Physician performance standard rates of increase for federal fiscal year 1994 and physician fee schedule update for calendar year 1994--HCFA. Final notice with comment period

This notice announces the calendar year (CY) 1994 updates to the Medicare physician fee schedule and the Federal fiscal year (FY) 1994 performance standard rates of increase for expenditures and volume of physicians' services under the Medicare Supplementary Medical Insurance (Part B) program as required by sections 1848 (d) and (f), respectively, of the Social Security Act. The physician performance standard rates of increase for Federal FY 1994 are 8.6 percent for surgical services, 10.5 percent for primary care services, 9.2 percent for other nonsurgical services, and 9.3 percent for all physicians' services. The fee schedule update for CY 1994 is 10.0 percent for surgical services, 7.9 percent for primary care services, and 5.3 percent for other nonsurgical services. This notice also references the surgical and nonsurgical designations for new and revised procedure codes in the Physicians' Current Procedural Terminology, to be used in applying the CY 1994 updates and for establishing and measuring expenditures under the MVPS for FY 1994. These designations appear in Addendum C of the final rule with comment period entitled "Medicare Program; Revisions to Payment Policies and Adjustments to the Relative Value Units under the Physician Fee Schedule for Calendar Year 1994 (BPD-770-FC)," published elsewhere in this Federal Register issue. The new and revised surgical and nonsurgical designations are subject to public comment. In addition, this notice addresses public comments on the "initial" procedure-specific list of surgical services published in our November 25, 1992, notice.     

Physician performance standard rates of increase for federal fiscal year 1993 and physician fee schedule update for calendar year 1993--HCFA. Final notice with comment period

This notice announces the calendar year (CY) 1993 updates to the Medicare physician fee schedule and the Federal fiscal year (FY) 1993 performance standard rates of increase for expenditures and volume of physician services under the Medicare Supplementary Medical Insurance (Part B) program as required by sections 1848(d) and (f), respectively, of the Social Security Act. It also sets forth an "initial" procedure-specific list of surgical and nonsurgical services to be used in applying the CY 1993 updates. These surgical and nonsurgical designations are subject to public comment. The physician performance standard rates of increase for Federal FY 1993 are 10.0 percent for all physician services, 8.4 percent for surgical services, and 10.8 percent for nonsurgical services. The fee schedule update for CY 1993 is 3.1 percent for surgical services and 0.8 percent for nonsurgical services.     

Medicare program; physician fee schedule update for calendar year 1997 and physician volume performance standard rates of increase for Federal fiscal year 1997--HCFA. Final notice

This final notice announces the calendar year 1997 updates to the Medicare physician fee schedule and the Federal fiscal year 1997 volume performance standard rates of increase for expenditures for physicians' services under the Medicare Supplementary Medical Insurance (Part B) program as required by sections 1848 (d) and, (f), respectively, of the Social Security Act. The fee schedule updates for calendar year 1997 are 1.9 percent for surgical services, 2.5 percent for primary care services, and -0.8 percent for other nonsurgical services. While it does not affect payment for any particular service, there was a 0.6 percent increase in the update for all physicians' services for 1997. The physician volume performance standard rates of increase for Federal fiscal year 1997 are -3.7 percent for surgical services, 4.5 percent for primary care services, -0.5 percent for other nonsurgical services, and a weighted average of -0.3 percent for all physicians' services.     

Medicare program; physician fee schedule update for calendar year 1996 and physician volume performance standard rates of increase for federal fiscal year 1996--HCFA. Final notice

