Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016; Corrections, 12024-12030 [2016-05054]

Agencies

• Centers for Medicare & Medicaid Services
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 81, Number 45 (Tuesday, March 8, 2016)]
[Rules and Regulations]
[Pages 12024-12030]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-05054]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 405, 410, 411, 414, 425, and 495

[CMS-1631-F2]
RIN 0938-AS40


Medicare Program; Revisions to Payment Policies Under the 
Physician Fee Schedule and Other Revisions to Part B for CY 2016; 
Corrections

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Final rule; correcting amendment.

-----------------------------------------------------------------------

SUMMARY: This document corrects technical and typographical errors that 
appeared in the final rule with comment period published in the 
November 16, 2015 Federal Register (80 FR 70886 through 71386) entitled 
``Medicare Program; Revisions to Payment Policies Under the Physician 
Fee Schedule and Other Revisions to Part B for CY 2016.''

DATES: Effective date: This correcting document is effective March 7, 
2016.
    Applicability date: The corrections indicated in this document are 
applicable beginning January 1, 2016.

FOR FURTHER INFORMATION CONTACT: Lisa Ohrin Wilson (410) 786-8852, or 
Matthew Edgar (410) 786-0698, for issues related to physician self-
referral updates. Jessica Bruton, (410) 786-5991 for all other issues.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 2015-28005 (80 FR 70886 through 71386), the final rule 
entitled ``Medicare Program; Revisions to Payment Policies Under the 
Physician Fee Schedule and Other Revisions to Part B for CY 2016'' 
(hereinafter referred to as the CY 2016 PFS final rule with comment 
period), there were a number of technical and typographical errors that 
are identified and corrected in section IV., the Correction of Errors. 
The effective date for the rule was January 1, 2016, except for the 
definition of ``ownership or investment interest'' in Sec.  411.362(a), 
which has an effective date of January 1, 2017. These corrections are 
applicable as of January 1, 2016. We note that Addenda B and C to the 
CY 2016 PFS final rule with comment period as corrected by this 
correcting amendment are available on the CMS Web site at https://www.cms.gov//PhysicianFeeSched/.

II. Summary of Errors

A. Summary of Errors in the Preamble

    On page 70894, we inadvertently omitted a sentence from the first 
comment summary regarding applying the same overrides used for the MP 
RVU calculations to the PE calculations.
    On page 70894, we inadvertently omitted a clause from the response 
summary regarding the overrides that also apply to the MP RVU 
calculation in the development of PE RVUs.
    On page 70898, due to data errors made in the ratesetting process, 
many of the values contained in Table 4: Calculation of PE RVUs under 
Methodology for Selected Codes, are incorrect.
    On page 70953, we inadvertently included language regarding the 
application of the equipment utilization assumption.
    On page 70971,
    a. Due to a typographical error, the work RVU for CPT code 76945 
was listed incorrectly. As a result, the work RVU for CPT code 76948 
was also inadvertently listed incorrectly.
    b. Due to a typographical error, we inadvertently referred to CPT 
code 76948 rather than CPT code 76945.
    On page 70992, due to a typographical error in Table 13--CY 2016 
Actions on Codes with CY 2015 Interim Final RVUs, the CY 2016 work RVU 
for CPT code 76948 was incorrectly displayed.
    On page 71317, we inadvertently included language in our comment 
discussion on the issue regarding compensation arrangements.
    On page 71357,
    a. Due to data errors, we incorrectly stated the estimated CY 2016 
net reduction in expenditures.
    b. Due to data errors, we incorrectly stated the reduction to the 
conversion factor.
    c. Due to data errors, we incorrectly stated the CY 2016 PFS 
conversion factors. As a result, many of the values in Table 60--
Calculation of the CY 2016 PFS Conversion Factor, are incorrect.
    d. Due to data errors, we incorrectly stated the CY 2016 PFS 
anesthesia conversion factors. As a result, many of the values in Table 
61--Calculation of the CY 2016 PFS Anesthesia Conversion Factor, are 
incorrect.
    On pages 71358 through 71359, due to data errors, many of the 
values in Table 62--CY 2016 PFS Estimated Impact On Total Allowed 
Charges By Specialty, are incorrect.
    On pages 71359 through 71360, due to data errors, many of the 
values in Table 63-- Impact on CY 2016 Payment for Selected Procedures, 
are incorrect.
    On page 71369,
    a. Due to data errors, we incorrectly stated the CY 2016 national 
payment amount in the nonfacility setting for CPT code 99203.
    b. Due to data errors, we incorrectly stated the CY 2016 proposed 
beneficiary coinsurance for CPT code 99203.

