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Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006 and Certain Provisions Related to the Competitive Acquisition Program of Outpatient Drugs and Biologicals Under Part B; Correcting Amendment

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Information about this document as published in the Federal Register.

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Start Preamble

AGENCY:

Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION:

Correcting amendment to final rule with comment.

SUMMARY:

In the November 21, 2005 Federal Register (70 FR 70116), we published a final rule with comment period entitled “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006 and Certain Provisions Related to the Competitive Acquisition Program of Outpatient Drugs and Biologicals Under Part B.” This correcting amendment corrects technical errors in the November 21, 2005 publication.

EFFECTIVE DATE:

This correcting amendment is effective January 1, 2006.

Start Further Info

FOR FURTHER INFORMATION CONTACT:

Diane Milstead, (410) 786-3355.

End Further Info End Preamble Start Supplemental Information

SUPPLEMENTARY INFORMATION:

I. Background

FR Doc. 05-22160, entitled “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006 and Certain Provisions Related to the Competitive Acquisition Program of Outpatient Drugs and Biologicals Under Part B” and appearing in the Federal Register on November 21, 2005 (70 FR 70116), addressed Medicare Part B payment policy, including the physician fee schedule, that is applicable for calendar year (CY) 2006; and finalized certain provisions of the interim final rule to implement the Competitive Acquisition Program (CAP) for Part B Drugs.

It also revised Medicare Part B payment and related policies regarding: Physician work, practice expense and malpractice relative value units (RVUs); Medicare telehealth services; multiple diagnostic imaging procedures; covered outpatient drugs and biologicals; supplemental payments to Federally Qualified Health Centers (FQHCs); renal dialysis services; coverage for glaucoma screening services; National Coverage Decision (NCD) timeframes; and physician referrals for nuclear medicine services and supplies to health care entities with which physicians have financial relationships.

In addition, the rule finalized the interim RVUs for CY 2005 and issued interim RVUs for new and revised procedure codes for CY 2006. This rule also updated the codes subject to the physician self-referral prohibition and discussed payment policies relating to teaching anesthesia services, therapy caps, private contracts and opt-out, and chiropractic and oncology demonstrations.

We have identified a number of technical errors in that final rule with comment period.

II. Summary of Errors

We are identifying and correcting errors made to certain parts of the preamble, regulations text and addenda of the November 21, 2005 final rule with comment (70 FR 70116). In addition, addendum B, C, D, E and F are revised under this correcting amendment, although these addenda will not appear in the Code of Federal Regulations.

A. Summary of Preamble Errors

In the preamble text, there were a number of errors and omissions beginning on pages 70150 through 70335.

1. On page 70150, in the first column, in the last paragraph under Section m. (Additional PE Issues Raised by Commenters), in the second sentence, the number of the CPT code referenced is incorrect.

2. On page 70155, in the center column, the last sentence of the second paragraph under the discussion titled, “3. Cardiac Catheritization and Angioplasty Exception,” there was an error in one of the code ranges referenced.

3. On page 70263, in the third column; in last paragraph, the reference to Table 26 is incorrect.

4. On page 70263, Table 26 was numbered incorrectly.

5. On page 70274, in the first column; in the second paragraph language concerning the specific deleted practice Start Printed Page 9459expense items was inadvertently omitted.

6. On page 70282, in the second column; from the top of the column, lines 8 through 11, the sentence, “We are assigning a status indicator of N for these services because they are nonvcovered under Medicare.” reflects an incorrect status indicator and will be revised.

7. On page 70282, in the third column; we inadvertently omitted a paragraph before section F. (Establishment of Interim PE RVUs for New and Revised Physician's Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System (HCPCS) Codes for 2006).

8. On page 70296, in the second column; in the last paragraph, in line 6, we incorrectly used the term “PFS”, and that term will be replaced.

9. On page 70302, in Table 35, the figures for Annual Actual Expenditures and the Cumulative Actual Expenditures, for the period of 1/1/03-12/31/03, are incorrect and will be revised.

10. On page 70316, the first column, the percentage adjustment referenced in the third complete sentence is incorrect and will be revised.

11. On page 70320, the second footnote to Table 49 has incorrectly listed the numerical scaler. This footnote will be corrected.

These corrections are reflected in Section III.A of this correcting amendment.