This final notice announces the calendar year 1996 updates to the Medicare physician fee schedule and the Federal fiscal year 1996 volume performance standard rates of increase for expenditures for physicians' services under the Medicare Supplementary Medical Insurance (Part B) program as required by sections 1848 (d) and (f), respectively, of the Social Security Act. The fee schedule update for calendar year 1996 is 3.8 percent for surgical services, -2.3 percent for primary care services, and 0.4 percent for other nonsurgical services. While it does not affect payment for any particular service, there was a 0.8 percent increase in the update for all physicians' services for 1996. The physician volume performance standard rates of increase for Federal fiscal year 1996 are -0.5 percent for surgical services, 9.3 percent for primary care services, 0.6 percent for other nonsurgical services, and a weighted average of 1.8 percent for all physicians' services. In our July 26, 1995 proposed rule concerning revisions to payment policies under the Medicare physician fee schedule for calendar year 1996, we proposed using category-specific volume and intensity growth allowances in calculating the default Medicare Volume Performance Standard (MVPS). We received 20 comments on this proposal. Since this proposal is related to the MVPS and this notice deals with MVPS issues, we are responding to those comments in this notice instead of in the final rule for the fee schedule entitled "Medicare Program; Revisions to Payment Policies and Adjustments to the Relative Value Units Under the Physician Fee Schedule for Calendar Year 1996" published elsewhere in this Federal Register issue.     

Physician fee schedule update for calendar year 1995 and physician volume performance standard rates of increase for federal fiscal year 1995--HCFA. Final notice

This final notice announces the calendar year (CY) 1995 updates to the Medicare physician fee schedule and the Federal fiscal year (FY) 1995 volume performance standard rates of increase for expenditures for physicians' services under the Medicare Supplementary Medical Insurance (Part B) program as required by sections 1848(d) and (f), respectively, of the Social Security Act. The fee schedule update for CY 1995 is 12.2 percent for surgical services, 7.9 percent for primary care services, and 5.2 percent for other nonsurgical services. While it does not affect payment, there was a 7.7 percent increase in the update for all physicians' services for 1995. The physician volume performance standard rates of increase for Federal FY 1995 are 9.2 percent for surgical services, 13.8 percent for primary care services, 4.4 percent for other nonsurgical services, and a weighted average of 7.5 percent for all physicians' services. In our December 2, 1993 notice announcing the CY 1994 update to the Medicare physician fee schedule and FY 1994 volume performance standard rates of increase, we invited public comment on the update indicators for surgical and nonsurgical procedures that were new or revised in 1994. There were no public comments on those indicators. We have decided not to establish a public comment period for the codes that are new and revised in 1995 since, although these codes are initially classified as surgical or nonsurgical based on the clinical judgment of our medical staff, that classification ultimately rests on charge data that we use when they become available to determine whether the codes classified as surgical meet the criteria specified in our December 1993 notice.(ABSTRACT TRUNCATED AT 250 WORDS)     

Medicare program; fee schedule for physicians' services for calendar year 1993--HCFA. Correction of final notice with comment period

This document corrects technical errors that appeared in the final notice with comment period published in the Federal Register on November 25, 1992 (57 FR 55914) entitled "Medicare Program; Fee Schedule for Physicians' Services for Calendar Year 1993."     

Physician fee schedule update for calendar year 1992 and physician performance standard rates of increase for federal fiscal year 1992--HCFA. Notice

This notice announces the calendar year 1992 update to the Medicare physician fee schedule and the Federal fiscal year 1992 performance standard rates of increase for expenditures and volume of physician services under the Medicare Supplementary Medical Insurance (Part B) program as required by sections 1848 (d) and (f) respectively of the Social Security Act. The fee schedule update for calendar year 1992 is 1.9 percent. The physician performance standard rates of increase for Federal fiscal year 1992 are 10.0 percent for all physician services, 6.5 percent for surgical services, and 11.2 percent for nonsurgical services.     

Medicare program; fee schedule for physicians' services for calendar year 1993--HCFA. Final notice with comment period

This final notice with comment period announces the final relative value units (RVUs) for Medicare payment for existing procedure codes under the physician fee schedule and interim RVUs for new and revised codes. Section 6102(a) of the Omnibus Budget Reconciliation Act of 1989, as amended by section 4118 of the Omnibus Budget Reconciliation Act of 1990, requires establishment of the physician fee schedule and periodic review and adjustment of the RVUs.     