B. Summary of Errors in Regulation Text

    On page 71375 of the CY 2016 PFS final rule with comment period, we 
made a typographical error in Sec.  411.357(d)(1)(iv). In this 
paragraph, we inadvertently included the word ``for''.
    On page 71377 of the CY 2016 PFS final rule with comment period, we 
made a typographical error in Sec.  411.357(x)(1)(vi)(A). In this 
paragraph, we inadvertently omitted the word ``directly''.

C. Summary and Correction of Errors in the Addenda on the CMS Web site

    Due to the errors identified and summarized in section II.A and B 
of this document, we are correcting errors in the work, PE or MP RVUs 
(or combinations of these RVUs) in Addendum B: CY 2016 Relative Value 
Units (RVUs) And Related Information Used In Determining Final Medicare 
Payments and Addendum C: CY 2016

[[Page 12025]]

Interim Final Relative Value Units (RVUs). We note that corrections to 
the RVUs for codes with identified errors affect additional codes due 
to the budget neutrality and relativity of the PFS. These errors are 
corrected in the revised Addenda B and C available on the CMS Web site 
at https://www.cms.gov//PhysicianFeeSched/.
    In addition to the errors identified in section II.A. of this 
document, the following errors occur in the addenda.
    Due to a technical error in the development of PE RVUs, the PE RVUS 
displayed in Addenda B and C were incorrect. In constructing the 
algorithm used to adjust specialty-specific volume for individual codes 
as described on page 70895 of the CY 2016 PFS final rule, claims 
volumes for codes billed with payment modifiers with different 
adjustments for payment and time were erroneously adjusted based on the 
time-based adjustment factor, not the payment-based factor. As a 
result, payment-adjusted volume associated with those modifiers for 
which the time-based adjustment factor is different from the payment-
based adjustment factor was inaccurate and has been corrected. The 
direct impact of the errors were limited to the practice expense for 
services frequently reported with payment modifiers with different 
adjustments for payment and time. However, the PE RVUs for many more 
codes may have been affected indirectly due to BN adjustments. The two 
specialties that report services paid under the anesthesia fee schedule 
were the only specialties significantly affected by the change. The PE 
RVUs that result from the correction of this error are reflected in the 
corrected Addendum B (and Addendum C, if applicable) available on the 
CMS Web site at https://www.cms.gov//PhysicianFeeSched/.
    Due to an error in the algorithm that we used to identify services 
that were subject to the phase-in of significant RVU reductions, CPT 
codes 67108, 67113, 67227 and 67228 were not included on the list of 
codes subject to the phase-in. These errors are corrected in the 
revised Codes Subject to Phase-in file available on the CMS Web site at 
https://www.cms.gov//PhysicianFeeSched/, and the resulting changes to 
the RVUs are reflected in the corrected Addenda B and C, available on 
the CMS Web site at https://www.cms.gov//PhysicianFeeSched/.
    Due to a data error, the useful life for the equipment item 
``FibroScan'' (ER101) was incorrect in the direct PE input database. 
This error is corrected in the revised Direct PE Input Database 
available on the CMS Web site at https://www.cms.gov//PhysicianFeeSched/
. As a result of this error being corrected, changes to PE RVUs are 
reflected in the corrected Addenda B and C, available on the CMS Web 
site at https://www.cms.gov//PhysicianFeeSched/.
    Due to a data error, the incorrect CY 2016 global periods were 
included in Addendum B (and Addendum C, if applicable) for the 
following CPT codes: 20240, 43210, 61650, 67227, 67228, 73060, and 
73560. The corrected CY 2016 global periods for these codes are 
reflected in the corrected Addendum B (and Addendum C, if applicable) 
available on the CMS Web site at https://www.cms.gov//PhysicianFeeSched/
.
    Due to an inadvertent error, the CY 2016 work RVUs for HCPCS codes 
G0296 and G0297 were incorrectly displayed in Addendum B. The correct 
CY 2016 work RVUS for these codes are reflected in the corrected 
Addendum B available on the CMS Web site at https://www.cms.gov//PhysicianFeeSched/.
    Due to a technical error, the clinical labor times associated with 
CPT codes 31654, 88333 and 99416 were inadvertently omitted from the 
direct PE input database. This error is corrected in the revised direct 
PE input database available on the CMS Web site at https://www.cms.gov//PhysicianFeeSched/. The PE RVUs that result from the correction of this 
error are reflected in the corrected Addendum B available on the CMS 
Web site at https://www.cms.gov//PhysicianFeeSched/.
    Due to a data input omission, the RVUs that reflect the appropriate 
payment rates for the treatment of intensive cardiac rehabilitation, as 
specified under section 1848(b)(5) of the Social Security Act (the 
Act), were not included in Addendum B. The appropriate RVUs for 
intensive cardiac rehabilitation are reflected in the corrected 
Addendum B available on the CMS Web site at https://www.cms.gov//PhysicianFeeSched/.