B. Summary of Regulations Text Errors

In the regulation text, there were technical errors and omissions in § 405.2469, § 414.190, § 414.904, § 414.906, and § 426.340.

1. On page 70329, in the third column, under § 405.2469, paragraph (a)(1) does not reflect the correct format for amendatory language. Paragraph (a)(1) will be restructured.

2. On page 70331, in the third column, the reference to § 414.190 is incorrect.

3. On page 70332, in the third column, the title (Basis for payment.) for § 414.904 is incorrect.

4. On page 70333, in the first column, under § 414.906, we inadvertently omitted a change to bring the regulations text into conformity with our policy on updating CAP drug prices, as described in the interim final rule with comment period published July 6, 2005.

5. On page 70335, in the first column, under § 426.340, the statutory references in paragraphs (e)(2)(ii) and (f)(2)(ii) are incorrect.

The corrections are reflected in section III.B. of this correcting amendment.

C. Summary of Addendum B, C, D, E and F Errors

1. In Addendum B, pages 70337 through 70463, we are making the following corrections:

a. We assigned incorrect RVUs to the following Physicians' CPT or HCPCS codes:

50000:

i. 52648;

60000:

ii. 61630, 61635;

80000:

iii. 88385-26, 88385-TC, 88385, 88386-26, 88386-TC, and 88386;

90000:

iv. 90760, 90761, 90765, 90766, 90767, 90768, 90772, 90773, 90774, 90775, 92626, 92627, 93514, 96401, 96402, 96405, 96406, 96409, 96411, 96413, 96415, 96416, 96417, 96420, 96440, 96450, 96521, 96522, 96542, 97606, 99300, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, and 99337.

b. We assigned an incorrect global period for CPT code 92627.

c. We assigned incorrect status indicators to the following CPT or codes 0141T, 0142T, 0143T, 88385-26, 88385-TC, 88385, 88386-26, 88386-TC, 88386, 96523, 98960, 98961, 98962 and 99340.

d. The following HCPCS codes were inadvertently included: G9041, G9042, G9043 and G9044. These numbers should not have been included because they were not in effect.

e. HCPCS code G0332 was inadvertently omitted from the addendum.

f. The first footnote to addendum B should be corrected to read “1 CPT codes and descriptions only. Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.”

These corrections are reflected in Sections III.C.1. and 2. of this correcting amendment.

2. In Addendum C, pages 70463 through 70466, we are making the following corrections:

a. We assigned incorrect RVUs to the following CPT or alphanumeric HCPCS number for service codes:

60000:

i. 61630 and 61635.

80000:

ii. 88385-26 and 88386-26.

90000:

iii. 90760, 90761, 90765, 90766, 90767, 90768, 90772, 90773, 90774, 90775, 92626, 92627, 96401, 96402, 96409, 96411, 96413, 96415, 96416, 96417, 96450, 96521, 96522, 96523, 96542, 99300, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336 and 99337.

b. We assigned incorrect status indicators to the following CPT codes 88385-26, 88386-26, 98960, 98961, 98962 and 99340.

These corrections are reflected in Section III.C.3 of this correcting amendment.

3. In Addendum D, pages 70466 through 70467, we are correcting the locality name “Kansas*” to read “Kansas”.

These corrections are reflected in Section III.C.4 of this correcting amendment.

4. In Addendum E, pages 70468 through 70469, we are correcting the locality name “Kansas*” to read “Kansas”.

These corrections are reflected in Section III.C.5 of this correcting amendment.

5. In Addendum F, pages 70469 through 70471, we are correcting this Addendum by replacing this Addendum in its entirety to address two errors. First, we inadvertently left a discontinued HCPCS code, J1750, on Addendum F. This code was replaced by J1751 and J1752 which are found on Addendum G “Revised New Drugs for CAP Bidding for 2006”. Second, we included a new HCPCS code, J7318, which we understood would replace HCPCS codes J7317 and J7320. HCPCS J7318 was not issued and HCPCS codes J7317 & J3120 were retained. We have reweighted and corrected Addendum F to reflect these changes.

These corrections are reflected in Section III.C.6 of this correcting amendment.