Medicare program; physician performance standard rates of increase for federal fiscal year 1991--HCFA. Notice

This notice announces the Federal fiscal year (FY) 1991 physician performance standard rates of increase for expenditures and volume of physician services under the Medicare Supplementary Medical Insurance (part B) Program as required by section 1848(f)(2)(C) of the Social Security Act as added by section 4105(d) of the Omnibus Budget Reconciliation Act of 1990. The physician performance standard rates of increase for FY 1991 are the following: 7.3 percent for all physician services, 3.3 percent for surgical services, and 8.6 percent for nonsurgical services.     

Medicare program; physician fee schedule conversion factor for calendar year 1998 and sustainable growth rate for fiscal year 1998--HCFA. Final notice

This final notice announces the calendar year 1998 Medicare physician fee schedule conversion factor and the fiscal year 1998 sustainable growth rate for expenditures for physicians' services under the Medicare Supplementary Medical Insurance (Part B) program as required by sections 1846(d) and (f), respectively, of the Social Security Act. The 1998 Medicare physician fee schedule conversion factor is $36,6873. The sustainable growth rate for fiscal year 1998 is 1.5 percent.     

Medicare program; revisions to payment policies and adjustments to the relative value units under the physician fee schedule for calendar year 1994--HCFA. Correction of final rule with comment period

This document corrects technical errors that appeared in the final rule with comment period published in the Federal Register on December 2, 1993 (58 FR 63626) entitled "Revisions to Payment Policies and Adjustments to the Relative Value Units Under the Physician Fee Schedule for Calendar Year 1994."     

Medicare program; physician fee schedule update for calendar year 2003. Final rule

This final rule revises the estimates used to establish the sustainable growth rates (SGRs) for fiscal years 1998 and 1999 for the purposes of determining future updates to the physician fee schedule and announces a 1.6 percent increase in the calendar year (CY) 2003 physician fee schedule conversion factor (CF) for March 1 to December 31, 2003. The physician fee schedule CF from March 1 to December 31, 2003, will be $36.7856. The anesthesia CF for this period will be $17.05. Any information contained in this final rule related to the CY 2003 physician or anesthesia CFs takes the place of the information contained in the December 31, 2002, final rule. All other provisions of the December 31, 2002, final rule are unchanged by this final rule.     

Medicare program; revisions to payment policies and adjustments to the relative value units under the physician fee schedule for calendar year 1994--HCFA. Final rule with comment period

This final rule revises the payment policy for specific physician services and supplies, revises the relative value units (RVUs) assigned to certain existing procedure codes, and establishes interim RVUs for new and revised procedure codes. Section 6102(a) of the Omnibus Budget Reconciliation Act of 1989, as amended by section 4118 of the Omnibus Budget Reconciliation Act of 1990, requires establishment of the physician fee schedule and periodic review and adjustment of the RVUs. Further changes concerning payment for certain physician services are required by sections 13513 through 13517 of the Omnibus Budget Reconciliation Act of 1993.     

Medicare program; revisions to payment policies under the physician fee schedule for calendar year 2004. Final rule with comment period

This final rule will refine the resource-based practice expense relative value units (RVUs) and make other changes to Medicare Part B payment policy. The policy changes concern: Medicare Economic Index, practice expense for professional component services, definition of diabetes for diabetes self-management training, supplemental survey data for practice expense, geographic practice cost indices, and several coding issues. In addition, this rule updates the codes subject to the physician self-referral prohibition. We also make revisions to the sustainable growth rate and the anesthesia conversion factor. These changes will ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. We are also finalizing the calendar year (CY) 2003 interim RVUs and are issuing interim RVUs for new and revised procedure codes for CY 2004. As required by the statute, we are announcing that the physician fee schedule update for CY 2004 is -4.5 percent, the initial estimate of the sustainable growth rate for CY 2004 is 7.4 percent, and the conversion factor for CY 2004 is $35.1339. We published a proposed rule (68 FR 50428) in the Federal Register on Part B drug payment reform on August 20, 2003. This proposed rule would also make changes to Medicare payment for furnishing or administering certain drugs and biologicals. We have not finalized these proposals to take into account that the Congress is considering legislation that would address these issues. We will continue to monitor legislative activity that would reform the Medicare Part B drug payment system. If legislation is not enacted soon on this issue, we remain committed to completing the regulatory process.     