III. Waiver of Proposed Rulemaking

    Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA), 
the agency is required to publish a notice of the proposed rule in the 
Federal Register before the provisions of a rule take effect. 
Similarly, section 1871(b)(1) of the Act requires the Secretary to 
provide for notice of the proposed rule in the Federal Register and 
provide a period of not less than 60 days for public comment. In 
addition, section 553(d) of the APA, and section 1871(e)(1)(B)(i) of 
the Act mandate a 30-day delay in effective date after issuance or 
publication of a rule. Sections 553(b)(B) and 553(d)(3) of the APA 
provide for exceptions from the APA notice and comment, and delay in 
effective date requirements; similarly, sections 1871(b)(2)(C) and 
1871(e)(1)(B)(ii) of the Act provide exceptions from the notice and 
comment, and delay in effective date requirements of the Act. Section 
553(b)(B) of the APA and section 1871(b)(2)(C) of the Act authorize an 
agency to dispense with normal notice and comment rulemaking procedures 
for good cause if the agency makes a finding that the notice and 
comment process is impracticable, unnecessary, or contrary to the 
public interest; and includes a statement of the finding and the 
reasons for it in the notice. In addition, both section 553(d)(3) of 
the APA and section 1871(e)(1)(B)(ii) of the Act allow the agency to 
avoid the 30-day delay in effective date where such delay is contrary 
to the public interest and the agency includes in the rule a statement 
of the finding and the reasons for it.
    In our view, this correcting document does not constitute a 
rulemaking that would be subject to these requirements. This document 
merely corrects typographical and technical errors in the CY 2016 PFS 
final rule with comment period and the corresponding addenda posted on 
the CMS Web site. The corrections contained in this document are 
consistent with, and do not make substantive changes to, the policies 
and payment methodologies that were adopted subject to notice and 
comment procedures in the CY 2016 PFS final rule with comment period. 
As a result, the corrections made through this correcting document are 
intended to ensure that the CY 2016 PFS final rule with comment period 
accurately reflects the policies adopted in that rule.
    Even if this were a rulemaking to which the notice and comment and 
delayed effective date requirements applied, we find that there is good 
cause to waive such requirements. Undertaking further notice and 
comment procedures to incorporate the corrections in this document into 
the CY 2016 PFS final rule with comment period or delaying the 
effective date of the corrections would be contrary to the public 
interest because it is in the public interest to ensure that the CY 
2016 PFS final rule with comment period accurately reflects our final 
policies as soon as possible following the date they take effect. 
Further, such procedures would be unnecessary, because we are not 
altering the payment methodologies or policies, but rather, we are 
simply correcting the Federal Register document to reflect the policies 
that we previously proposed, received comment on, and subsequently

[[Page 12026]]

finalized. This correcting document is intended solely to ensure that 
the CY 2016 PFS final rule with comment period accurately reflects 
these policies. For these reasons, we believe there is good cause to 
waive the requirements for notice and comment and delay in effective 
date.

