
Misvalued Codes, the RUC/HCPAC
recommended work RVUs listed on
page 67658 for CPT codes 76932 and
76948 are incorrect and entries for CPT
codes 76940 and 76965 were
inadvertently omitted from the table.
On page 67660, the RUC/HCPAC
recommended work RVU listed for CPT
code 92545 is incorrect.
On page 67668,
a. We inadvertently omitted G0279
from the list of codes in the title of (13).
b. Due to a typographical error, G0279
is referred to as G–2079.
c. We inadvertently omitted the
phrase ‘‘, whether or not a 2–D
mammography is furnished’’ from the
sentence beginning, ‘‘In addition, we are
creating . . .’’
On page 67669, we inadvertently
listed CPT code 93644 in the title of
(18).
On page 67671, in Table 28: CY 2015
Interim Final Codes with Direct PE
Input Recommendations Accepted
without Refinement, we inadvertently
listed CPT code 31620.
On page 67673, in Table 29: Invoices
Received for New Direct PE Inputs we
inadvertently listed entries associated
with CPT code 31620.
On page 67674, in Table 30: Invoices
Received For Existing Direct PE Inputs,
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14853
certain PE direct inputs for CPT code
31627 were inadvertently omitted.
On pages 67678 through 67711, in
Table 31: CY 2015 Interim Final Codes
With Direct PE Input Recommendations
Accepted with Refinements, due to
technical errors, on page 67678, entries
associated with CPT codes 77061 and
77062 were inadvertently listed; on page
67702, entries associated with CPT
codes 93320, 93321, and 93325 were
inadvertently omitted and an input code
for CPT code 93880 was inadvertently
omitted.
On page 67726, we incorrectly stated
that practitioners do not have to use any
‘‘specific content exchange standard.’’
On pages 67741 through 67742, we
incorrectly stated the CY 2015 PFS
conversion factors.
On page 67742, in Table 45:
Calculation of the CY 2015 PFS CF, due
to corrections being made in this
document, the CY 2014 budget
neutrality adjustment, the CY 2015 CFs,
and the percentage changes from the CY
2014 CF stated in the table are incorrect.
On page 67743, due to technical
errors, the budget neutrality factor, the
anesthesia CF in effect from January 1,
2015 through March 31, 2015, and the
anesthesia CF in effect from April 1,
2015 through December 31, 2015 are
incorrectly stated. The entries in Table
46: Calculation of the CY 2015
Anesthesia CF for budget neutrality
adjustments, CFs and percentage change
are inaccurate.
On pages 67803 and 67804, in Table
52: Individual Quality Cross-Cutting
Measures for the PQRS to Be Available
for Satisfactory Reporting Via Claims,
Registry, and EHR Beginning in 2015,
we inadvertently listed the incorrect
National Quality Strategy (NQS) domain
for Physician Quality Reporting System
(PQRS) Measure 131, Pain Assessment
and Follow-Up.
On pages 67848 and 67849, in Table
55: Measures Being Removed from the
Existing PQRS Measure Set Beginning
in 2015, we inadvertently omitted
adding an ‘‘X’’ to the claims reporting
option for Physician Quality Reporting
System (PQRS) Measure 0091/051:
Chronic Obstructive Pulmonary Disease
(COPD): Spirometry Evaluation,
Measure 0102/052: Chronic Obstructive
Pulmonary Disease (COPD): Inhaled
Bronchodilator Therapy, and Measure
0050/109: Osteoarthritis (OA) Function
and Pain Assessment.
On page 67854, in Table 56: Existing
Individual Quality Measures and Those
Included in Measures Groups for the
PQRS for Which Measure Reporting
Updates Will Be Effective Beginning in
2015, we inadvertently added an ‘‘X’’ to
the Group Practice Reporting Option
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(GPRO) Web Interface reporting option
for Physician Quality Reporting System
(PQRS) Measure 0067/006: Coronary
Artery Disease (CAD): Antiplatelet
Therapy.
On page 67877, in Table 56: Existing
Individual Quality Measures and Those
Included in Measures Groups for the
PQRS for Which Measure Reporting
Updates Will Be Effective Beginning in
2015, we inadvertently added an ‘‘X’’ to
the claims reporting option and omitted
adding an ‘‘X’’ to the registry reporting
option for Physician Quality Reporting
System (PQRS) Measure 0409/205: HIV/
AIDS: Sexually Transmitted Disease
Screening for Chlamydia, Gonorrhea,
and Syphilis.
On page 67988, in Table 93: CY 2015
PFS Final Rule with Comment Period
Estimated Impact Table: Impacts of
Work, Practice Expense, and
Malpractice RVUs, due to ratesetting
errors, the values are inaccurate.
On page 67991 through 67992, in
Table 94: Impact of the Final Rule with
Comment Period on CY 2014 Payment
for Selected Procedures, due to
ratesetting errors, the stated payment
rates are inaccurate.
On page 67999, the January 1–March
31, 2015 CF, the CY 2015 national
payment amount in the nonfacility
setting for CPT code 99203, and the
beneficiary coinsurance amount are
incorrect.
B. Summary and Correction of Errors in
the Addenda on the CMS Web Site
Due to the errors identified and
summarized in section II.A and B of this
correction document, we are correcting
errors in the work, PE or MP RVUs (or
combinations of these RVUs) in
Addendum B: CY 2015 Relative Value
Units (RVUs) And Related Information
Used In Determining Final Medicare
Payments and Addendum C: CY 2015
Interim Final Relative Value Units
(RVUs). We note that corrections to the
RVUs for codes with identified errors
affect additional codes due to the budget
neutrality and relativity of the PFS.
These errors are corrected in the revised
Addenda B and C available on the CMS
Web site at www.cms.gov//
PhysicianFeeSched/.
In addition to the errors identified in
section II.A. of this correction
document, the following errors occur in
the addenda.
Due to a technical error in the
creation of the direct PE database,
nonfacility PE RVUs were created and
displayed in Addendum B (and
Addendum C, if applicable) for the
following CPT codes: 21811, 21812,
21813, 22858, 33418, 33951, 33952,
33953, 33954, 33955, 33956, 33957,
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33958, 33959, 33962, 33963, 33964,
33965, 33966, 33969, 33984, 33985,
33986, 33987, 33988, 33989, 37218,
43180, 44380, 44382, 66179, and 66184.
These errors are corrected in the revised
Direct PE Input Database available on
the CMS Web site at www.cms.gov//
PhysicianFeeSched/. Resulting changes
to the PE RVUs are reflected in the
corrected Addendum B (and Addendum
C, if applicable) available on the CMS
Web site at www.cms.gov//
PhysicianFeeSched/.
Due to technical errors in the creation
of the direct PE database, some or all of
the PE inputs were inadvertently
omitted for CPT codes 22510, 22511,
22512, 22513, 22514, 22515, 31620,
33951, 33952, 33953, 33954, 33955,
33956, 33957, 33958, 33959, 33962,
33963, 33964, 33969, 33984, 33985,
33986, 33988, 33989, 58541, 58542,
58543, 58544, 58570, 58571, 58572,
64486, 64487, 64488, 64489, 70496,
70498, 76700, 76705, 77080, 88348,
93260, 93261, and 93644. These errors
are corrected in the revised Direct PE
Input Database available on the CMS
Web site at www.cms.gov//
PhysicianFeeSched/.
Due to technical errors in the creation
of the direct PE database, the incorrect
inputs were used for creating PE RVUs
for CPT codes 20982, 31620, 31627,
32998, 33262, 32998, 41530, 50592,
64600, 64605, 64610, 64633, 64634,
64635, 64636, 93925, 93880, and 93990.
These errors are corrected in the revised
Direct PE Input Database available on
the CMS Web site at www.cms.gov//
PhysicianFeeSched/.
Due to a technical error, we
incorrectly displayed in Addenda B and
C PE RVUs in a nonfacility setting for
CPT codes 33270, 33271, 33272, and
33273. The PE RVUs for these codes in
a non-facility setting have been removed
in the corrected Addenda B and C
available on the CMS Web site at
www.cms.gov//PhysicianFeeSched/.
Due to a technical error, HCPCS codes
33330, 33474, 61610, and 61870 were
inadvertently left out of Addendum B.
These codes are reflected in the
corrected Addendum B available on the
CMS Web site at www.cms.gov//
PhysicianFeeSched/.
Due to a technical error, the average
risk factor, and not the specialty risk
factor that we indicated that we were
using in the preamble, was applied
when calculating the MP RVUs for CPT
codes 33620 and 33622. As a result, the
MP RVUs listed in Addendum B are
incorrect for these codes. We have
corrected these errors in the corrected
Addendum B available on the CMS Web
site at www.cms.gov//
PhysicianFeeSched/.
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Due to a technical error, the incorrect
work RVUs were applied in calculating
the MP RVUs for CPT codes 33418 and
33419. As a result, the MP RVUs listed
in Addenda B and C are incorrect for
these codes. We have corrected these
errors in the corrected Addenda B and
C available on the CMS Web site at
www.cms.gov//PhysicianFeeSched/.
Due to a technical error, the incorrect
CY 2015 work RVUs are included in
Addendum B (and Addendum C, if
applicable) for the following codes:
43191, 43192, 43193, 43194, 43195,
43196, 43197, 43198, 43200, 43201,
43202, 43204, 43205, 43211, 43212,
43214, 43215, 43229, 43232, 43233,
43235, 43236, 43238, 43239, 43242,
43247, 43253, 43254, 43257, 43266,
43270, 43274, 43276, 43278, 58541,
58542, 58543, 58544, 58570, 58571,
58572, 58573, 71275, 76930, 76932,
76948, 92545, 93315, 93317, 93318, and
95973. The correct CY 2015 work RVUS
for these codes are reflected in the
corrected Addenda B and C available on
the CMS Web site at www.cms.gov//
PhysicianFeeSched/.
Due to a technical error in the
creation of the direct PE database, PE
RVUs for the facility setting were
created and are displayed in Addendum
B for HCPCS code 77372 and Addenda
B and C for HCPCS code G0277. These
technical errors are corrected in
Addenda B and C available on the CMS
Web site at www.cms.gov//
PhysicianFeeSched/.
Due to technical errors in the creation
of the direct PE database, direct PE
inputs were inadvertently included for
CPT code 99183 and are reflected in the
PE RVUs shown in Addenda B and C.
This error is corrected in the Direct PE
Input Database available on the CMS
Web site at www.cms.gov//
PhysicianFeeSched/. The corrected PE
RVUS are included in Addenda B and
C available on the CMS Web site at
www.cms.gov//PhysicianFeeSched/.
Due to a technical error, in
Addendum B, work and MP RVUs for
CPT codes 99487 and 99489 were
inadvertently included. The work and
MP RVUs for these codes have been
removed in the corrected Addendum B
available on the CMS Web site at
www.cms.gov//PhysicianFeeSched/.
Due to a technical error in the
creation of the direct PE database, PE
RVUs were not created for CPT code
99490 in the facility setting. The correct
PE RVU for this code is reflected in the
corrected Addendum B available on the
CMS Web site at www.cms.gov//
PhysicianFeeSched/.
Due to a technical error, HCPCS codes
G9407 through G9472 are inadvertently
included in Addendum B. These codes
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have been removed in the corrected
Addendum B available on the CMS Web
site at www.cms.gov//
PhysicianFeeSched/.
