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Regulation #
CMS-1429-FC
Display Date
11/02/2004
Publication Date
11/15/2004
Calendar Year
2005
Regulation Type
Final Rule with Comment
Description
Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005
Comment Period Date
01/03/2006
Supporting Documentation
See Files in Download section below.

Scaling Factors Used to Adjust Estimated Costs for Individual Procedures: To develop practice expense relative value units, estimates of costs for individual procedures are adjusted by "scaling factors" to match them with estimated aggregate costs for each physician specialty obtained from practice expense surveys. The file contains the scaling factors that were used to develop the 2005 final rule. Physician Time File Used To Create the Resource-Based Practice Expense Relative Value Units For Calendar Year 2005: This file contains physician or clinical staff times use to create practice expense relative value units for more than 7,000 different procedure codes that will be paid by Medicare using the Medicare Physician Fee Schedule (MPFS) in 2005.

Specialty Utilization File Used To Create Resource-Based Practice Expense Relative Value Units For Calendar Year 2005: This file contains Medicare utilization data used to develop the 2005 resource-based practice expense relative value units and the payment impacts displayed in the physician fee schedule final rule.

Direct Practice Expense Values Used To Create Resource-Based Practice Expense Relative Value Units For Calendar Year 2004: Revised 11/10/04 This file contains resource inputs used in establishing resource-based practice expense values for more than 7,000 physician services. There are 3 different types of practice inputs: clinical staff, medical supplies and medical equipment. The source of the resource inputs are from one of the following: (1) Clinical Practice Expert Panels (CPEPs) convened in 1995 to develop estimates of the different types of resource inputs necessary to perform medical services (2) A crosswalk to a related service developed based upon a clinical opinion by CMS (formerly known as HCFA) (3) the AMA's Relative Value Update Committee (RUC) (4) refinement of the CPEP inputs by the AMA's Practice Expense Advisory Committee (PEAC) (5) CMS 's clinical judgment or (6) A medical specialty society.