医疗保险计划；外科服务的定义——医疗保健财务管理局。关于医师工作量绩效标准费率下外科服务定义增加并征求意见的通知。

Medicare program; definition of surgical services--HCFA. Notice of definition of surgical services for physician volume performance standard rates for increase with comment.

出版信息

Fed Regist. 1990 May 3;55(86):18668-72.

Abstract

This notice announces the definition of surgical services for purposes of the performance standard rates of increase for expenditures and volume of physician services and the appropriate fee schedule updates under the Medicare Supplementary Medical Insurance (Part B) program as required by section 6102 of the Omnibus Budget Reconciliation Act of 1989 (Pub. L. 101-239). Surgical services are defined as follows: All services currently classified as type of service "surgery" in the Medicare payment record that are performed by surgical specialists, including podiatrists and oral surgeons. All services currently classified as type of service "assistant at surgery" in Medicare payment records. This definition includes procedures recognized in the surgical section of Current Procedural Terminology published by the American Medical Association and certain other invasive procedures. This definition would not lead to payment differentials by physician specialty. Any differential in annual updates because of separate performance standard rates would be procedure-specific without regard to specialty.

摘要

本通知公布了根据1989年《综合预算协调法案》（公法101 - 239）第6102节要求，在医疗保险补充医疗保险（B部分）计划下，医生服务支出和量的绩效标准增长率以及适当的费用表更新方面的外科服务定义。外科服务定义如下：所有目前在医疗保险支付记录中归类为“手术”服务类型且由外科专科医生（包括足病医生和口腔外科医生）执行的服务。所有目前在医疗保险支付记录中归类为“手术助手”服务类型的服务。该定义包括美国医学协会出版的《现行程序术语》外科部分认可的程序以及某些其他侵入性程序。此定义不会导致因医生专科不同而产生支付差异。由于单独的绩效标准率导致的年度更新中的任何差异将是特定程序的，而不考虑专科。

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