C. Summary of Errors in the Regulations
Text
On page 68002 of the CY 2015 PFS
final rule with comment period, we
made a technical error in § 410.26(b)(5).
In this paragraph, we inadvertently
omitted language to limit the
applicability of the exception that
allows general, rather than direct,
supervision of transitional care
management services furnished incident
to a practitioner’s professional services
to the non-face-to-face aspects of the
service.
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III. Waiver of Proposed Rulemaking
and Delay in Effective Date
Under 5 U.S.C. 553(b) of the
Administrative Procedure Act (APA),
the agency is required to publish a
notice of the proposed rule in the
Federal Register before the provisions
of a rule take effect. Similarly, section
1871(b)(1) of the Act requires the
Secretary to provide for notice of the
proposed rule in the Federal Register
and provide a period of not less than 60
days for public comment. In addition,
section 553(d) of the APA, and section
1871(e)(1)(B)(i) of the Act mandate a 30day delay in effective date after issuance
or publication of a rule. Sections
553(b)(B) and 553(d)(3) of the APA
provide for exceptions from the notice
and comment and delay in effective date
APA requirements; in cases in which
these exceptions apply, sections
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1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the
Act provide exceptions from the notice
and 60-day comment period and delay
in effective date requirements of the Act
as well. Section 553(b)(B) of the APA
and section 1871(b)(2)(C) of the Act
authorize an agency to dispense with
normal rulemaking requirements for
good cause if the agency makes a
finding that the notice and comment
process are impracticable, unnecessary,
or contrary to the public interest. In
addition, both section 553(d)(3) of the
APA and section 1871(e)(1)(B)(ii) of the
Act allow the agency to avoid the 30day delay in effective date where such
delay is contrary to the public interest
and an agency includes a statement of
support.
In our view, this correction document
does not constitute a rulemaking that
would be subject to these requirements.
This correction document corrects
technical errors in the CY 2015 PFS
final rule with comment period and the
corresponding addenda posted on the
CMS Web site. The corrections
contained in this document are
consistent with, and do not make
substantive changes to, the policies and
payment methodologies that were
adopted subjected to notice and
comment procedures in the CY 2015
PFS final rule with comment period. As
a result, the corrections made through
this correction document are intended
to ensure that the CY 2015 PFS final
rule with comment period accurately
reflects the policies adopted in that rule.
Even if this were a rulemaking to
which the notice and comment and
delayed effective date requirements
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14855
applied, we find that there is good cause
to waive such requirements.
Undertaking further notice and
comment procedures to incorporate the
corrections in this document into the
CY 2015 PFS final rule with comment
period or delaying the effective date of
the corrections would be contrary to the
public interest because it is in the
public interest to ensure that the CY
2015 PFS final rule with comment
period accurately reflects our final
policies as soon as possible following
the date they take effect. Further, such
procedures would be unnecessary,
because we are not altering the payment
methodologies or policies, but rather,
we are simply correcting the Federal
Register document to reflect the policies
that we previously proposed, received
comment on, and subsequently
finalized. This correcting document is
intended solely to ensure that the CY
2015 PFS final rule with comment
period accurately reflects these policies.
For these reasons, we believe there is
good cause to waive the requirements
for notice and comment and delay in
effective date.
IV. Correction of Errors
In FR Doc. 2014–26183 of November
13, 2014 (79 FR 67547), make the
following corrections:
A. Correction of Errors in the Preamble
1. On page 67559, in Table 4:
Calculation of PE RVUs Under
Methodology for Selected Codes, the
table is corrected to read as follows:
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Step 1 .................
Step 1 .................
Step 1 .................
Step 1 .................
Steps 2–4 ...........
Steps 2–4 ...........
Steps 2–4 ...........
Steps 2–4 ...........
Steps 2–4 ...........
Step 5 .................
Step 5 .................
Labor cost (Lab) ........................
Supply cost (Sup) ......................
Equipment cost (Eqp) ................
Direct cost (Dir) .........................
Direct adjustment (Dir. Adj.) ......
Adjusted Labor ..........................
Step
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Step 5 .................
Step 5 .................
Setup File ...........
Steps 6,7 ............
Steps 6,7 ............
Step 8 .................
Step 8 .................
Step 8 .................
Step 8 .................
Step 8 .................
Steps 9–11 .........
Steps 9–11 .........
Steps 12–16 .......
Step 17 ...............
Step 18 ...............
(13) Adj. equipment cost converted
Adj. direct cost converted ........
Work RVU ................................
Dir_pct ......................................
Ind_pct .....................................
Ind. Alloc. Formula (1st part) ...
Ind. Alloc. (1st part) .................
Ind. Alloc. Formula (2nd part) ..
Ind. Alloc. (2nd part) ................
Indirect Allocator (1st + 2nd) ...
Indirect Adjustment (Ind. Adj.)
Adjusted Indirect Allocator .......
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
(25) Ind. Practice Cost Index (IPCI)
(26) Adjusted Indirect ......................
(27) Final PE RVU ..........................
.............................
See Step 8 .........
.............................
.............................
See Footnote * * ..
’%=Ind Alloc * Ind
Adj.
.............................
’%= Adj.Ind
Alloc * PCI.
’%=(Adj Dir + Adj
Ind) * Other Adj.
’%=((14)+(26)) *
Other Adj)
..............................
’%=(24) * (25)
See 18
..............................
See 20
’%=(19)+(21)
..............................
..............................
’%=(11)+(12)+(13)
..............................
..............................
..............................
..............................
’%=(8)/(10)
’%=(7)/(10)
’%=(2) * (5)
’%=(3) * (5)
’%=(6)+(7)+(8)
..............................
’%=(6)/(10)
..............................
..............................
..............................
’%=(1)+(2)+(3)
..............................
’%=(1) * (5)
Formula
1.01
1.07
0.74
0.27
0.97
0.25
0.75
(14)/
(16) * (17)
0.83
¥15%
0.97
1.8
0.3829
0.69
0
0.05
1.78
0.1
9.81
35.8228
0.22
13.32
2.98
0.17
16.48
0.5953
7.93
99213 Office visit, est
non-facility
12.99
0.75
11.64
1.42
33.75
0.17
0.83
(14)/
(16) * (17)
6.73
¥15%
33.75
40.48
0.3829
15.5
0.01
0.12
4.37
0.35
50.87
35.8228
1.29
77.52
7.34
0.58
85.45
0.5953
46.15
33533
CABG, arterial, single
facility
0.54
0.99
0.32
0.22
0.22
0.29
0.71
(14)/
(16) * (17)
0.53
%(15+11)
0.32
0.85
0.3829
0.33
0.11
0.01
0.32
4.12
7.85
35.8228
0.1
5.74
0.53
6.92
13.19
0.5953
3.42
71020
Chest x-ray
non-facility
Note: PE RVUs in Table 4, row 27, may not match Addendum B due to rounding.
* The direct adj = [current pe rvus * CF * avg dir pct]/[sum direct inputs] = [step2]/[step3]
* * The indirect adj = [current pe rvus * avg ind pct]/[sum of ind allocators] = [step9]/[step10]
Note: The use of any particular conversion factor (CF) in Table 4 to illustrate the PE Calculation has no effect on the resulting RVUs.
Step 5 .................
(12) Adj. supply cost converted ......
AMA ....................
AMA ....................
AMA ....................
.............................
See footnote * .....
’%=Labor * Dir
Adj.
’%=Eqp * Dir Adj
’%=Sup * Dir Adj
.............................
PFS ....................
’%=(Lab * Dir
Adj)/CF.
’%=(Sup * Dir
Adj)/CF.
’%=(Eqp * Dir
Adj)/CF.
.............................
PFS ....................
Surveys ..............
Surveys ..............
See Step 8 .........
Source
0.46
0.99
0.24
0.22
0
0.29
0.71
(14)/
(16) * (17)
0.53
¥11%
0.1
0.63
0.3829
0.24
0.11
0.01
0.32
4.12
7.85
35.8228
0.1
5.74
0.53
6.92
13.19
0.5953
3.42
71020–TC
Chest x-ray,
non-facility
0.08
0.99
0.08
0
0.22
0.29
0.71
(14)/
(16) * (17)
0
¥15%
0.22
0.22
0.3829
0.08
0
0
0
0
0
35.8228
0
0
0
0
0
0.5953
0
71020–26
Chest x-ray,
non-facility
TABLE 4—CALCULATION OF PR RVUS UNDER METHODOLOGY FOR SELECTED CODES
(7) Adjusted Supplies ......................
(8) Adjusted Equipment ..................
(9) Adjusted Direct ..........................
(10) Conversion Factor (CF) ...........
(11) Adj. labor cost converted .........
(1)
(2)
(3)
(4)
(5)
(6)
Factor (CF) (2nd part)
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0.29
0.91
0.18
0.11
0.17
0.29
0.71
(14)/
(16) * (17)
0.26
%(15+11)
0.25
0.52
0.3829
0.2
0
0.02
0.71
0.05
3.8
35.8228
0.08
5.1
1.19
0.09
6.38
0.5953
3.04
93000 ECG,
complete,
non-facility
0.23
0.91
0.12
0.11
0
0.29
0.71
(14)/
(16) * (17)
0.26
¥11%
0.08
0.35
0.3829
0.13
0
0.02
0.71
0.05
3.8
35.8228
0.08
5.1
1.19
0.09
6.38
0.5953
3.04
93005 ECG,
tracing, nonfacility
0.06
0.91
0.06
0
0.17
0.29
0.71
(14)/
(16) * (17)
0
¥15%
0.17
0.17
0.3829
0.07
0
0
0
0
0
35.8228
0
0
0
0
0
0.5953
0
93010 ECG,
report nonfacility
14856
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E:\FR\FM\20MRR1.SGM
20MRR1
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
2. On page 67562, in Table 8: Codes
Affected by Removal of Film Inputs, the
following listed entries are removed.
HCPCS
93320 ........
93321 ........
93325 ........
Short descriptor
Doppler echo exam heart
Doppler echo exam heart
Doppler color flow add-on
3. On page 67591, third column, first
full paragraph, line 10, the sentence ‘‘In
section II.G. of this CY 2015 PFS final
rule with comment period, we address
interim final values and establish CY
2015 inputs for the lower
gastrointestinal procedures, many of
which are also listed in Appendix G.’’
is corrected to read ‘‘In section II.G. of
this CY 2015 PFS final rule with
Descriptor
43204 ........
Injection of dilated esophageal veins using an endoscope.
Tying of esophageal veins using an endoscope .............
Balloon dilation of esophagus, stomach, and/or upper
small bowel using an endoscope.
5. On page 67633, third column, first
full paragraph, line 14, the phrase ‘‘CPT
code 41391,’’ is corrected to read ‘‘CPT
code 43391,’’.
6. On page 67636, third column, first
partial paragraph, lines 24 through 25,
comment period, we note that we are
delaying the adoption of the new code
set for lower gastrointestinal procedures
until CY 2016; many of these codes are
also listed in Appendix G.’’
4. On page 67612, in Table 14: Codes
reviewed by the 2014 Multi-Specialty
Refinement Panel, the entries for CPT
codes 43204, 43205 and 43233 are
corrected to read as follows:
CY 2014
interim final
work RVU
HCPCS
code
43205 ........
43233 ........