III. Correction of Errors

In FR Doc. 05-22160, entitled “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006 and Certain Provisions Related to the Competitive Acquisition Program of Outpatient Drugs and Biologicals Under Part B,” which appeared in the Federal Register on November 21, 2005 (70 FR 70116), make the following corrections:

A. Correction of Preamble Errors

1. On page 70150, in the first column; in the last paragraph under Section m. (Additional PE Issues Raised by Commenters), in the second sentence, the number “99755” is corrected to read “97755”.

2. On page 70155, in the center column; the last sentence of the second paragraph under the discussion titled, “3. Cardiac Catheterization and Start Printed Page 9460Angioplasty Exception,” the number “93617” is corrected to read “93618”.

3. On page 70263, in the third column; in the last paragraph, the phrase “Table 26” is corrected to read “Table 26A”.

4. On page 70263, the table heading “Table 26.—Example of Payments” is corrected to read “Table 26A.—Example of Payments”.

5. On page 70274, in the first column; in the second paragraph, the paragraph is corrected by adding a new sentence at the end of the paragraph to read as follows: “Because payment for the supplies and equipment for both of these procedures is provided under a separate DMERC policy, we have deleted the following practice expense items from these codes: Supplies deleted include dressings, both Adaptic and microporous, the drainage canister, and the sharp debridement kit—which was identified as not being needed for the typical scenario; and, the vacuum pump was deleted from the equipment.”

6. On page 70282, in the second column; lines 8 through 11, the sentence, “We are assigning a status indicator of N for these services because they are noncovered under Medicare.” is corrected to read, “We are assigning a status indicator of B for these services because payment for these services is bundled into payment for other Medicare services.”

7. On page 70282, in the third column; we are adding a new paragraph before section F. (Establishment of Interim PE RVUs for New and Revised Physician's Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System (HCPCS) Codes for 2006). The new paragraph reads as follows: “CPT code 99339 Individual physician supervision of patient (patient not present) in home, domiciliary or rest home (e.g., assisted living facility) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment care decisions with health care professional(s), family member(s), surrogate decision maker(s) (e.g., legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 15-29 minutes.

CPT code 99340 Individual physician supervision of patient (patient not present) in home, domiciliary or rest home (e.g., assisted living facility) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment care decisions with health care professional(s), family member(s), surrogate decision maker(s) (e.g., legal guardian) and/or key caregiver(s) involved inpatient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 30 minutes or more. We are assigning a status indicator of B for these codes because payment for these services is bundled into payment for other services.”

8. On page 70296, in the second column; in the last paragraph, in line 6, the term “PFS” is corrected to read “Code List”.

9. On page 70302, in Table 35; in the third column titled “Annual Actual Expenditures”, in line 10 (1/1/03-12/31/03) of that column, “76.8” is corrected to read “78.2”; and in the fifth column titled “Cumulative Actual Expenditures”, in line 10 (1/1/03-12/31/03) of that column, “460.6” is corrected to read “462.0”.

10. On page 70316, in the first column; in the third complete sentence, the figure “−0.6” is corrected to read “−0.15”.

11. On page 70320, in the second footnote to Table 49, the figure “0.9984” is corrected to read “0.9985”.

B. Correction of Regulation Text Errors

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List of Subjects

End List of Subjects

Given the errors summarized in section II.B. of this correcting amendment, we are making the following correcting amendments to 42 CFR parts 405, 414, and 426:

Start Part

PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED

End Part Start Amendment Part

1. The authority citation for part 405 continues to read as follows:

End Amendment Part Start Authority

Authority: Secs. 1102, 1861, 1862(a), 1871, 1874, 1881, and 1886(k) of the Social Security Act (42 U.S.C. 1302, 1395x, 1395y(a), 1395hh, 1395kk, 1395rr, and 1395ww(k)), and sec. 353 of the Public Health Service Act (42 U.S.C. 263a).

End Authority Start Amendment Part

2. Section 405.2469 is amended by revising paragraph (a)(1) to read as follows:

End Amendment Part
Federally Qualified Health Centers supplemental payments.
* * * * *

(a) Calculation of supplemental payment. (1) The supplemental payment for Federally Qualified Health Center covered services provided to Medicare patients enrolled in Medicare Advantage plans is based on the difference between—

(i) Payments received by the center from the Medicare Advantage plan as determined on a per visit basis; and

(ii) The Federally Qualified Health Center's all-inclusive cost-based per visit rate as set forth in this subpart, less any amount the FQHC may charge as described in section 1857(e)(3)(B) of the Act.

