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医疗保险计划;1997年日历年医师费率表下支付政策的修订以及相对价值单位的五年审查与调整——医疗保健财务管理局。附意见征求期的最终规则。

Medicare program; revisions to payment policies and five-year review of and adjustments to the relative value units under the physician fee schedule for calendar year 1997--HCFA. Final rule with comment period.

出版信息

Fed Regist. 1996 Nov 22;61(227):59490-716.

Abstract

This final rule makes several policy changes affecting Medicare payment for physician services, including payment for diagnostic services and transportation in connection with furnishing diagnostic tests. The final rule also makes changes in geographic payment areas (localities) and changes in the procedure status codes for a variety of services. Since we established the physician fee schedule on January 1, 1992, our experience indicates that some of our policies may need to be reconsidered. This final rule is intended to correct several inequities in physician payment. This final rule also makes changes to work relative value units (RVUs) affecting payment for physician services. Section 1848(c)(2)(B)(i) of the Social Security Act requires that we review all work RVUs no less often than every 5 years. Since we implemented the physician fee schedule effective for services furnished beginning January 1, 1992, we have completed the 5-year review of work RVUs that will be effective for services furnished beginning January 1, 1997. In addition, we are finalizing the 1996 interim RVUs and are issuing interim RVUs for new and revised procedure codes for 1997.

摘要

本最终规则做出了多项政策变更,这些变更影响医疗保险对医师服务的支付,包括对诊断服务以及与提供诊断检查相关的交通费用的支付。最终规则还对地理支付区域(地区)进行了变更,并对多种服务的程序状态代码进行了更改。自1992年1月1日我们制定医师费率表以来,我们的经验表明,我们的一些政策可能需要重新考虑。本最终规则旨在纠正医师支付方面的一些不公平现象。本最终规则还对影响医师服务支付的工作相对价值单位(RVU)进行了更改。《社会保障法》第1848(c)(2)(B)(i)条要求我们至少每5年对所有工作RVU进行一次审查。自我们实施自1992年1月1日起提供的服务有效的医师费率表以来,我们已经完成了对自1997年1月1日起提供的服务有效的工作RVU的5年审查。此外,我们正在确定1996年临时RVU,并发布1997年新的和修订的程序代码的临时RVU。

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