14857
RUC
recommended
work RVU
Refinement
panel
median rating
CY 2015 work
RVU
2.40
2.89
2.77
2.43
2.51
4.05
3.00
4.45
2.88
4.26
2.54
4.17
the sentence ‘‘The final work RVU for
CPT code 43278 is 8.’’ is corrected to
read ‘‘The final work RVU for CPT code
43278 is 8.02.’’
7. On pages 67651 through 67663, in
Table 25: CY 2015 Interim Final Work
RVUS For New/Revised or Potentially
Misvalued Codes, the listed entries on
page 67658 are corrected to read:
HCPCS
code
Long descriptor
CY 2014
WRVU
RUC/HCPAC
recommended
work RVU
CY 2015 work
RVU
CMS time
refinement
76932 ........
Ultrasonic guidance for endomyocardial biopsy, imaging
supervision and interpretation.
Ultrasound guidance for, and monitoring of, parenchymal tissue ablation.
Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation.
Ultrasonic guidance for interstitial radioelement application.
C
0.67
0.67
No
2.00
2.00
2.00
No
0.38
0.38
0.38
No
1.34
1.34
1.34
No
76940 ........
76948 ........
76965 ........
8. On page 67660, in Table 25: CY
2015 Interim Final Work RVUS For
New/Revised or Potentially Misvalued
Codes, the listed entry is corrected to
read:
Long descriptor
CY 2014
WRVU
RUC/HCPAC
recommended
work RVU
CY 2015 work
RVU
CMS time
refinement
92545 ........
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HCPCS
code
Oscillating tracking test, with recording ...........................
0.23
0.25
0.25
No
9. On page 67668,
a. First column, line 1, the title ‘‘(13)
Breast Tomosynthesis (CPT codes
77061, 77062, and 77063)’’ is corrected
to read ‘‘(13) Breast Tomosynthesis (CPT
codes 77061, 77062, 77063 and
G2079)’’.
b. Second column, line 19, the phrase
‘‘a new code, G–2079’’ is corrected to
read ‘‘a new code, G0279’’.
c. Second column, line 27, is
corrected by adding ‘‘whether or not a
2-D mammography is furnished’’ after
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the phrase ‘‘diagnostic breast
tomosynthesis’’.
10. On page 67669, second column,
lines 8 through 11, we are correcting the
title ‘‘(18) Interventional
Transesophageal Echocardiography
(TEE) (CPT Codes 93312, 93313, 93314,
93315, 93316, 93317, 93318, 93355, and
93644)’’ to read ‘‘(18) Interventional
Transesophageal Echocardiography
(TEE) (CPT Codes 93312, 93313, 93314,
93315, 93316, 93317, 93318, and
93355).’’
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11. On page 67671, in Table 28: CY
2015 Interim Final Codes with Direct PE
Input Recommendations Accepted
without Refinements, the following
listed entry is removed:
HCPCS
31620 ........
Short descriptor
Endobronchial us add-on
12. On page 67673, in Table 29:
Invoices Received for New Direct PE
Inputs, the following listed entries for
CPT code 31620 are removed:
E:\FR\FM\20MRR1.SGM
20MRR1
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Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
CPT/HCPCS codes
Item name
CMS code
Average price
Number of
invoices
Non-facility allowed services
for HCPCS codes using this
item (or projected services for
new CPT codes*)
31620 ........................
Flexible dual-channeled EBUS bronchoscope, with radial probe.
Video system, Ultrasound (processor,
digital capture, monitor, printer, cart).
EBUS, single use aspiration needle, 21
g.
Balloon for Bronchosopy Fiberscope ....
EQ361
$160,260.06 .....
6
107
ER099
$13,379.57 .......
6
107
SC102
$145.82 ............
5
107
SD294
$28.68 ..............
4
107
31620 ........................
31620 ........................
31620 ........................
13. On page 67674, Table 30: Invoices
Received for Existing Direct PE Inputs,
the list entries for CPT code 31627 are
corrected by adding the following:
Updated price
%
Change
Number
of
invoices
Non-facility allowed services
for HCPCS
codes using this
item
$1.10 ............................
$3.00 ............................
173
2
37
EQ326
$137,800.00 .................
$189,327.66 .................
37
4
37
SA097
$995.00 ........................
$1,063.67 .....................
7
3
37
CPT/HCPCS
codes
Item name
CMS code
Current price
31627 ..............
sensor, patch,
bronchosopy
(for kit,
locatable
guide) (patient).
system, navigational
bronchoscopy
(superDimension).
kit, locatable
guide, ext.
working
channel, wb-scope
adapter.
SD235
31627 ..............
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31627 ..............
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14859
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
HCPCS
Code
HCPCS
Code
Description
Breast
tomosynthes
Accepted with Refinements, we are
correcting the table by
Labor
Activity
(where
applicable)
a. On page 67687, deleting the
following listed entries:
RUC
Recomme
nd-ation
or current
value (min
or qty)
CMS
Refine
-ment
(min
or
qty)
Input
Code
Input Code
Description
NF/F
/PO
L043
Mammography
Technologist
NF
Availability
of prior
images
confirmed
3
2
NF
Availability
of prior
images
confirmed
3
2
A
lSUlll
77061
Breast
tomosynthes
is bi
L043
A
Mammography
Technologist
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77062
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E:\FR\FM\20MRR1.SGM
20MRR1
Comment
Direct
Costs
Change
Standard
times for
clinical
labor
tasks
associated
with
digital
imaging
Standard
times for
clinical
labor
tasks
associated
with
digital
imaging
$-0.43
$-0.43
ER20MR15.015</GPH>
14. On pages 67678 through 67711, in
Table 31: CY 2015 Interim Final Codes
With Direct PE Input Recommendations
14860
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
b. On page 67702, correcting the
bottom half of the table to read:
HCPCS
Code
Description
Input
Code
Input Code
Description
NF/F/
PO
)
RUC
Recommendation
or current
value (min
or qty)
CMS
Refine
-ment
(min
or
qty)
93321
93321
93325
93325
computer,
desktop, wmonitor
NF
5
0
Doppler
echo exam
heart
ED036
NF
14
0
Doppler
echo exam
heart
ED021
video printer,
color (Sony
medical
grade)
computer,
desktop, wmonitor
NF
2
0
Doppler
echo exam
heart
ED036
NF
8
0
Doppler
color flow
add-on
ED021
video printer,
color (Sony
medical
grade)
computer,
desktop, wmonitor
NF
2
0
Doppler
color flow
add-on
ED036
NF
9
0
L037D
video printer,
color (Sony
medical
grade)
RN/LPN/MT
A
2
0
Extracrania1
bilat study
ED021
7
0
ED036
computer,
desktop, wmonitor
video printer,
color (Sony
medical
grade)
NF
Extracranial
bilat study
93320
ED021
Bis xtracell
fluid
analysis
93320
Doppler
echo exam
heart
NF
10
0
NF
93702
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93880
93880
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19:59 Mar 19, 2015
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uploaded
from the
device into
the analysis
software
and a
report is
generated
and printed
for
physician
review.
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20MRR1
Duplicative;
item is in
vascular
ultrasound
room
(EL016)
Direct
Costs
Change
$-0.05
$-0.15
Duplicative;
item is in
vascular
ultrasound
room
(EL016)
$-0.02
$-0.09
Duplicative;
item is in
vascular
ultrasound
room
(EL016)
$-0.02
$-0.10
Included as
an automatic
process for
the new
device.
$-0.74
$-0.07
Duplicative;
item is in
vascular
ultrasound
room
(EL016)
$-0.11
ER20MR15.016</GPH>
HCPCS
Code
Labor
Activity
(where
applicable
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
15. On page 67726, first column,
second full paragraph, lines 6 through 8,
the phrase ‘‘with a clarification that
practitioners do not have to use any
specific content exchange standard in
CY 2015.’’ is corrected to read ‘‘with a
clarification that practitioners do not
have to use any specific exchange or
transfer standard in CY 2015.’’
16. On page 67741, first column, first
paragraph, we are correcting the entire
paragraph to read:
The CY 2015 PFS CF for January 1,
2015 through March 31, 2015 is
$35.7547. The CY 2015 PFS CF for April
1, 2015 through December 31, 2015 is
$28.1872. The CY 2015 national average
anesthesia CF for January 1, 2015
through March 31, 2015 is $22.4968.
The CY 2015 national average
anesthesia CF for April 1, 2015 through
December 31, 2015 is $17.7454.
17. On page 67742, third column, first
partial paragraph,
a. Line 3, the phrase ‘‘by 0.06
percent’’ is corrected to read ‘‘by 0.19
percent’’.
14861
b. Third column, first full paragraph,
line 8, the figure ‘‘$35.8013.’’ is
corrected to read ‘‘$35.7547.’’
c. Third column, second full
paragraph, line 6, the figure ‘‘$28.2239.’’
is corrected to read ‘‘$28.1872.’’
d. Third column, second full
paragraph, line 9, the phrase ‘‘21.2
percent’’ is corrected to read ‘‘21.3
percent’’.
18. On page 67742, in Table 45:
Calculation of the CY 2015 PFS CF, the
table is corrected to read as follows:
TABLE 45—CALCULATION OF THE CY 2015 PFS CF
Conversion Factor in effect in CY 2014 .......................................................................
...................................................................
$35.8228
Update ..........................................................................................................................
CY 2015 RVU Budget Neutrality Adjustment ...............................................................
CY 2015 Conversion Factor (1/1/2015 through 3/31/2015) .........................................
0.0 percent (1.00) .....................................
¥0.19 percent (0.9981) ...........................
...................................................................
........................
........................
$35.7547
April 1, 2015 through December 31, 2015
Conversion Factor in effect in CY 2014 .......................................................................
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E:\FR\FM\20MRR1.SGM
20MRR1
$35.8228
ER20MR15.017</GPH>
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January 1, 2015 through March 31, 2015
14862
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
TABLE 45—CALCULATION OF THE CY 2015 PFS CF—Continued
CY 2014 Conversion Factor had statutory increases not applied ...............................
CY 2015 Medicare Economic Index .............................................................................
CY 2015 Update Adjustment Factor ............................................................................
CY 2015 RVU Budget Neutrality Adjustment ...............................................................
CY 2015 Conversion Factor (4/1/2015 through 12/31/2015) .......................................
Percent Change in Conversion Factor on 4/1/2015 (relative to the CY 2014 CF) .....
Percent Change in Update (without budget neutrality adjustment) on 4/1/2015 (relative to the CY 2014 CF).
19. On page 67743,
a. First column, first full paragraph,
line 5, the sentence ‘‘After applying the
0.9994 budget’’ is corrected to read
‘‘After applying the 0.9981 budget’’.
...................................................................
0.8 percent (1.008) ...................................
3.0 percent (1.03) .....................................
¥0.19 percent (0.9981) ...........................
...................................................................
...................................................................
...................................................................
b. Second column, line 2, the figure
‘‘$22.5550.’’ is corrected to read
‘‘$22.4968.’’
c. Third column, line 12, the figure
‘‘$17.7913.’’ is corrected to read
‘‘$17.7454.’’
$27.2006
........................
........................
........................
$28.1872
¥21.3%
¥21.2%
d. Table 46: Calculation of the CY
2015 Anesthesia CF is corrected to read
as follows:
TABLE 46—CALCULATION OF THE CY 2015 ANESTHESIA CF
January 1, 2015 through March 31, 2015
CY 2014 National Average Anesthesia CF ..................................................................
...................................................................