* * * * *
Start Part

PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES

End Part Start Amendment Part

3. The authority citation for part 414 continues to read as follows:

End Amendment Part Start Authority

Authority: Secs. 1102, 1871, and 1881(b)(1) of the Social Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1)).

End Authority Start Amendment Part

4. Section 414.906 is amended by revising paragraph (c)(1) introductory text to read as follows:

End Amendment Part
Competitive acquisition program as the basis of payment.
* * * * *

(c) Computation of payment amount. (1) Except as specified in paragraph (c)(2) of this section, payment for CAP drugs is based on bids submitted, as a result of the bidding process as described in § 414.910. Based on these bids, a single payment amount for each CAP drug in the competitive acquisition area is determined on the basis of the bids submitted and accepted and updated from the bidding period to the payment year. This single payment amount is then updated on an annual Start Printed Page 9461basis based on the approved CAP vendor's reasonable net acquisition costs for that category as determined by CMS, based, in part, on information disclosed to CMS and limited by the weighted payment amount established under section 1847A of the Act across all drugs for which a composite bid is required in the category, and limited by the payment amount established under section 1847A of the Act for each other drug for which the approved CAP vendor submits a bid in accordance with § 414.910. Adjustment to the payment amounts may be made more often than annually, but no more often than quarterly, in any of the following cases:

* * * * *
Start Part

PART 426—REVIEW OF NATIONAL COVERAGE DETERMINATIONS AND LOCAL COVERAGE DETERMINATIONS

End Part Start Amendment Part

5. The authority citation for part 426 continues to read as follows:

End Amendment Part Start Authority

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

End Authority Start Amendment Part

6. Section 426.340 is amended by revising paragraphs (e)(2)(ii) and (f)(2)(ii) to read as follows:

End Amendment Part
Procedures for review of new evidence.
* * * * *

(e) * * *

(2) * * *

(ii) For NCDs, in compliance with the timeframes specified in section 1862(1) of the Act, by which CMS completes the reconsideration.

(f) * * *

(2) * * *

(ii) For NCDs, the reconsideration timeframe specified by the Board, in compliance with section 1862(l) of the Act.

* * * * *

C. Correction of Addendum Errors

Start Amendment Part

Given the errors summarized in Section II.C of this correcting amendment, we are making the following corrections to Addendum B, C, D, E, and F. These addenda will not appear in the Code of Federal Regulations.