Medicare program; revisions to payment policies under the physician fee schedule for calendar year 1999--HCFA. Proposed rule

This proposed rule would make several policy changes affecting Medicare Part B payment. The changes that relate to physician services include: resource-based practice expense relative value units, medical direction rules for anesthesia services, and payment for abnormal Pap smears. Also, we would rebase the Medicare Economic Index from a 1989 base year to a 1996 base year. Under the law, we are required to develop a resource-based system for determining practice expense relative value units. The Balanced Budget Act of 1997 (BBA 1997) delayed, for 1 year, implementation of the resource-based practice expense relative value units until January 1, 1999. Also, BBA 1997 revised our payment policy for nonphysician practitioners, for outpatient rehabilitation services, and for drugs and biologicals not paid on a cost or prospective payment basis. In addition, BBA 1997 permits certain physicians and practitioners to opt out of Medicare and furnish covered services to Medicare beneficiaries through private contracts. In addition, since we established the physician fee schedule on January 1, 1992, our experience indicates that some of our Part B payment policies need to be reconsidered. This proposed rule is intended to correct inequities in physician payment and solicits public comments on specific proposed policy changes.     

Medicare program; sustainable growth rate for fiscal year 1999--HCFA. Notice with comment period

This notice announces the fiscal year 1999 sustainable growth rate (SGR) for expenditures for physicians' services under the Medicare Supplementary Medical Insurance (Part B) program as required by section 1848(f) of the Social Security Act. The SGR for fiscal year 1999 is -0.3 percent. The negative fiscal year 1999 SGR is driven by the projected drop in Medicare fee-for-service enrollment.     

Medicare program; revisions to payment policies and adjustments to the relative value units under the physician fee schedule for calendar year 1999--HCFA. Final rule with comment period

This final rule makes several policy changes affecting Medicare Part B payment. The changes that relate to physicians' services include: resource-based practice expense relative value units (RVUs), medical direction rules for anesthesia services, and payment for abnormal Pap smears. Also, we are rebasing the Medicare Economic Index from a 1989 base year to a 1996 base year. Under the law, we are required to develop a resource-based system for determining practice expense RVUs. The Balanced Budget Act of 1997 (BBA) delayed, for 1 year, implementation of the resource-based practice expense RVUs until January 1, 1999. Also, BBA revised our payment policy for nonphysician practitioners, for outpatient rehabilitation services, and for drugs and biologicals not paid on a cost or prospective payment basis. In addition, BBA permits certain physicians and practitioners to opt out of Medicare and furnish covered services to Medicare beneficiaries through private contracts and permits payment for professional consultations via interactive telecommunication systems. Furthermore, we are finalizing the 1998 interim RVUs and are issuing interim RVUs for new and revised codes for 1999. This final rule also announces the calendar year 1999 Medicare physician fee schedule conversion factor under the Medicare Supplementary Medical Insurance (Part B) program as required by section 1848(d) of the Social Security Act. The 1999 Medicare physician fee schedule conversion factor is $34.7315.     

Medicare program; revisions to payment policies and adjustments to the relative value units under the physician fee schedule for calendar year 1996--HCFA. Final rule with comment period

This final rule revises various policies affecting payment for physician services including Medicare payment for physician services in teaching settings, the relative value units (RVUs) for certain existing procedure codes, and establishes interim RVUs for new and revised procedure codes. The rule also includes the final revised 1996 geographic practice cost indices. The rule redesignates current regulations on teaching hospitals, on the services of physicians to providers, on the services of physicians in providers, and on the services of interns and residents. This redesignation consolidates related rules affecting a specific audience in a separate part and, thereby, makes them easier to use.