$22.6765
Update ..........................................................................................................................
CY 2015 RVU Budget Neutrality Adjustment ...............................................................
CY 2015 Anesthesia Fee Schedule Practice Expense Adjustment ............................
CY 2015 National Average Anesthesia CF (1/1/2015 through 3/31/2015) .................
0.0 percent (1.00) .....................................
¥0.19 percent (0.9981) ...........................
¥0.00494 percent (0.99506) ...................
...................................................................
........................
........................
........................
$22.4968
April 1, 2015 through December 31, 2015
mstockstill on DSK4VPTVN1PROD with RULES
20. On page 67803, last row, in Table
52: Individual Quality Cross-Cutting
Measures for the PQRS to Be Available
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...................................................................
...................................................................
0.8 percent (1.008) ...................................
3.0 percent (1.03) .....................................
¥0.19 percent (0.9981) ...........................
¥0.00494 percent (0.99506) ...................
¥0.00494 percent (0.99506) ...................
...................................................................
...................................................................
for Satisfactory Reporting Via Claims,
Registry, and EHR Beginning in 2015,
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$22.6765
$17.2283
........................
........................
........................
........................
........................
$17.7454
¥21.7%
the listed entry is corrected to read as
follows:
E:\FR\FM\20MRR1.SGM
20MRR1
ER20MR15.007</GPH>
2014 National Average Anesthesia Conversion Factor in effect in CY 2015 ..............
2014 National Anesthesia Conversion Factor had Statutory Increases Not Applied ..
CY 2015 Medicare Economic Index .............................................................................
CY 2015 Update Adjustment Factor ............................................................................
CY 2015 Budget Neutrality Work and Malpractice Adjustment ...................................
CY 2015 Anesthesia Fee Schedule Practice Expense Adjustment ............................
CY 2015 Anesthesia Fee Schedule Practice Expense Adjustment ............................
CY 2015 Anesthesia Conversion Factor (4/1/2015 through 12/31/2015) ....................
Percent Change from 2014 to 2015 (4/1/2015 through 12/31/2015) ..........................
14863
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
BILLING CODE 4120–01–P
21. On page 67848, the last two rows,
and the first row on page 67849, in
Table 55: Measures Being Removed
from the Existing PQRS Measure Set
-
-=
~
...
....
rJJ.
...
=
"'
...
<'II
NQS
Domain
0~
z~
Measure Title and Description¥
<'II
~
0091/051
0102/052
mstockstill on DSK4VPTVN1PROD with RULES
0050/109
VerDate Sep<11>2014
Effective
Clinical
Care
Effective
Clinical
Care
Person and
CaregiverCentered
Experience
and
Outcomes
19:59 Mar 19, 2015
Chronic Obstructive Pulmonary Disease
(COPD): Spirometry Evaluation:
Percentage of patients aged 18 years and
older with a diagnosis of COPD who had
spirometry evaluation results documented
American
Thoracic
Society
A steward has been identified for this
measure, and for this reason CMS is not
fmalizing its proposal to remove this
measure from reporting in 2015 PQRS.
Chronic Obstructive Pulmonary Disease
(COPD): Inhaled Bronchodilator
Therapy: Percentage of patients aged 18
years and older with a diagnosis of COPD
and who have an FEV/FVC less than 60%
and have symptoms who were prescribed an
inhaled bronchodilator
American
Thoracic
Society
A steward has been identified for this
measure, and for this reason CMS is not
fmalizing its proposal to remove this
measure from reporting in 2015 PQRS.
Osteoarthritis (OA): Function and Pain
Assessment: Percentage of patient visits for
patients aged 21 years and older with a
diagnosis of osteoarthritis (OA) with
assessment for function and pain
AAOS
"'
c
= =~ ~
~
lh: e
"' > .... ~ ~~ ~ o•=
e
·; rJJ. "S'JJ
"' = :! ...
"'
•:&.~
...
0 u ~ lioil ~ ~ = .;:~~
... ...
~= "'
....
g,
,Q
~
Q
...
<'II
~
X
X
X
-
X
X
0
-
X
X
Q
X
A steward has been identified for this
measure, and for this reason CMS is not
finalizing its proposal to remove this
measure from reporting in 2015 PQRS.
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ER20MR15.008</GPH>
~rJJ.
Beginning in 2015, the listed are
corrected to read as follows:
14864
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
22. On page 67854, the second row, in
Table 56: Existing Individual Quality
Measures and Those Included in
Measures Groups for the PQRS for
Which Measure Reporting Updates Will
Be Effective Beginning in 2015, the
listed entry is corrected to read as
follows:
Coronary Artery Disease (CAD):
Antiplatelet Therapy: Percentage of
patients aged 18 years and older with a
diagnosis of coronary artery disease (CAD)
seen within a 12 month period who were
prescribed aspirin or clopidogrel
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Clinical
Care
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AMAPCPI
ACCF
AHA
E:\FR\FM\20MRR1.SGM
X
20MRR1
X
ACO
ER20MR15.009</GPH>
mstockstill on DSK4VPTVN1PROD with RULES
006
7/0
06
Several commenters were concerned with
CMS' proposal to eliminate the claims-based
reporting option for various measures, noting
that not all eligible professionals have the
resources to implement registry or EHR
reporting and will no longer be able to
participate in PQRS. CMS appreciates the
commenters' concerns and believes that
removal of the claims-based reporting option
will not negatively impact a significant
number of providers reporting these
measures. CMS also received comments
supporting inclusion of the measure in the
Shared Savings Program CAD Composite
measure but with composite measure testing
and NQF review. Therefore, CMS is
finalizing its proposal to remove the claimsbased reporting option for this measure in
2015 PQRS as part of its goal to lower the
data error rate and decrease provider burden.
CMS will not finalize adding this measure in
the Shared Savings Program CAD
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
listed entry is corrected to read as
follows:
of Work, Practice Expense, and
Malpractice RVUs, the table is corrected
to read as follows:
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BILLING CODE 4120–01–C
E:\FR\FM\20MRR1.SGM
20MRR1
ER20MR15.010</GPH>
Measures Groups for the PQRS for
Which Measure Reporting Updates Will
Be Effective Beginning in 2015, the
24. On page 67988, in Table 93: CY
2015 PFS Final Rule with Comment
Period Estimated Impact Table: Impacts
mstockstill on DSK4VPTVN1PROD with RULES
23. On page 67877, second row, in
Table 56: Existing Individual Quality
Measures and Those Included in
14865
14866
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
TABLE 93: CY 2015 PFS Final Rule with Comment Period Estimated Impact Table: Impacts
of Work, Practice Expense, and Malpractice RVUs
(B)
Allowed
Charges
(mil)
(C)
Impact of
WorkRVU
Changes
(D)
ImpactofPE
RVU
Changes
$88,095
0%
0%
0%
0%
$216
0%
0%
0%
0%
$1,993
0%
0%
0%
0%
$60
0%
0%
-1%
0%
$356
0%
0%
0%
0%
$6,470
0%
0%
0%
1%
CHIROPRACTOR
$812
0%
0%
-1%
-1%
CLINICAL PSYCHOLOGIST
$704
0%
-1%
-1%
-1%
CLINICAL SOCIAL WORKER
$522
0%
-1%
-1%
-1%
COLON AND RECTAL SURGERY
$159
0%
0%
1%
0%
CRITICAL CARE
$287
0%
0%
1%
0%
DERMATOLOGY
$3,177
0%
-1%
0%
-2%
$715
0%
-2%
0%
-2%
$3,053
0%
0%
1%
1%
ENDOCRINOLOGY
$457
0%
0%
0%
0%
FAMILY PRACTICE
$6,116
1%
0%
0%
1%
GASTROENTEROLOGY
$1,884
0%
0%
0%
0%
GENERAL PRACTICE
$507
0%
0%
0%
0%
GENERAL SURGERY
$2,256
0%
-1%
1%
0%
GERIATRICS
$227
1%
1%
0%
1%
HAND SURGERY
$160
0%
0%
0%
0%
$1,811
0%
0%
0%
1%
$714
-1%
0%
0%
-1%
INFECTIOUS DISEASE
$655
0%
0%
0%
0%
INTERNAL MEDICINE
$11,132
1%
0%
0%
1%
INTERVENTIONAL PAIN MGMT
$678
0%
0%
0%
0%
INTERVENTIONAL RADIOLOGY
$273
0%
1%
0%
1%
$84
0%
0%
0%
0%
NEPHROLOGY
$2,181
0%
0%
0%
0%
NEUROLOGY
$1,513
0%
0%
0%
0%
$740
0%
0%
2%
2%
$49
0%
0%
0%
0%
NURSE ANES I ANES ASST
$1,185
0%
0%
0%
0%
NURSE PRACTITIONER
$2,225
0%
0%
0%
0%
$696
0%
0%
0%
-1%
TOTAL
ALLERGYnMMUNOLOGY
ANESTHESIOLOGY
AUDIOLOGIST
CARDIAC SURGERY
CARDIOLOGY
DIAGNOSTIC TESTING FACILITY
EMERGENCY MEDICINE
HEMATOLOGY/ONCOLOGY
INDEPENDENT LABORATORY
MUL TISPECIALTY CLINIC/OTHER PHY
NEUROSURGERY
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NUCLEAR MEDICINE
OBSTETRICS/GYNECOLOGY
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(E)
Impact of
MPRVU
Changes
(F)
Combined
Impact
ER20MR15.013</GPH>
(A)
Specialty
14867
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
25. On page 67991 through 67992, in
Table 94: Impact of Final Rule with
Comment Period on CY 2015 Payment
for Selected Procedures the table is
corrected to read as follows:
BILLING CODE 4120–01–P
(A)
Specialty
(B)
Allowed
Charges
(mil)
(C)
Impact of
WorkRVU
Changes
(D)
ImpactofPE
RVU
Changes
(E)
Impact of
MPRVU
Changes
(F)
Combined
Impact
OPHTHALMOLOGY
$5,685
0%
0%
-2%
-2%
OPTOMETRY
$1,163
0%
0%
-1%
-1%
$45
0%
0%
0%
0%
$3,673
0%
-1%
0%
0%
$28
0%
0%
-1%
-1%
OTOLARNGOLOGY
$1,174
0%
0%
0%
0%
PATHOLOGY
$1,077
-1%
1%
0%
0%
$59
0%
0%
0%
0%
PHYSICAL MEDICINE
$1,009
0%
0%
0%
0%
PHYSICAL/OCCUPATIONAL THERAPY
$2,836
0%
0%
0%
0%
PHYSICIAN ASSISTANT
$1,565
0%
0%
0%
0%
$376
0%
0%
0%
-1%
$2,003
0%
0%
0%
0%
$112
0%
-2%
0%
-2%
PSYCHIATRY
$1,352
0%
0%
0%
0%
PULMONARY DISEASE
$1,795
0%
0%
0%
0%
RADIATION ONCOLOGY
$1,794
0%
0%
0%
0%
$57
0%
0%
0%
0%
$4,524
0%
-1%
0%
-1%
RHEUMATOLOGY
$541
0%
0%
0%
-1%
THORACIC SURGERY
$344
0%
0%
0%
0%
$1,838
0%
0%
0%
0%
ORTHOPEDIC SURGERY
OTHER
PEDIATRICS
PLASTIC SURGERY
PODIATRY
PORTABLE X-RAY SUPPLIER
RADIATION THERAPY CENTERS
RADIOLOGY
UROLOGY
$980
0%
0%
0%
Note: Table 93 shows only the payment Impact on PFS services. These Impacts use a constant conversiOn factor and
thus do not include the effects of the April2015 conversion factor change required under current law.