End Amendment Part Start Amendment Part

1. On pages 70337 through 70463, the following entries to Addendum B are corrected to read as follows:

End Amendment Part

Addendum B.—Relative Value Units (RVUs) and Related Information—Continued

CPT 1/HCPCS 2ModStatusDescriptionPhysician work RVUs 3Nonfacility PE RVUsFacility PE RVUsMalpractice RVUsNonfacility totalFacility totalGlobal
0141TIPerq islet transplant0.000.000.000.000.000.00XXX
0142TIOpen islet transplant0.000.000.000.000.000.00XXX
0143TILaparoscopic islet transplant0.000.000.000.000.000.00XXX
52648ALaser surgery of prostate11.1974.154.800.7986.0716.78090
61630NIntracranial angioplasty+21.08NA12.532.01NA35.62090
61635NIntracran angioplasty w/stent+23.08NA13.582.20NA38.86090
8838526AEval molecul probes, 51-2501.500.65NA0.062.21NAXXX
88385TCAEval molecul probes, 51-2500.006.45NA0.066.51NAXXX
88385AEval molecul probes, 51-2501.507.10NA0.128.72NAXXX
8838626AEval molecul probes, 251-5001.880.82NA0.082.78NAXXX
88386TCAEval molecul probes, 251-5000.006.23NA0.086.31NAXXX
88386AEval molecul probes, 251-5001.887.05NA0.169.09NAXXX
90760AHydration iv infusion init0.171.43NA0.071.67NAXXX
90761AHydrate iv infusion, add-on0.090.40NA0.040.53NAZZZ
90765ATher/proph/diag iv inf, init0.211.76NA0.072.04NAXXX
90766ATher/proph/dg iv inf, add-on0.180.46NA0.040.68NAZZZ
90767ATx/proph/dg addl seq iv inf0.190.89NA0.041.12NAZZZ
90768ATher/diag concurrent inf0.170.44NA0.040.65NAZZZ
90772ATher/proph/diag inj, sc/im0.170.31NA0.010.49NAXXX
90773ATher/proph/diag inj, ia0.170.31NA0.020.50NAXXX
90774ATher/proph/diag inj, iv push0.181.30NA0.041.52NAXXX
90775ATher/proph/diag inj add-on0.100.57NA0.040.71NAZZZ
92626AEval aud status rehab0.002.20NA0.062.26NAXXX
92627AEvallaud status rehab add-on0.000.55NA.020.57NAZZZ
93514CLeft heart catheterization0.000.000.000.000.000.00000
96401AChemo, anti-neopl, sq/im0.211.17NA0.011.39NAXXX
96402AChemo hormon antineopl sq/im0.191.01NA0.011.21NAXXX
96405AChemo intralesional, up to 70.522.440.240.032.990.79000
96406AChemo intralesional over 70.803.020.290.033.851.12000
96409AChemo, iv push, sngl drug0.242.93NA0.063.23NAXXX
96411AChemo, iv push, addl drug0.201.61NA0.061.87NAZZZ
96413AChemo, iv infusion, 1 hr0.284.20NA0.084.56NAXXX
96415AChemo, iv infusion, addl hr0.190.77NA0.071.03NAZZZ
96416AChemo prolong infuse w/pump0.214.61NA0.084.90NAXXX
96417AChemo iv infuse each addl seq0.211.95NA0.072.23NAZZZ
96420AChemo, ia, push technique0.172.67NA0.082.92NAXXX
96440AChemotherapy, intracavitary2.378.151.230.1710.693.77000
96450AChemotherapy, into CNS1.536.971.290.098.592.91000
96521ARefill/maint, portable pump0.213.77NA0.064.04NAXXX
96522ARefill/maint pump/resvr syst0.212.65NA0.062.92NAXXX
96523AIrrig drug delivery device0.040.69NA0.010.74NAXXX
96542AChemotherapy injection0.754.260.660.075.081.48XXX
97606ANeg press wound tx, >50 cm0.600.350.240.030.980.87XXX
Start Printed Page 9462

Addendum B.—Relative Value Units (RVUs) and Related Information—Continued

CPT 1/HCPCS 2ModStatusDescriptionPhysician work RVUs 3Nonfacility PE RVUsFacility PE RVUsMalpractice RVUsNonfacility totalFacility totalGlobal
98960BSelf-mgmt educ & train, 1 pt0.000.000.000.000.000.00XXX
98961BSelf-mgmt educ/train, 2-4 pt0.000.000.000.000.000.00XXX
98962BSelf-mgmt educ/train, 5-8 pt0.000.000.000.000.000.00XXX
99300Alc, infant pbw 2501-5000 gm2.40NA0.840.15NA3.35XXX
99324ADomicil/r-home visit new pat1.010.49NA0.051.55NAXXX
99325ADomicil/r-home visit new pat1.520.68NA0.072.27NAXXX
99326ADomicil/r-home visit new pat2.270.92NA0.103.29NAXXX
99327ADomicil/r-home visit new pat3.031.17NA0.134.33NAXXX
99328ADomicil/r-home visit new pat3.781.42NA0.165.36NAXXX
99334ADomicil/r-home visit est pat0.760.40NA0.041.20NAXXX
99335ADomicil/r-home visit est pat1.260.58NA0.061.90NAXXX
99336ADomicil/r-home visit est pat2.020.82NA0.092.93NAXXX
99337ADomicil/r-home visit est pat3.031.15NA0.134.31NAXXX
99340BDomicil/r-home care supervis0.000.000.000.000.000.00XXX
G0332APreadmin IV immunoglobulin0.001.91NA0.001.91NAXXX
1 CPT codes and descriptions only. Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
2 Copyright 2005 American Dental Association. All Rights Reserved.
3 Indicates RVUs are not used for Medicare payment.