Correction of Errors

    In FR Doc. 2015-28005 of November 16, 2015 (80 FR 70886), make the 
following corrections:

A. Correction of Errors in the Preamble

    1. On page 70894, first column,
    a. First full paragraph, line 9, is corrected by adding the 
sentence ``One commenter suggested that for CY 2016 we apply the same 
overrides used for the MP RVU calculations to the PE calculations.''.
    b. Second full paragraph, lines 21 through 27, the sentence 
``Therefore, we are finalizing the policy as proposed for CY 2016 but 
will seek comment on the proposed CY 2017 PFS rates and whether or not 
the incorporation a new year of utilization data mitigates the need for 
service-level overrides.'' is corrected to read ``Therefore, we are 
finalizing the policy as proposed for CY 2016 and only apply the 
overrides that also apply to the MP RVU calculation in the development 
of PE RVUs but will seek comment on the proposed CY 2017 PFS rates and 
whether or not the incorporation of a new year of utilization data 
mitigates the need for service-level overrides.''.
    2. On page 70898, Table 4-Calculation of PE RVUs under Methodology 
for Selected Codes, the table is corrected to read as follows:
BILLING CODE 4120-01-P

[[Page 12027]]

[GRAPHIC] [TIFF OMITTED] TR08MR16.001

BILLING CODE 4120-01-C
    3. On page 70953, second column, first partial paragraph, lines 3 
through 6, the sentence ``This approach is consistent with the 
application of the equipment utilization assumption for advanced 
diagnostic imaging'' is deleted.
    4. On page 70971,
    a. First column, first full paragraph, line 15, the phrase ``work 
RVU of 0.56'' is corrected to read ``work RVU of 0.67''.
    b. First column, third full paragraph, line 12, the CPT code 
``76945'' is corrected to read ``76948''.
    c. First column, fourth full paragraph, line 4 the CPT code 
``76945'' is corrected to read ``76948''.

[[Page 12028]]

    d. First column, fourth full paragraph, line 16 the CPT code 
``76945'' is corrected to read ``76948''.
    5. On page 70992, in Table 13--CY 2016 Actions on Codes with CY 
2015 Interim Final RVUs, bottom half of the page, in columns 3 and 4, 
the work RVU ``0.38'' for CPT code 76948 is corrected to read ``0.67''.
    6. On page 71317,
    a. Third column, second full paragraph, line 2, the phrase ``on 
this issue (38, 50, 68, 73, 80)'' is corrected to read ``on this 
issue''.
    b. Third column, second full paragraph, line 10, the phrase 
``Another commenter (38)'' is corrected to read ``Another commenter''.
    7. On page 71357,
    a. Third column, first partial paragraph, line 13, the figure 
``0.23'' is corrected to read ``0.22''.
    b. Third column, first partial paragraph, line 24, the figure ``-
0.77'' is corrected to read ``-0.78.''
    c. Third column, first full paragraph, line 9, the figure 
``$35.8279'' is corrected to read ``$35.8043''.
    d. Third column, first full paragraph, line 17, the figure 
``$22.3309'' is corrected to read ``$21.9935''.
    e. Table 60--Calculation of the CY 2016 PFS Conversion Factor, the 
table is corrected to read as follows:

------------------------------------------------------------------------
 
------------------------------------------------------------------------
Conversion Factor in effect in   .......................         35.9335
 CY 2015.
Update Factor..................  0.5 percent (1.005)....  ..............
CY 2016 RVU Budget Neutrality    -0.076 percent           ..............
 Adjustment.                      (0.99924).
CY 2016 Target Recapture Amount  -0.78 percent (0.9922).  ..............
CY 2016 Conversion Factor......  .......................         35.8043
------------------------------------------------------------------------

    f. Table 61--Calculation of the CY 2016 Anesthesia Conversion, the 
table is corrected to read as follows:

------------------------------------------------------------------------
 
------------------------------------------------------------------------
CY 2015 National Average         .......................         22.6093
 Anesthesia Conversion Factor.
Update Factor..................  0.5 percent (1.005)....  ..............
CY 2016 RVU Budget Neutrality    -0.076 percent           ..............
 Adjustment.                      (0.99924).
CY 2016 Anesthesia Fee Schedule  -2.372 percent           ..............
 Practice Expense Adjustment.     (0.97628).
CY 2016 Anesthesia Fee Schedule  -0.78 percent (0.9922).  ..............
 Malpractice Adjustment.
CY 2016 Target Recapture Amount  -0.78 percent (0.9922).  ..............
CY 2016 Conversion Factor......  .......................         21.9935
------------------------------------------------------------------------

    8. On pages 71358 through 71359, Table 62--CY 2016 PFS Estimated 
Impact On Total Allowed Charges By Specialty, the table is corrected to 
read as follows:

----------------------------------------------------------------------------------------------------------------
               (A)                      (B)             (C)             (D)             (E)             (F)
Specialty                                Allowed  Impact of work    Impact of PE    Impact of MP        Combined
                                         charges     RVU changes     RVU changes     RVU changes       impact **
                                           (mil)       (percent)       (percent)       (percent)       (percent)
----------------------------------------------------------------------------------------------------------------
TOTAL...........................         $89,020               0               0               0               0
ALLERGY/IMMUNOLOGY..............             221               0               1               0               1
ANESTHESIOLOGY..................           1,970               0               0              -2              -2
AUDIOLOGIST.....................              61               0              -1               1               0
CARDIAC SURGERY.................             343               0               0               0               0
CARDIOLOGY......................           6,498               0               0               0               0
CHIROPRACTOR....................             789               0               0               0               0
CLINICAL PSYCHOLOGIST...........             720               0               0               0               0
CLINICAL SOCIAL WORKER..........             558               0               0               0               0
COLON AND RECTAL SURGERY........             161              -1               0               0              -1
CRITICAL CARE...................             296               0               0               0               0
DERMATOLOGY.....................           3,217               0               0               0               1
DIAGNOSTIC TESTING FACILITY.....             725               0               0               0               0
EMERGENCY MEDICINE..............           3,120               0               0               0               0
ENDOCRINOLOGY...................             454               0               0               0               0
FAMILY PRACTICE.................           6,089               0               0               0               0
GASTROENTEROLOGY................           1,843              -2              -1              -1              -4
GENERAL PRACTICE................             478               0               0               0               0
GENERAL SURGERY.................           2,210               0               0               0               0
GERIATRICS......................             216               0               0               0               0
HAND SURGERY....................             169               0               0               0               0
HEMATOLOGY/ONCOLOGY.............           1,788               0               0               0               0
INDEPENDENT LABORATORY..........             834               1               8               0               9
INFECTIOUS DISEASE..............             660               0               0               0               0
INTERNAL MEDICINE...............          11,058               0               0               0               0
INTERVENTIONAL PAIN MGMT........             720               0               0               0               0
INTERVENTIONAL RADIOLOGY........             298               0               0               0               1
MULTISPECIALTY CLINIC/OTHER PHYS              96               0               0               0               0
NEPHROLOGY......................           2,199               0               0               0               0

[[Page 12029]]

 
NEUROLOGY.......................           1,524               0               0               0               0
NEUROSURGERY....................             776               0               0               0               0
NUCLEAR MEDICINE................              46               0               0               0              -1
NURSE ANES/ANES ASST............           1,187               0               0              -2              -2
NURSE PRACTITIONER..............           2,551               0               0               0               0
OBSTETRICS/GYNECOLOGY...........             669               0               0               0               0
OPHTHALMOLOGY...................           5,506               0               0               0              -1
OPTOMETRY.......................           1,178               0               0               0               0
ORAL/MAXILLOFACIAL SURGERY......              47               0               0               0               0
ORTHOPEDIC SURGERY..............           3,672               0               0               0               0
OTHER...........................              25               0               0               0               0
OTOLARNGOLOGY...................           1,197               0               0               0               0
PATHOLOGY.......................           1,330               4               4               0               8
PEDIATRICS......................              59               0               0               0               0
PHYSICAL MEDICINE...............           1,035               0               0               0               0
PHYSICAL/OCCUPATIONAL THERAPY...           3,102               0               0               0               0
PHYSICIAN ASSISTANT.............           1,728               0               0               0               0
PLASTIC SURGERY.................             376               0               0               0               0
PODIATRY........................           1,999               0               0               0               0
PORTABLE X-RAY SUPPLIER.........             106               0               1               0               1
PSYCHIATRY......................           1,317               0               0               0               0
PULMONARY DISEASE...............           1,780               0               0               0               0
RADIATION ONCOLOGY..............           1,776               0              -2               0              -2
RADIATION THERAPY CENTERS.......              52               0              -1               0              -1
RADIOLOGY.......................           4,494               0               0               0               0
RHEUMATOLOGY....................             536               0               0               0               0
THORACIC SURGERY................             350               0               0               0               0
UROLOGY.........................           1,796               0               0               0               0
VASCULAR SURGERY................           1,019               0              -1               0             -1
----------------------------------------------------------------------------------------------------------------
** Column F may not equal the sum of columns C, D, and E due to rounding.