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VASCULAR SURGERY
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ORAL/MAXILLOFACIAL SURGERY
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93307
ER20MR15.011</GPH>
I 26
Cardiovascular stress test
Tte w/o doppler complete
NA
$45.85
NA
$45.77
NA
0%
NA
$36.08
I
NA
-21%
$75.94
$45.85
1%
0%
$60.60 I -20%
$36.08 -21%
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20MRR1
14869
c. Line 23, the phrase ‘‘this service
would be $21.84.’’ is corrected to read
‘‘this service would be $21.74.’’
E:\FR\FM\20MRR1.SGM
b. Line 21, the figure ‘‘$109.19,’’ is
corrected to read ‘‘$108.18,’’.
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
18:21 Mar 19, 2015
27. On page 67999, third column, first
full paragraph,
a. Line 18, the figure ‘‘35.8013,’’ is
corrected to read ‘‘35.7547,’’.
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CPT codes and descriptions are copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
The CY 2014 conversion factor is 35.8228.
3 Payments based on the CY 2015 conversion factor of35.7547 effective January 1- March 31.
4 Payments based on the CY 2015 conversion factor of28.1872 effective Aprill.
2
14870
Federal Register / Vol. 80, No. 54 / Friday, March 20, 2015 / Rules and Regulations
List of Subjects in 42 CFR Part 410
DEPARTMENT OF COMMERCE
Health facilities, Health professions,
Kidney diseases, Laboratories,
Medicare, Reporting and recordkeeping
requirements, Rural areas, X-rays.
National Oceanic and Atmospheric
Administration
Accordingly, 42 CFR chapter IV is
corrected by making the following
correcting amendments to part 410:
[Docket No. 140902739–5224–02]
RIN 0648–BE49
Fisheries of the Northeastern United
States; Atlantic Mackerel, Squid, and
Butterfish Fisheries; Specifications
and Management Measures
PART 410—SUPPLEMENTARY
MEDICAL INSURANCE (SMI)
BENEFITS
Authority: Secs. 1102, 1834, 1871, 1881,
and 1893 of the Social Security Act (42
U.S.C. 1302, 1395m, 1395hh, and 1395ddd.
§ 410.26 Services and supplies incident to
a physician’s professional services:
Conditions.
*
*
*
*
*
(b) * * *
(5) In general, services and supplies
must be furnished under the direct
supervision of the physician (or other
practitioner). Chronic care management
services and transitional care
management services (other than the
required face-to-face visit) can be
furnished under general supervision of
the physician (or other practitioner)
when they are provided by clinical staff
incident to the services of a physician
(or other practitioner). The physician (or
other practitioner) supervising the
auxiliary personnel need not be the
same physician (or other practitioner)
upon whose professional service the
incident to service is based.
*
*
*
*
*
Dated: March 13, 2015.
C’Reda Weeden,
Executive Secretary to the Department,
Department of Health and Human Services.
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NMFS is implementing 2015
specifications and management
measures for Atlantic mackerel, 2015–
2017 specifications for Illex squid,
2015–2017 specifications for longfin
squid, and 2015–2017 specifications for
butterfish. This action also establishes a
simplified butterfish fishery closure
mechanism. These specifications set
catch levels to prevent overfishing and
allocate catch to commercial and
recreational fisheries. Additionally, the
simplified butterfish closure mechanism
makes operation of the fishery more
efficient and consistent with the higher
catch limit for butterfish. These
specifications and management
measures are consistent with the
Atlantic Mackerel, Squid, and Butterfish
Fishery Management Plan and the
recommendations of the Mid-Atlantic
Fishery Management Council.
DATES: Effective April 20, 2015.
ADDRESSES: Copies of the specifications
document, including the Environmental
Assessment and Initial Regulatory
Flexibility Analysis (EA/IRFA) and
other supporting documents for the
specifications, are available from Dr.
Christopher Moore, Executive Director,
Mid-Atlantic Fishery Management
Council, Suite 201, 800 N. State Street,
Dover, DE 19901. The specifications
document is also accessible via the
Internet at: https://
www.greateratlantic.fisheries.noaa.gov/.
FOR FURTHER INFORMATION CONTACT:
Carly Bari, Fishery Policy Analyst, (978)
281–9224.
SUPPLEMENTARY INFORMATION:
SUMMARY:
2. Section 410.26 is amended by
revising paragraph (b)(5) to read as
follows:
■
BILLING CODE 4120–01–C
National Marine Fisheries
Service (NMFS), National Oceanic and
Atmospheric Administration (NOAA),
Commerce.
ACTION: Final rule.
AGENCY:
1. The authority citation for part 410
continues to read as follows:
■
[FR Doc. 2015–06427 Filed 3–19–15; 8:45 am]
50 CFR Part 648
Background
Specifications, as referred to in this
rule, are the combined suite of
commercial and recreational catch
levels established for one or more
fishing years. The specifications process
also allows for the modification of a
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select number of management measures,
such as closure thresholds, gear
restrictions, and possession limits. The
Council’s process for establishing
specifications relies on provisions
within the Atlantic Mackerel, Squid,
and Butterfish Fishery Management
Plan (FMP) and its implementing
regulations, as well as requirements
established by the Magnuson-Stevens
Fishery Conservation and Management
Act. Specifically, section 302(g)(1)(B) of
the Magnuson-Stevens Act states that
the Scientific and Statistical Committee
(SSC) for each Regional Fishery
Management Council shall provide its
Council ongoing scientific advice for
fishery management decisions,
including recommendations for
acceptable biological catch (ABC),
preventing overfishing, maximum
sustainable yield, and achieving
rebuilding targets. The ABC is a level of
catch that accounts for the scientific
uncertainty in the estimate of the stock’s
defined overfishing level (OFL).
The Council’s SSC met on May 7 and
8, 2014, to recommend ABCs for the
2015 Atlantic mackerel specifications,
and the 2015–2017 butterfish, Illex
squid, and longfin squid specifications.
On November 14, 2014, NMFS
published a proposed rule for fishing
year 2015 for the mackerel, squid, and
butterfish fishery specifications and
management measures (79 FR 68202);
the public comment period for the
proposed rule ended December 15,
2014.
The Atlantic Mackerel, Squid, and
Butterfish FMP regulations require the
specification of annual catch limits
(ACL) and accountability measures
(AM) for mackerel and butterfish (both
squid species are exempt from the ACL/
AM requirements because they have a
life cycle of less than 1 year). In
addition, the regulations require the
specification of domestic annual harvest
(DAH), domestic annual processing
(DAP), and total allowable level of
foreign fishing (TALFF), along with
joint venture processing for (JVP)
commercial and recreational annual
catch totals (ACT) for mackerel, the
butterfish mortality cap in the longfin
squid fishery, and initial optimum yield
(IOY) for both squid species. Details
concerning the Council’s development
of these measures were presented in the
preamble of the proposed rule and are
not repeated here.
In addition to the specifications, this
action simplifies the management
measure for the directed buttefish
fishery and changes the regulations in
regard to possession limits.
E:\FR\FM\20MRR1.SGM
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]]>Agencies
[Federal Register Volume 80, Number 54 (Friday, March 20, 2015)]
[Rules and Regulations]
[Pages 14853-14870]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2015-06427]
[[Page 14853]]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 403, 405, 410, 411, 412, 413, 414, 425, 489, 495, and
498
[CMS-1612-F2]
RIN 0938-AS12
Medicare Program; Revisions to Payment Policies Under the
Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to
Identifiable Data for the Center for Medicare and Medicaid Innovation
Models & Other Revisions to Part B for CY 2015; Corrections
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule; correcting amendment.
-----------------------------------------------------------------------
SUMMARY: This document corrects technical errors that appeared in the
final rule with comment period published in the November 13, 2014
Federal Register (79 FR 67547-68092) entitled, ``Medicare Program;
Revisions to Payment Policies under the Physician Fee Schedule,
Clinical Laboratory Fee Schedule, Access to Identifiable Data for the
Center for Medicare and Medicaid Innovation Models & Other Revisions to
Part B for CY 2015.'' The effective date for the rule was January 1,
2015.
DATES: Effective date: This correcting document is effective March 19,
2015. Applicability date: The corrections indicated in this document
are applicable beginning January 1, 2015.
FOR FURTHER INFORMATION CONTACT: Christine Estella, (410) 786-0485, for
issues related to the physician quality reporting system. Donta Henson,
(410) 786-1947 for all other issues.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2014-26183 (79 FR 67547 through 68092) the final rule
entitled, ``Medicare Program; Revisions to Payment Policies under the
Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to
Identifiable Data for the Center for Medicare and Medicaid Innovation
Models & Other Revisions to Part B for CY 2015'' (hereinafter referred
to as the CY 2015 PFS final rule with comment period), there were a
number of technical errors that are identified and corrected in section
IV., Correction of Errors. These corrections are applicable as of
January 1, 2015. We note that the Addenda B and C to the CY 2015 PFS
final rule with comment period as corrected by this correction document
are available on the CMS Web site at www.cms.gov/PhysicianFeeSched/.
II. Summary of Errors
A. Summary of Errors in the Preamble
On page 67559, due to errors made in ratesetting, many of the
values contained in Table 4: Calculation of PE RVUs Under Methodology
for Selected Codes, are incorrect.
On page 67562, in Table 8: Codes Affected by Removal of Film
Inputs, we inadvertently included CPT codes 93320, 93321, and 93325.
On page 67591, we incorrectly stated that in section II. G. of the
rule, we address the interim final values and establish CY 2015 inputs
for the lower gastrointestinal procedures.
On page 67612, in Table 14: Codes Reviewed by the 2014 Multi-
Specialty Refinement Panel, the work RVUs for CPT codes 43204, 43205,
and 43233 are incorrect.
On page 67633, due to a typographical error we referred to CPT code
41391 rather than CPT code 43391.
On page 67636, due to a technical error, the final work RVU for
code 43278 is incorrect.
On pages 67651 through 67663, in Table 25: CY 2015 Interim Final
Work RVUS For New/Revised or Potentially Misvalued Codes, the RUC/HCPAC
recommended work RVUs listed on page 67658 for CPT codes 76932 and
76948 are incorrect and entries for CPT codes 76940 and 76965 were
inadvertently omitted from the table.
On page 67660, the RUC/HCPAC recommended work RVU listed for CPT
code 92545 is incorrect.
On page 67668,
a. We inadvertently omitted G0279 from the list of codes in the
title of (13).
b. Due to a typographical error, G0279 is referred to as G-2079.
c. We inadvertently omitted the phrase ``, whether or not a 2-D
mammography is furnished'' from the sentence beginning, ``In addition,
we are creating . . .''
On page 67669, we inadvertently listed CPT code 93644 in the title
of (18).
On page 67671, in Table 28: CY 2015 Interim Final Codes with Direct
PE Input Recommendations Accepted without Refinement, we inadvertently
listed CPT code 31620.
On page 67673, in Table 29: Invoices Received for New Direct PE
Inputs we inadvertently listed entries associated with CPT code 31620.
On page 67674, in Table 30: Invoices Received For Existing Direct
PE Inputs, certain PE direct inputs for CPT code 31627 were
inadvertently omitted.