2. On page 70463, the following entries to Addendum B, G9041, G9042, G9043, and G9044 are removed.

Addendum B.—Relative Value Units (RVUs) and Related Information—Continued

CPT 1/HCPCS 2ModStatusDescriptionPhysician work RVUs 3Nonfacility PE RVUsFacility PE RVUsMalpractice RVUsNonfacility totalFacility totalGlobal
G9041XLow vision rehab occupationa0.000.000.000.000.000.00XXX
G9042XLow vision rehab orient/mobi0.000.000.000.000.000.00XXX
G9043XLow vision lowvision therapy0.000.000.000.000.000.00XXX
G9044XLow vision rehabilate teache0.000.000.000.000.000.00XXX
1 CPT codes and descriptions only. Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
2 Copyright 2005 American Dental Association. All Rights Reserved.
3 +Indicates RVUs are not used for Medicare payment.
Start Amendment Part

3. On pages 70463 through 70466, the following entries to Addendum C are corrected to read as follows:

End Amendment Part

Addendum C.—Codes With Interim RVUs

CPT 1/ HCPCS 2ModStatusDescriptionPhysician work RVUs 3Nonfacility PE RVUsFacility PE RVUsMalpractice RVUsNonfacility TotalFacility TotalGlobal
61630NIntracranial angioplasty+21.08NA12.532.01NA35.62090
61635NIntracran angioplasty w/stent+23.08NA13.582.20NA30.66090
8838526AEval Molecul probes, 51-2501.500.65NA0.062.21NAXXX
8838626AEval Molecul probes, 251-5001.880.82NA0.082.78NAXXX
90760AHydration iv infusion, init0.171.43NA0.071.67NAXXX
90761AHydrate iv infusion, add-on0.090.40NA0.040.53NAZZZ
90765ATher/proph/diag iv inf, init0.211.76NA0.072.04NAXXX
90766ATher/proph/dg iv inf, add-on0.180.46NA0.040.68NAZZZ
90767ATx/proph/dg addl seq iv inf0.190.89NA0.041.12NAZZZ
90768ATher/diag concurrent inf0.170.44NA0.040.65NAZZZ
90772ATher/proph/diag inj, sc/im0.170.31NA0.010.49NAXXX
90773ATher/proph/diag inj, ia0.170.31NA0.020.50NAXXX
90774ATher/proph/diag inj, iv push0.181.30NA0.041.52NAXXX
90775ATher/proph/diag inj add-on0.100.57NA0.040.71NAZZZ
92626AEval aud status rehab0.002.20NA0.062.26NAXXX
92627AEvalaud status rehab add-on0.000.55NA0.020.57NAZZZ
96401AChemo, anti-neopl, sq/im0.211.17NA0.011.39NAXXX
96402AChemo hormone antineopl sq/im0.191.01NA0.011.21NAXXX
96409AChemo, iv push, sngl drug0.242.93NA0.063.23NAXXX
96411AChemo, iv push, addl drug0.201.61NA0.061.87NAZZZ
96413AChemo, iv infusion, 1 hr0.284.20NA0.084.56NAXXX
96415AChemo, iv infusion, addl hr0.190.77NA0.071.03NAZZZ
96416AChemo prolong infuse w/pump0.214.61NA0.084.90NAXXX
96417AChemo iv infuse each addl seq0.211.95NA0.072.23NAZZZ
96450AChemotherapy, into CNS1.536.971.290.098.592.91000
Start Printed Page 9463
96521ARefill/maint, portable pump0.213.77NA0.064.04NAXXX
96522ARefil/maint pump/resvr syst0.212.65NA0.062.92NAXXX
96523AIrrig drug delivery device0.040.69NA0.010.74NAXXX
96542AChemotherapy injection0.754.260.660.075.081.48XXX
98960BSelf-mgmt educ & train, 1 pt0.000.000.000.000.000.00XXX
98961BSelf-mgmt educ/train, 2-4 pt0.000.000.000.000.000.00XXX
98962BSelf-mgmt educ/train 5-8 pt0.000.000.000.000.000.00XXX
99300AIc, infant pbw 2501-5000 gm2.40NA0.840.15NA3.35XXX
99324ADomicil/r-home visit new pat1.010.49NA0.051.55NAXXX
99325ADomicil/r-home visit new pat1.520.68NA0.072.27NAXXX
99326ADomicil/r-home visit new pat2.270.92NA0.103.29NAXXX
99327ADomicil/r-home visit new pat3.031.17NA0.134.33NAXXX
99328ADomicil/r-home visit new pat3.781.42NA0.165.36NAXXX
99334ADomicil/r-home visit est pat0.760.40NA0.041.20NAXXX
99335ADomicil/r-home visit est pat1.260.58NA0.061.90NAXXX
99336ADomicil/r-home visit est pat2.020.82NA0.092.93NAXXX
99337ADomicil/r-home visit est pat3.031.15NA0.134.31NAXXX
99340BDomicil/r-home care supervis0.000.000.000.000.000.00XXX
1 CPT codes and descriptions only. Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
2 Copyright 2005 American Dental Association. All Rights Reserved.
3 +Indicates RVUs are not used for Medicare payment.
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4. On page 70467, in Addendum D, in the 11th entry, in the third column, the locality “Kansas*” is corrected to read “Kansas” as follows:

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Addendum D.—2006 Geographic Practice Cost Indices by Medicare Carrier and Locality—Continued

CarrierLocalityLocality nameWork GPCIPE GPCIMP GPCI
0065000Kansas1.0000.8780.721
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5. On page 70469, in Addendum E, in the fourth entry, in the third column, the locality “Kansas*” is corrected to read “Kansas” as follows:

End Amendment Part

Addendum E.—2006 GAFs—Continued

CarrierLocalityLocality name2006 GAF
0065000Kansas0.0936
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6. On pages 70469 through 70471, Addendum F, in its entirety, is corrected to read as follows:

End Amendment Part

Addendum F.—Revised Single Drug Category List

HCPCSLong descriptionWeight
J0150Injection, adenosine for therapeutic use, 6 mg0.00070000
J0152Injection, adenosine for diagnostic use, 30 mg0.00459478
J0170Injection, adrenalin, epinephrine, 1 ml ampule0.00007897
J0207Injection, amifostine, 500 mg0.00016099
J0215Injection, alefacept, 0.5 mg0.00083383
J0280Injection, aminophyllin, 250 mg0.00082088
J0290Injection, ampicillin sodium, 500 mg0.00012657
J0475Injection, baclofen, 10 mg0.00024643
J0540Injection, penicillin g benzathine and penicillin g procaine, 1,200,000 units0.00007209
J0550Injection, penicillin g benzathine and penicillin g procaine, 2,400,000 units0.00001831
J0570Injection, penicillin g benzathine, 1,200,000 units0.00004605
J0585Botulinum toxin type A, per unit0.03743206
J0587Botulinum toxin type B, per 100 units0.00150704
J0600Injection, edetate calcium disodium, 1000 mg0.00004459
J0637Injection, caspofungin acetate, 5 mg0.00008483
J0640Injection, leucovorin calcium, per 50 mg0.01064503
J0670Injection, mepivacaine hydrochloride, per 10 ml0.00038398
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J0690Injection, cefazolin sodium, 500 mg0.00042410
J0692Injection, cefepime hydrochloride, 500 mg0.00024846
J0696Injection, ceftriaxone sodium, per 250 mg0.00668833
J0698Injection, cefotaxime sodium, per gm0.00014878
J0702Injection, betamethasone acetate & betamethasone sodium phosphate, per 3 mg0.00287709
J0704Injection, betamethasone sodium phosphate, per 4 mg0.00057059
J0735Injection, clonidine hydrochloride, 1 mg0.00034149
J0800Injection, corticotropin, 40 units0.00363945
J0881Injection, darbepoetin alfa, 1 mcg (non-ESRD use)0.15953454
J0885Injection, epoetin alpha, (for non ESRD use), per 1000 units0.25136609
J0895Injection, deferoxamine mesylate, 500 mg0.00024448
J1000Injection, depo-estradiol cypionate, 5 mg0.00021013
J1020Injection, methylprednisolone acetate, 20 mg0.00127329
J1030Injection, methylprednisolone acetate, 40 mg0.00593138
J1040Injection, methylprednisolone acetate, 80 mg0.00527803
J1051Injection, medroxyprogesterone acetate, 50 mg0.00006526
J1094Injection, dexamethasone acetate, 1 mg0.00351268
J1100Injection, dexamethasone sodium phosphate, 1 mg0.05492057
J1190Injection, dexrazoxane hydrochloride, per 250 mg0.00002444
J1200Injection, diphenhydramine hcl, 50 mg0.00216491
J1212Injection, DMSO, dimethyl sulfoxide, 50%, 50 ml0.00008475
J1245Injection, dipyridamole, per 10 mg0.00383178
J1250Injection, dobutamine hydrochloride, per 250 mg0.00053182
J1260Injection, dolasetron mesylate, 10 mg0.01737101
J1335Injection, ertapenem sodium, 500 mg0.00013263