    9. On pages 71359 through 71360, Table 63--Impact on CY 2016 
Payment for Selected Procedures, the table is corrected to read as 
follows:

----------------------------------------------------------------------------------------------------------------
                                                                   Facility                   Non facility
                                                       ---------------------------------------------------------
      CPT/HCPCS \1\         MOD      Short descriptor    CY 2015    CY 2016      %     CY 2015  CY 2016     %
                                                           \2\        \3\      Change    \2\      \3\     Change
----------------------------------------------------------------------------------------------------------------
11721...................  .......  Debride nail 6 or       $25.15     $25.42        1   $45.28   $45.47        0
                                    more.
17000...................  .......  Destruct premalg         53.90      54.42        1    67.20    67.67        1
                                    lesion.
27130...................  .......  Total hip             1,407.87   1,400.66       -1       NA       NA       NA
                                    arthroplasty.
27244...................  .......  Treat thigh           1,277.80   1,271.05       -1       NA       NA       NA
                                    fracture.
27447...................  .......  Total knee            1,407.52   1,400.31       -1       NA       NA       NA
                                    arthroplasty.
33533...................  .......  Cabg arterial         1,952.63   1,947.04        0       NA       NA       NA
                                    single.
35301...................  .......  Rechanneling of       1,203.41   1,199.44        0       NA       NA       NA
                                    artery.
43239...................  .......  Egd biopsy single/      154.15     151.45       -2   412.52   403.87       -2
                                    multiple.
66821...................  .......  After cataract          316.21     315.44        0   334.90   334.05        0
                                    laser surgery.
66984...................  .......  Cataract surg w/iol     650.40     648.42        0       NA       NA       NA
                                    1 stage.
67210...................  .......  Treatment of            508.82     507.35        0   526.79   524.89        0
                                    retinal lesion.
71010...................  .......  Chest x-ray 1 view          NA         NA       NA    22.64    22.56        0
                                    frontal.
71010...................       26  Chest x-ray 1 view        9.34       9.31        0     9.34     9.31        0
                                    frontal.
77056...................  .......  Mammogram both              NA         NA       NA   116.42   116.01        0
                                    breasts.
77056...................       26  Mammogram both           44.56      44.40        0    44.56    44.40        0
                                    breasts.
77057...................  .......  Mammogram screening         NA         NA       NA    83.01    82.71        0
77057...................       26  Mammogram screening      35.93      35.80        0    35.93    35.80        0
77427...................  .......  Radiation tx            187.57     187.61        0   187.57   187.61        0
                                    management x5.
88305...................       26  Tissue exam by           39.17      39.74        1    39.17    39.74        1
                                    pathologist.
90935...................  .......  Hemodialysis one         73.66      73.40        0       NA       NA       NA
                                    evaluation.
92012...................  .......  Eye exam establish       53.18      53.35        0    86.24    85.93        0
                                    patient.
92014...................  .......  Eye exam&tx estab        80.85      80.92        0   124.69   124.60        0
                                    pt 1/>vst.
93000...................  .......  Electrocardiogram           NA         NA       NA    17.25    17.19        0
                                    complete.
93010...................  .......  Electrocardiogram         8.62       8.59        0     8.62     8.59        0
                                    report.
93015...................  .......  Cardiovascular              NA         NA       NA    77.26    76.98        0
                                    stress test.
93307...................       26  Tte w/o doppler          45.99      45.83        0    45.99    45.83        0
                                    complete.
93458...................       26  L hrt artery/           323.76     323.31        0   323.76   323.31        0
                                    ventricle angio.
98941...................  .......  Chiropract manj 3-4      35.21      35.09        0    41.32    41.17        0
                                    regions.
99203...................  .......  Office/outpatient        77.98      77.70        0   109.60   108.85       -1
                                    visit new.