On pages 67678 through 67711, in Table 31: CY 2015 Interim Final
Codes With Direct PE Input Recommendations Accepted with Refinements,
due to technical errors, on page 67678, entries associated with CPT
codes 77061 and 77062 were inadvertently listed; on page 67702, entries
associated with CPT codes 93320, 93321, and 93325 were inadvertently
omitted and an input code for CPT code 93880 was inadvertently omitted.
On page 67726, we incorrectly stated that practitioners do not have
to use any ``specific content exchange standard.''
On pages 67741 through 67742, we incorrectly stated the CY 2015 PFS
conversion factors.
On page 67742, in Table 45: Calculation of the CY 2015 PFS CF, due
to corrections being made in this document, the CY 2014 budget
neutrality adjustment, the CY 2015 CFs, and the percentage changes from
the CY 2014 CF stated in the table are incorrect.
On page 67743, due to technical errors, the budget neutrality
factor, the anesthesia CF in effect from January 1, 2015 through March
31, 2015, and the anesthesia CF in effect from April 1, 2015 through
December 31, 2015 are incorrectly stated. The entries in Table 46:
Calculation of the CY 2015 Anesthesia CF for budget neutrality
adjustments, CFs and percentage change are inaccurate.
On pages 67803 and 67804, in Table 52: Individual Quality Cross-
Cutting Measures for the PQRS to Be Available for Satisfactory
Reporting Via Claims, Registry, and EHR Beginning in 2015, we
inadvertently listed the incorrect National Quality Strategy (NQS)
domain for Physician Quality Reporting System (PQRS) Measure 131, Pain
Assessment and Follow-Up.
On pages 67848 and 67849, in Table 55: Measures Being Removed from
the Existing PQRS Measure Set Beginning in 2015, we inadvertently
omitted adding an ``X'' to the claims reporting option for Physician
Quality Reporting System (PQRS) Measure 0091/051: Chronic Obstructive
Pulmonary Disease (COPD): Spirometry Evaluation, Measure 0102/052:
Chronic Obstructive Pulmonary Disease (COPD): Inhaled Bronchodilator
Therapy, and Measure 0050/109: Osteoarthritis (OA) Function and Pain
Assessment.
On page 67854, in Table 56: Existing Individual Quality Measures
and Those Included in Measures Groups for the PQRS for Which Measure
Reporting Updates Will Be Effective Beginning in 2015, we inadvertently
added an ``X'' to the Group Practice Reporting Option
[[Page 14854]]
(GPRO) Web Interface reporting option for Physician Quality Reporting
System (PQRS) Measure 0067/006: Coronary Artery Disease (CAD):
Antiplatelet Therapy.
On page 67877, in Table 56: Existing Individual Quality Measures
and Those Included in Measures Groups for the PQRS for Which Measure
Reporting Updates Will Be Effective Beginning in 2015, we inadvertently
added an ``X'' to the claims reporting option and omitted adding an
``X'' to the registry reporting option for Physician Quality Reporting
System (PQRS) Measure 0409/205: HIV/AIDS: Sexually Transmitted Disease
Screening for Chlamydia, Gonorrhea, and Syphilis.
On page 67988, in Table 93: CY 2015 PFS Final Rule with Comment
Period Estimated Impact Table: Impacts of Work, Practice Expense, and
Malpractice RVUs, due to ratesetting errors, the values are inaccurate.
On page 67991 through 67992, in Table 94: Impact of the Final Rule
with Comment Period on CY 2014 Payment for Selected Procedures, due to
ratesetting errors, the stated payment rates are inaccurate.
On page 67999, the January 1-March 31, 2015 CF, the CY 2015
national payment amount in the nonfacility setting for CPT code 99203,
and the beneficiary coinsurance amount are incorrect.
B. Summary and Correction of Errors in the Addenda on the CMS Web Site
Due to the errors identified and summarized in section II.A and B
of this correction document, we are correcting errors in the work, PE
or MP RVUs (or combinations of these RVUs) in Addendum B: CY 2015
Relative Value Units (RVUs) And Related Information Used In Determining
Final Medicare Payments and Addendum C: CY 2015 Interim Final Relative
Value Units (RVUs). We note that corrections to the RVUs for codes with
identified errors affect additional codes due to the budget neutrality
and relativity of the PFS. These errors are corrected in the revised
Addenda B and C available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
In addition to the errors identified in section II.A. of this
correction document, the following errors occur in the addenda.
Due to a technical error in the creation of the direct PE database,
nonfacility PE RVUs were created and displayed in Addendum B (and
Addendum C, if applicable) for the following CPT codes: 21811, 21812,
21813, 22858, 33418, 33951, 33952, 33953, 33954, 33955, 33956, 33957,
33958, 33959, 33962, 33963, 33964, 33965, 33966, 33969, 33984, 33985,
33986, 33987, 33988, 33989, 37218, 43180, 44380, 44382, 66179, and
66184. These errors are corrected in the revised Direct PE Input
Database available on the CMS Web site at www.cms.gov//PhysicianFeeSched/. Resulting changes to the PE RVUs are reflected in
the corrected Addendum B (and Addendum C, if applicable) available on
the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to technical errors in the creation of the direct PE database,
some or all of the PE inputs were inadvertently omitted for CPT codes
22510, 22511, 22512, 22513, 22514, 22515, 31620, 33951, 33952, 33953,
33954, 33955, 33956, 33957, 33958, 33959, 33962, 33963, 33964, 33969,
33984, 33985, 33986, 33988, 33989, 58541, 58542, 58543, 58544, 58570,
58571, 58572, 64486, 64487, 64488, 64489, 70496, 70498, 76700, 76705,
77080, 88348, 93260, 93261, and 93644. These errors are corrected in
the revised Direct PE Input Database available on the CMS Web site at
www.cms.gov//PhysicianFeeSched/.
Due to technical errors in the creation of the direct PE database,
the incorrect inputs were used for creating PE RVUs for CPT codes
20982, 31620, 31627, 32998, 33262, 32998, 41530, 50592, 64600, 64605,
64610, 64633, 64634, 64635, 64636, 93925, 93880, and 93990. These
errors are corrected in the revised Direct PE Input Database available
on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, we incorrectly displayed in Addenda B and
C PE RVUs in a nonfacility setting for CPT codes 33270, 33271, 33272,
and 33273. The PE RVUs for these codes in a non-facility setting have
been removed in the corrected Addenda B and C available on the CMS Web
site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, HCPCS codes 33330, 33474, 61610, and
61870 were inadvertently left out of Addendum B. These codes are
reflected in the corrected Addendum B available on the CMS Web site at
www.cms.gov//PhysicianFeeSched/.
Due to a technical error, the average risk factor, and not the
specialty risk factor that we indicated that we were using in the
preamble, was applied when calculating the MP RVUs for CPT codes 33620
and 33622. As a result, the MP RVUs listed in Addendum B are incorrect
for these codes. We have corrected these errors in the corrected
Addendum B available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, the incorrect work RVUs were applied in
calculating the MP RVUs for CPT codes 33418 and 33419. As a result, the
MP RVUs listed in Addenda B and C are incorrect for these codes. We
have corrected these errors in the corrected Addenda B and C available
on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, the incorrect CY 2015 work RVUs are
included in Addendum B (and Addendum C, if applicable) for the
following codes: 43191, 43192, 43193, 43194, 43195, 43196, 43197,
43198, 43200, 43201, 43202, 43204, 43205, 43211, 43212, 43214, 43215,
43229, 43232, 43233, 43235, 43236, 43238, 43239, 43242, 43247, 43253,
43254, 43257, 43266, 43270, 43274, 43276, 43278, 58541, 58542, 58543,
58544, 58570, 58571, 58572, 58573, 71275, 76930, 76932, 76948, 92545,
93315, 93317, 93318, and 95973. The correct CY 2015 work RVUS for these
codes are reflected in the corrected Addenda B and C available on the
CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error in the creation of the direct PE database,
PE RVUs for the facility setting were created and are displayed in
Addendum B for HCPCS code 77372 and Addenda B and C for HCPCS code
G0277. These technical errors are corrected in Addenda B and C
available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to technical errors in the creation of the direct PE database,
direct PE inputs were inadvertently included for CPT code 99183 and are
reflected in the PE RVUs shown in Addenda B and C. This error is
corrected in the Direct PE Input Database available on the CMS Web site
at www.cms.gov//PhysicianFeeSched/. The corrected PE RVUS are included
in Addenda B and C available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, in Addendum B, work and MP RVUs for CPT
codes 99487 and 99489 were inadvertently included. The work and MP RVUs
for these codes have been removed in the corrected Addendum B available
on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error in the creation of the direct PE database,
PE RVUs were not created for CPT code 99490 in the facility setting.
The correct PE RVU for this code is reflected in the corrected Addendum
B available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
Due to a technical error, HCPCS codes G9407 through G9472 are
inadvertently included in Addendum B. These codes
[[Page 14855]]
have been removed in the corrected Addendum B available on the CMS Web
site at www.cms.gov//PhysicianFeeSched/.
C. Summary of Errors in the Regulations Text
On page 68002 of the CY 2015 PFS final rule with comment period, we
made a technical error in Sec. 410.26(b)(5). In this paragraph, we
inadvertently omitted language to limit the applicability of the
exception that allows general, rather than direct, supervision of
transitional care management services furnished incident to a
practitioner's professional services to the non-face-to-face aspects of
the service.
III. Waiver of Proposed Rulemaking and Delay in Effective Date
Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA),
the agency is required to publish a notice of the proposed rule in the
Federal Register before the provisions of a rule take effect.
Similarly, section 1871(b)(1) of the Act requires the Secretary to
provide for notice of the proposed rule in the Federal Register and
provide a period of not less than 60 days for public comment. In
addition, section 553(d) of the APA, and section 1871(e)(1)(B)(i) of
the Act mandate a 30-day delay in effective date after issuance or
publication of a rule. Sections 553(b)(B) and 553(d)(3) of the APA
provide for exceptions from the notice and comment and delay in
effective date APA requirements; in cases in which these exceptions
apply, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the Act provide
exceptions from the notice and 60-day comment period and delay in
effective date requirements of the Act as well. Section 553(b)(B) of
the APA and section 1871(b)(2)(C) of the Act authorize an agency to
dispense with normal rulemaking requirements for good cause if the
agency makes a finding that the notice and comment process are
impracticable, unnecessary, or contrary to the public interest. In
addition, both section 553(d)(3) of the APA and section
1871(e)(1)(B)(ii) of the Act allow the agency to avoid the 30-day delay
in effective date where such delay is contrary to the public interest
and an agency includes a statement of support.
In our view, this correction document does not constitute a
rulemaking that would be subject to these requirements. This correction
document corrects technical errors in the CY 2015 PFS final rule with
comment period and the corresponding addenda posted on the CMS Web
site. The corrections contained in this document are consistent with,
and do not make substantive changes to, the policies and payment
methodologies that were adopted subjected to notice and comment
procedures in the CY 2015 PFS final rule with comment period. As a
result, the corrections made through this correction document are
intended to ensure that the CY 2015 PFS final rule with comment period
accurately reflects the policies adopted in that rule.
