{"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. DATES: Effective Date: This rule is effective January 1, 1997, as provided by the Medicare statute. Ordinarily, 5 U.S.C. section 801 requires that agencies submit major rules to Congress 60 days before the rules are scheduled to become effective. However, the 104th Congress adjourned on October 4, 1996, and the 105th Congress is not scheduled to convene until January 7, 1997. The Department has concluded that, in this instance, a further delay in this rule's effective date in order to satisfy section 801 would not serve the law's intent, since Congress will not be in session during this period, and such delay in the effective date established by the Medicare statute is unnecessary and contrary to the public interest. The Department finds, on this basis, that there is good cause for establishing this effective date pursuant to 5 U.S.C. section 808(2). Comment Date: We will accept comments on interim RVUs for selected procedure codes identified in Addendum C. Comments will be considered if we receive them at the appropriate address, as provided below, no later than 5 p.m. on January 21, 1997.","action":"Final rule with comment period.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Health Care Financing Administration","name":"Health Care Finance Administration","id":559,"url":"https://www.federalregister.gov/agencies/health-care-finance-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/559","parent_id":221,"slug":"health-care-finance-administration"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/1996/11/22/96-29558.html","cfr_references":[{"chapter":null,"citation_url":null,"part":"410","title":42},{"chapter":null,"citation_url":null,"part":"415","title":42}],"citation":"61 FR 59490","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":null,"disposition_notes":null,"docket_ids":["BPD-852-FC"],"dockets":[],"document_number":"96-29558","effective_on":null,"end_page":59716,"executive_order_notes":null,"executive_order_number":null,"explanation":null,"full_text_xml_url":null,"html_url":"https://www.federalregister.gov/documents/1996/11/22/96-29558/medicare-program-revisions-to-payment-policies-and-five-year-review-of-and-adjustments-to-the","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/96-29558?publication_date=1996-11-22","mods_url":"https://www.govinfo.gov/metadata/granule/FR-1996-11-22/96-29558/mods.xml","not_received_for_publication":null,"page_length":227,"page_views":{"count":522,"last_updated":"2026-04-25 10:15:04 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-1996-11-22/pdf/96-29558.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"1996-11-22","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/1996/11/22/96-29558.txt","regulation_id_number_info":{"0938-AH40":{"issue":"199610","html_url":"https://www.federalregister.gov/regulations/0938-AH40/medicare-program-revisions-to-payment-policies-and-five-year-review-of-and-adjustments-to-relative-v","title":"Medicare Program: Revisions to Payment Policies and Five-Year Review of and Adjustments to Relative Value Units Under the Physician Fee Schedule for Calendar Year 1997 (BPD-852-FC)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=199610&RIN=0938-AH40&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"}},"regulation_id_numbers":["0938-AH40"],"regulations_dot_gov_info":{"checked_regulationsdotgov_at":"2011-09-21T11:55:16Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":59490,"subtype":null,"title":"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","toc_doc":null,"toc_subject":null,"topics":[],"type":"Rule","volume":61}