[[Page 12030]]

 
99213...................  .......  Office/outpatient        51.38      51.56        0    73.30    73.40        0
                                    visit est.
99214...................  .......  Office/outpatient        79.41      79.13        0   108.88   108.13       -1
                                    visit est.
99222...................  .......  Initial hospital        139.06     138.20       -1       NA       NA       NA
                                    care.
99223...................  .......  Initial hospital        205.90     204.44       -1       NA       NA       NA
                                    care.
99231...................  .......  Subsequent hospital      39.53      39.74        1       NA       NA       NA
                                    care.
99232...................  .......  Subsequent hospital      73.30      72.68       -1       NA       NA       NA
                                    care.
99233...................  .......  Subsequent hospital     105.64     104.91       -1       NA       NA       NA
                                    care.
99236...................  .......  Observ/hosp same        220.99     219.48       -1       NA       NA       NA
                                    date.
99239...................  .......  Hospital discharge      108.88     108.13       -1       NA       NA       NA
                                    day.
99283...................  .......  Emergency dept           62.88      62.66        0       NA       NA       NA
                                    visit.
99284...................  .......  Emergency dept          119.66     118.87       -1       NA       NA       NA
                                    visit.
99291...................  .......  Critical care first     227.46     225.93       -1   279.20   277.48       -1
                                    hour.
99292...................  .......  Critical care addl      113.55     113.14        0   124.33   123.88        0
                                    30 min.
99348...................  .......  Home visit est              NA         NA       NA    84.80    84.86        0
                                    patient.
99350...................  .......  Home visit est              NA         NA       NA   178.95   179.38        0
                                    patient.
G0008...................  .......  Immunization admin.         NA         NA       NA    25.51    25.42        0
----------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions are copyright 2016 American Medical Association. All Rights Reserved. Applicable
  FARS/DFARS apply.
\2\ Payments based on the July-December 2015 conversion factor of 35.9335.
\3\ Payments based on the 2016 conversion factor of $35.8043.

    10. On page 71369,
    a. Second column, fifth paragraph, line 20, the figure ``$109.28'' 
is corrected to read ``108.85''.
    b. Second column, fifth paragraph, line 23, the figure ``$21.86'' 
is corrected to read ``21.77''.

List of Subjects in 42 CFR Part 411

    Kidney diseases, Medicare, Physician referral, Reporting and 
recordkeeping requirements.

    Accordingly, 42 CFR chapter IV is corrected by making the following 
correcting amendments to part 411:

PART 411--EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE 
PAYMENT

0
1. The authority citation for part 411 continues to read as follows:

    Authority: Secs. 1102, 1860D-1 through 1860D-42, 1871, and 1877 
of the Social Security Act (42 U.S.C. 1302, 1395w-101 through 1395w-
152, 1395hh, and 1395nn).


0
2. Section 411.357 is amended:
0
a. In paragraph (d)(1)(iv) by removing the phrase ``is for at least 1 
year'' and adding in its place the phrase ``is at least 1 year''.
0
b. In paragraph (x)(1)(vi)(A) by removing the phrase ``The nonphysician 
practitioner has a compensation arrangement with'' and adding in its 
place the phrase ``The nonphysician practitioner has a compensation 
arrangement directly with''.

    Dated: February 29, 2016.
Wilma Robinson,
Deputy Executive, Secretary to the Department, Department of Health and 
Human Services.
[FR Doc. 2016-05054 Filed 3-7-16; 8:45 am]
 BILLING CODE 4120-01-P