Even if this were a rulemaking to which the notice and comment and
delayed effective date requirements applied, we find that there is good
cause to waive such requirements. Undertaking further notice and
comment procedures to incorporate the corrections in this document into
the CY 2015 PFS final rule with comment period or delaying the
effective date of the corrections would be contrary to the public
interest because it is in the public interest to ensure that the CY
2015 PFS final rule with comment period accurately reflects our final
policies as soon as possible following the date they take effect.
Further, such procedures would be unnecessary, because we are not
altering the payment methodologies or policies, but rather, we are
simply correcting the Federal Register document to reflect the policies
that we previously proposed, received comment on, and subsequently
finalized. This correcting document is intended solely to ensure that
the CY 2015 PFS final rule with comment period accurately reflects
these policies. For these reasons, we believe there is good cause to
waive the requirements for notice and comment and delay in effective
date.
IV. Correction of Errors
In FR Doc. 2014-26183 of November 13, 2014 (79 FR 67547), make the
following corrections:
A. Correction of Errors in the Preamble
1. On page 67559, in Table 4: Calculation of PE RVUs Under
Methodology for Selected Codes, the table is corrected to read as
follows:
[[Page 14856]]
Table 4--Calculation of PR RVUs Under Methodology for Selected Codes
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
99213
Office 33533 CABG, 71020 Chest 71020-TC 71020-26 93000 ECG, 93005 ECG, 93010 ECG,
Factor (CF) (2nd part) Step Source Formula visit, est arterial, x-ray non- Chest x- Chest x- complete, tracing, report non-
non- single facility ray, non- ray, non- non- non- facility
facility facility facility facility facility facility
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(1) Labor cost (Lab)........... Step 1........... AMA.............. ................. 13.32 77.52 5.74 5.74 0 5.1 5.1 0
(2) Supply cost (Sup).......... Step 1........... AMA.............. ................. 2.98 7.34 0.53 0.53 0 1.19 1.19 0
(3) Equipment cost (Eqp)....... Step 1........... AMA.............. ................. 0.17 0.58 6.92 6.92 0 0.09 0.09 0
(4) Direct cost (Dir).......... Step 1........... ................. '%=(1)+(2)+(3) 16.48 85.45 13.19 13.19 0 6.38 6.38 0
(5) Direct adjustment (Dir. Steps 2-4........ See footnote *... ................. 0.5953 0.5953 0.5953 0.5953 0.5953 0.5953 0.5953 0.5953
Adj.).
(6) Adjusted Labor............. Steps 2-4........ '%=Labor * Dir '%=(1) * (5) 7.93 46.15 3.42 3.42 0 3.04 3.04 0
Adj.
(7) Adjusted Supplies.......... Steps 2-4........ '%=Eqp * Dir Adj. '%=(2) * (5) 1.78 4.37 0.32 0.32 0 0.71 0.71 0
(8) Adjusted Equipment......... Steps 2-4........ '%=Sup * Dir Adj. '%=(3) * (5) 0.1 0.35 4.12 4.12 0 0.05 0.05 0
(9) Adjusted Direct............ Steps 2-4........ ................. '%=(6)+(7)+(8) 9.81 50.87 7.85 7.85 0 3.8 3.8 0
(10) Conversion Factor (CF).... Step 5........... PFS.............. ................. 35.8228 35.8228 35.8228 35.8228 35.8228 35.8228 35.8228 35.8228
(11) Adj. labor cost converted. Step 5........... '%=(Lab * Dir '%=(6)/(10) 0.22 1.29 0.1 0.1 0 0.08 0.08 0
Adj)/CF.
(12) Adj. supply cost converted Step 5........... '%=(Sup * Dir '%=(7)/(10) 0.05 0.12 0.01 0.01 0 0.02 0.02 0
Adj)/CF.
(13) Adj. equipment cost Step 5........... '%=(Eqp * Dir '%=(8)/(10) 0 0.01 0.11 0.11 0 0 0 0
converted. Adj)/CF.
(14) Adj. direct cost converted Step 5........... ................. '%=(11)+(12)+(13) 0.27 1.42 0.22 0.22 0 0.11 0.11 0
(15) Work RVU.................. Setup File....... PFS.............. ................. 0.97 33.75 0.22 0 0.22 0.17 0 0.17
(16) Dir_pct................... Steps 6,7........ Surveys.......... ................. 0.25 0.17 0.29 0.29 0.29 0.29 0.29 0.29
(17) Ind_pct................... Steps 6,7........ Surveys.......... ................. 0.75 0.83 0.71 0.71 0.71 0.71 0.71 0.71
(18) Ind. Alloc. Formula (1st Step 8........... See Step 8....... ................. (14)/(16) * (14)/(16) * (14)/(16) * (14)/(16) * (14)/(16) * (14)/(16) * (14)/(16) * (14)/(16) *
part). (17) (17) (17) (17) (17) (17) (17) (17)
(19) Ind. Alloc. (1st part).... Step 8........... ................. See 18 0.83 6.73 0.53 0.53 0 0.26 0.26 0
(20) Ind. Alloc. Formula (2nd Step 8........... See Step 8....... ................. -15% -15% %(15+11) -11% -15% %(15+11) -11% -15%
part).
(21) Ind. Alloc. (2nd part).... Step 8........... ................. See 20 0.97 33.75 0.32 0.1 0.22 0.25 0.08 0.17
(22) Indirect Allocator (1st + Step 8........... ................. '%=(19)+(21) 1.8 40.48 0.85 0.63 0.22 0.52 0.35 0.17
2nd).
(23) Indirect Adjustment (Ind. Steps 9-11....... See Footnote * *. ................. 0.3829 0.3829 0.3829 0.3829 0.3829 0.3829 0.3829 0.3829
Adj.).
(24) Adjusted Indirect Steps 9-11....... '%=Ind Alloc * ................. 0.69 15.5 0.33 0.24 0.08 0.2 0.13 0.07
Allocator. Ind Adj.
(25) Ind. Practice Cost Index Steps 12-16...... ................. ................. 1.07 0.75 0.99 0.99 0.99 0.91 0.91 0.91
(IPCI).
(26) Adjusted Indirect......... Step 17.......... '%= Adj.Ind Alloc '%=(24) * (25) 0.74 11.64 0.32 0.24 0.08 0.18 0.12 0.06
* PCI.
(27) Final PE RVU.............. Step 18.......... '%=(Adj Dir + Adj '%=((14)+(26)) * 1.01 12.99 0.54 0.46 0.08 0.29 0.23 0.06
Ind) * Other Adj. Other Adj)
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Note: PE RVUs in Table 4, row 27, may not match Addendum B due to rounding.
* The direct adj = [current pe rvus * CF * avg dir pct]/[sum direct inputs] = [step2]/[step3]
* * The indirect adj = [current pe rvus * avg ind pct]/[sum of ind allocators] = [step9]/[step10]
Note: The use of any particular conversion factor (CF) in Table 4 to illustrate the PE Calculation has no effect on the resulting RVUs.
[[Page 14857]]
2. On page 67562, in Table 8: Codes Affected by Removal of Film
Inputs, the following listed entries are removed.
------------------------------------------------------------------------
HCPCS Short descriptor
------------------------------------------------------------------------
93320.............................. Doppler echo exam heart
93321.............................. Doppler echo exam heart
93325.............................. Doppler color flow add-on
------------------------------------------------------------------------
3. On page 67591, third column, first full paragraph, line 10, the
sentence ``In section II.G. of this CY 2015 PFS final rule with comment
period, we address interim final values and establish CY 2015 inputs
for the lower gastrointestinal procedures, many of which are also
listed in Appendix G.'' is corrected to read ``In section II.G. of this
CY 2015 PFS final rule with comment period, we note that we are
delaying the adoption of the new code set for lower gastrointestinal
procedures until CY 2016; many of these codes are also listed in
Appendix G.''
4. On page 67612, in Table 14: Codes reviewed by the 2014 Multi-
Specialty Refinement Panel, the entries for CPT codes 43204, 43205 and
43233 are corrected to read as follows:
----------------------------------------------------------------------------------------------------------------
Refinement
HCPCS code Descriptor CY 2014 interim RUC recommended panel median CY 2015 work RVU
final work RVU work RVU rating
----------------------------------------------------------------------------------------------------------------
43204........... Injection of dilated 2.40 2.89 2.77 2.43
esophageal veins
using an endoscope.
43205........... Tying of esophageal 2.51 3.00 2.88 2.54
veins using an
endoscope.
43233........... Balloon dilation of 4.05 4.45 4.26 4.17
esophagus, stomach,
and/or upper small
bowel using an
endoscope.
----------------------------------------------------------------------------------------------------------------
5. On page 67633, third column, first full paragraph, line 14, the
phrase ``CPT code 41391,'' is corrected to read ``CPT code 43391,''.
6. On page 67636, third column, first partial paragraph, lines 24
through 25, the sentence ``The final work RVU for CPT code 43278 is
8.'' is corrected to read ``The final work RVU for CPT code 43278 is
8.02.''
7. On pages 67651 through 67663, in Table 25: CY 2015 Interim Final
Work RVUS For New/Revised or Potentially Misvalued Codes, the listed
entries on page 67658 are corrected to read:
----------------------------------------------------------------------------------------------------------------
RUC/HCPAC
HCPCS code Long descriptor CY 2014 WRVU recommended work CY 2015 work RVU CMS time
RVU refinement
----------------------------------------------------------------------------------------------------------------
76932........... Ultrasonic guidance C 0.67 0.67 No
for endomyocardial
biopsy, imaging
supervision and
interpretation.
76940........... Ultrasound guidance 2.00 2.00 2.00 No
for, and monitoring
of, parenchymal
tissue ablation.
76948........... Ultrasonic guidance 0.38 0.38 0.38 No
for aspiration of
ova, imaging
supervision and
interpretation.
76965........... Ultrasonic guidance 1.34 1.34 1.34 No
for interstitial
radioelement
application.
----------------------------------------------------------------------------------------------------------------
8. On page 67660, in Table 25: CY 2015 Interim Final Work RVUS For
New/Revised or Potentially Misvalued Codes, the listed entry is
corrected to read:
----------------------------------------------------------------------------------------------------------------
RUC/HCPAC
HCPCS code Long descriptor CY 2014 WRVU recommended work CY 2015 work RVU CMS time
RVU refinement
----------------------------------------------------------------------------------------------------------------
92545........... Oscillating tracking 0.23 0.25 0.25 No
test, with recording.
----------------------------------------------------------------------------------------------------------------
9. On page 67668,
a. First column, line 1, the title ``(13) Breast Tomosynthesis (CPT
codes 77061, 77062, and 77063)'' is corrected to read ``(13) Breast
Tomosynthesis (CPT codes 77061, 77062, 77063 and G2079)''.
b. Second column, line 19, the phrase ``a new code, G-2079'' is
corrected to read ``a new code, G0279''.
c. Second column, line 27, is corrected by adding ``whether or not
a 2-D mammography is furnished'' after the phrase ``diagnostic breast
tomosynthesis''.
10. On page 67669, second column, lines 8 through 11, we are
correcting the title ``(18) Interventional Transesophageal
Echocardiography (TEE) (CPT Codes 93312, 93313, 93314, 93315, 93316,
93317, 93318, 93355, and 93644)'' to read ``(18) Interventional
Transesophageal Echocardiography (TEE) (CPT Codes 93312, 93313, 93314,
93315, 93316, 93317, 93318, and 93355).''
11. On page 67671, in Table 28: CY 2015 Interim Final Codes with
Direct PE Input Recommendations Accepted without Refinements, the
following listed entry is removed:
------------------------------------------------------------------------
HCPCS Short descriptor
------------------------------------------------------------------------
31620.............................. Endobronchial us add-on
------------------------------------------------------------------------
12. On page 67673, in Table 29: Invoices Received for New Direct PE
Inputs, the following listed entries for CPT code 31620 are removed:
[[Page 14858]]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Non-facility allowed services
Number of for HCPCS codes using this
CPT/HCPCS codes Item name CMS code Average price invoices item (or projected services
for new CPT codes*)
--------------------------------------------------------------------------------------------------------------------------------------------------------
31620............................... Flexible dual-channeled EQ361 $160,260.06.................. 6 107
EBUS bronchoscope, with
radial probe.
31620............................... Video system, Ultrasound ER099 $13,379.57................... 6 107
(processor, digital
capture, monitor,
printer, cart).
31620............................... EBUS, single use SC10$145.82...................... 5 107
aspiration needle, 21 g.
31620............................... Balloon for Bronchosopy SD294 $28.68....................... 4 107
Fiberscope.
--------------------------------------------------------------------------------------------------------------------------------------------------------
13. On page 67674, Table 30: Invoices Received for Existing Direct
PE Inputs, the list entries for CPT code 31627 are corrected by adding
the following:
--------------------------------------------------------------------------------------------------------------------------------------------------------
Non-facility
Number of allowed services
CPT/HCPCS codes Item name CMS code Current price Updated price % Change invoices for HCPCS codes
using this item
--------------------------------------------------------------------------------------------------------------------------------------------------------
31627........................... sensor, patch, SD235 $1.10.............. $3.00.............. 173 2 37
bronchosopy (for
kit, locatable
guide) (patient).
31627........................... system, EQ326 $137,800.00........ $189,327.66........ 37 4 37
navigational
bronchoscopy
(superDimension).
31627........................... kit, locatable SA097 $995.00............ $1,063.67.......... 7 3 37
guide, ext.
working channel, w-
b-scope adapter.
--------------------------------------------------------------------------------------------------------------------------------------------------------
[[Page 14859]]
14. On pages 67678 through 67711, in Table 31: CY 2015 Interim
Final Codes With Direct PE Input Recommendations Accepted with
Refinements, we are correcting the table by
a. On page 67687, deleting the following listed entries:
[GRAPHIC] [TIFF OMITTED] TR20MR15.015
[[Page 14860]]
b. On page 67702, correcting the bottom half of the table to read:
[GRAPHIC] [TIFF OMITTED] TR20MR15.016
[[Page 14861]]
[GRAPHIC] [TIFF OMITTED] TR20MR15.017
15. On page 67726, first column, second full paragraph, lines 6
through 8, the phrase ``with a clarification that practitioners do not
have to use any specific content exchange standard in CY 2015.'' is
corrected to read ``with a clarification that practitioners do not have
to use any specific exchange or transfer standard in CY 2015.''
16. On page 67741, first column, first paragraph, we are correcting
the entire paragraph to read:
The CY 2015 PFS CF for January 1, 2015 through March 31, 2015 is
$35.7547. The CY 2015 PFS CF for April 1, 2015 through December 31,
2015 is $28.1872. The CY 2015 national average anesthesia CF for
January 1, 2015 through March 31, 2015 is $22.4968. The CY 2015
national average anesthesia CF for April 1, 2015 through December 31,
2015 is $17.7454.
17. On page 67742, third column, first partial paragraph,
a. Line 3, the phrase ``by 0.06 percent'' is corrected to read ``by
0.19 percent''.
b. Third column, first full paragraph, line 8, the figure
``$35.8013.'' is corrected to read ``$35.7547.''
c. Third column, second full paragraph, line 6, the figure
``$28.2239.'' is corrected to read ``$28.1872.''
d. Third column, second full paragraph, line 9, the phrase ``21.2
percent'' is corrected to read ``21.3 percent''.
18. On page 67742, in Table 45: Calculation of the CY 2015 PFS CF,
the table is corrected to read as follows:
Table 45--Calculation of the CY 2015 PFS CF
------------------------------------------------------------------------
------------------------------------------------------------------------
January 1, 2015 through March 31, 2015
------------------------------------------------------------------------
Conversion Factor in effect in CY .................... $35.8228
2014.
------------------------------------------------------------------------
Update............................ 0.0 percent (1.00).. ..............
CY 2015 RVU Budget Neutrality -0.19 percent ..............
Adjustment. (0.9981).
CY 2015 Conversion Factor (1/1/ .................... $35.7547
2015 through 3/31/2015).
------------------------------------------------------------------------
April 1, 2015 through December 31, 2015
------------------------------------------------------------------------
Conversion Factor in effect in CY .................... $35.8228
2014.
[[Page 14862]]
CY 2014 Conversion Factor had .................... $27.2006
statutory increases not applied.
CY 2015 Medicare Economic Index... 0.8 percent (1.008). ..............
CY 2015 Update Adjustment Factor.. 3.0 percent (1.03).. ..............
CY 2015 RVU Budget Neutrality -0.19 percent ..............
Adjustment. (0.9981).
CY 2015 Conversion Factor (4/1/ .................... $28.1872
2015 through 12/31/2015).
Percent Change in Conversion .................... -21.3%
Factor on 4/1/2015 (relative to
the CY 2014 CF).
Percent Change in Update (without .................... -21.2%
budget neutrality adjustment) on
4/1/2015 (relative to the CY 2014
CF).
------------------------------------------------------------------------
19. On page 67743,
a. First column, first full paragraph, line 5, the sentence ``After
applying the 0.9994 budget'' is corrected to read ``After applying the
0.9981 budget''.
b. Second column, line 2, the figure ``$22.5550.'' is corrected to
read ``$22.4968.''
c. Third column, line 12, the figure ``$17.7913.'' is corrected to
read ``$17.7454.''
d. Table 46: Calculation of the CY 2015 Anesthesia CF is corrected
to read as follows:
Table 46--Calculation of the CY 2015 Anesthesia CF
------------------------------------------------------------------------
------------------------------------------------------------------------
January 1, 2015 through March 31, 2015
------------------------------------------------------------------------
CY 2014 National Average .................... $22.6765
Anesthesia CF.
------------------------------------------------------------------------
Update............................ 0.0 percent (1.00).. ..............
CY 2015 RVU Budget Neutrality -0.19 percent ..............
Adjustment. (0.9981).
CY 2015 Anesthesia Fee Schedule -0.00494 percent ..............
Practice Expense Adjustment. (0.99506).
CY 2015 National Average .................... $22.4968
Anesthesia CF (1/1/2015 through 3/
31/2015).
------------------------------------------------------------------------
April 1, 2015 through December 31, 2015
------------------------------------------------------------------------
2014 National Average Anesthesia .................... $22.6765
Conversion Factor in effect in CY
2015.
2014 National Anesthesia .................... $17.2283
Conversion Factor had Statutory
Increases Not Applied.
CY 2015 Medicare Economic Index... 0.8 percent (1.008). ..............
CY 2015 Update Adjustment Factor.. 3.0 percent (1.03).. ..............
CY 2015 Budget Neutrality Work and -0.19 percent ..............
Malpractice Adjustment. (0.9981).
CY 2015 Anesthesia Fee Schedule -0.00494 percent ..............
Practice Expense Adjustment. (0.99506).
CY 2015 Anesthesia Fee Schedule -0.00494 percent ..............
Practice Expense Adjustment. (0.99506).
CY 2015 Anesthesia Conversion .................... $17.7454
Factor (4/1/2015 through 12/31/
2015).
Percent Change from 2014 to 2015 .................... -21.7%
(4/1/2015 through 12/31/2015).
------------------------------------------------------------------------
20. On page 67803, last row, in Table 52: Individual Quality Cross-
Cutting Measures for the PQRS to Be Available for Satisfactory
Reporting Via Claims, Registry, and EHR Beginning in 2015, the listed
entry is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR20MR15.007
[[Page 14863]]
BILLING CODE 4120-01-P
21. On page 67848, the last two rows, and the first row on page
67849, in Table 55: Measures Being Removed from the Existing PQRS
Measure Set Beginning in 2015, the listed are corrected to read as
follows:
[GRAPHIC] [TIFF OMITTED] TR20MR15.008
[[Page 14864]]
22. On page 67854, the second row, in Table 56: Existing Individual
Quality Measures and Those Included in Measures Groups for the PQRS for
Which Measure Reporting Updates Will Be Effective Beginning in 2015,
the listed entry is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR20MR15.009
[[Page 14865]]
23. On page 67877, second row, in Table 56: Existing Individual
Quality Measures and Those Included in Measures Groups for the PQRS for
Which Measure Reporting Updates Will Be Effective Beginning in 2015,
the listed entry is corrected to read as follows:
BILLING CODE 4120-01-C
[GRAPHIC] [TIFF OMITTED] TR20MR15.010
24. On page 67988, in Table 93: CY 2015 PFS Final Rule with Comment
Period Estimated Impact Table: Impacts of Work, Practice Expense, and
Malpractice RVUs, the table is corrected to read as follows:
[[Page 14866]]
[GRAPHIC] [TIFF OMITTED] TR20MR15.013
[[Page 14867]]
25. On page 67991 through 67992, in Table 94: Impact of Final Rule
with Comment Period on CY 2015 Payment for Selected Procedures the
table is corrected to read as follows:
BILLING CODE 4120-01-P
[GRAPHIC] [TIFF OMITTED] TR20MR15.014
[[Page 14868]]
[GRAPHIC] [TIFF OMITTED] TR20MR15.011
[[Page 14869]]
[GRAPHIC] [TIFF OMITTED] TR20MR15.012
27. On page 67999, third column, first full paragraph,
a. Line 18, the figure ``35.8013,'' is corrected to read
``35.7547,''.
b. Line 21, the figure ``$109.19,'' is corrected to read
``$108.18,''.
c. Line 23, the phrase ``this service would be $21.84.'' is
corrected to read ``this service would be $21.74.''
[[Page 14870]]
List of Subjects in 42 CFR Part 410
Health facilities, Health professions, Kidney diseases,
Laboratories, Medicare, Reporting and recordkeeping requirements, Rural
areas, X-rays.
Accordingly, 42 CFR chapter IV is corrected by making the following
correcting amendments to part 410:
PART 410--SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS
0
1. The authority citation for part 410 continues to read as follows:
Authority: Secs. 1102, 1834, 1871, 1881, and 1893 of the Social
Security Act (42 U.S.C. 1302, 1395m, 1395hh, and 1395ddd.
0
2. Section 410.26 is amended by revising paragraph (b)(5) to read as
follows:
Sec. 410.26 Services and supplies incident to a physician's
professional services: Conditions.
* * * * *
(b) * * *
(5) In general, services and supplies must be furnished under the
direct supervision of the physician (or other practitioner). Chronic
care management services and transitional care management services
(other than the required face-to-face visit) can be furnished under
general supervision of the physician (or other practitioner) when they
are provided by clinical staff incident to the services of a physician
(or other practitioner). The physician (or other practitioner)
supervising the auxiliary personnel need not be the same physician (or
other practitioner) upon whose professional service the incident to
service is based.
* * * * *
Dated: March 13, 2015.
C'Reda Weeden,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2015-06427 Filed 3-19-15; 8:45 am]
BILLING CODE 4120-01-C