J1440Injection, filgrastim (G-CSF), 300 mcg0.00193572
J1441Injection, filgrastim (G-CSF), 480 mcg0.00407388
J1450Injection fluconazole, 200 mg0.00001609
J1580Injection, garamycin, gentamicin, 80 mg0.00039937
J1600Injection, gold sodium thiomalate, 50 mg0.00005613
J1626Injection, granisetron hydrochloride, 100 mcg0.01483731
J1631Injection, haloperidol decanoate, per 50 mg0.00020702
J1642Injection, heparin sodium, (heparin lock flush), per 10 units0.06422737
J1644Injection, heparin sodium, per 1000 units0.00354562
J1645Injection, dalteparin sodium, per 2500 iu0.00011526
J1650Injection, enoxaparin sodium, 10 mg0.00135618
J1655Injection, tinzaparin sodium, 1000 iu0.00047170
J1720Injection, hydrocortisone sodium succinate, 100 mg0.00013327
J1745Injection infliximab, 10 mg0.02762721
J1756Injection, iron sucrose, 1 mg0.01026994
J1885Injection, ketorolac tromethamine, per 15 mg0.00330082
J1940Injection, furosemide, 20 mg0.00065369
J1956Injection, levofloxacin, 250 mg0.00008629
J2001Injection, lidocaine hcl for intravenous infusion, 10 mg0.00077528
J2010Injection, lincomycin hcl, 300 mg0.00062461
J2150Injection, mannitol, 25% in 50 ml0.00029211
J2260Injection, milrinone lactate, 5 mg0.00004959
J2300Injection, nalbuphine hydrochloride, per 10 mg0.00026341
J2325Injection, nesiritide, 0.1 mg0.00027406
J2353Injection, octreotide, depot form for intramuscular injection, 1 mg0.00195107
J2354Injection, octreotide, non-depot subcutaneous or intravenous injection, 25 mcg0.00008412
J2405Injection, ondansetron hydrochloride, per 1 mg0.01373037
J2430Injection, pamidronate disodium, per 30 mg0.00156790
J2505Injection, pegfilgrastim, 6 mg0.00065114
J2550Injection, promethazine hcl, 50 mg0.00068681
J2680Injection, fluphenazine decanoate, 25 mg0.00015113
J2765Injection, metoclopramide hCL, 10 mg0.00011134
J2780Injection, ranitidine hydrochloride, 25 mg0.00088550
J2820Injection, sargramostim (GM-CSF), 50 mcg0.00217910
J2912Injection, sodium chloride, 0.9%, per 2 ml0.00680009
J2916Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg0.00061134
J2920Injection, methylprednisolone sodium succinate, 40 mg0.00031230
J2930Injection, methylprednisolone sodium succinate, 125 mg0.00077199
J2997Injection, alteplase recombinant, 1 mg0.00012239
J3260Injection, tobramycin sulfate, 80 mg0.00018292
J3301Injection, triamcinolone acetonide, per 10 mg0.02166537
J3302Injection, triamcinolone diacetate, per 5 mg0.00173214
J3303Injection, triamcinolone hexacetonide, per 5 mg0.00094603
J3315Injection, triptorelin pamoate, 3.75 mg0.00000713
J3370Injection, vancomycin hCL, 500 mg0.00084187
J3396Injection, verteporfin, 0.1 mg0.05438624
J3410Injection, hydroxyzine hCL, 25 mg0.00041004
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J3420Injection, vitamin B-12 cyanocobalamin, up to 1000 mcg0.01203050
J3475Injection, magnesium sulfate, per 500 mg0.00108505
J3480Injection, potassium chloride, per 2 meq0.00215709
J3487Injection, zoledronic acid, 1 mg0.00336479
J7030Infusion, normal saline solution, 1000 cc0.00102834
J7040Infusion, normal saline solution, sterile (500 ml = 1 unit)0.00243166
J70425% dextrose/normal saline (500 ml = 1 unit)0.00049872
J7050Infusion, normal saline solution, 250 cc0.00993344
J70605% dextrose/water (500 ml = 1 unit)0.00102860
J7070Infusion, D5W, 1000 cc0.00015894
J7120Ringers lactate infusion, 1000 cc0.00016980
J7317Sodium hyaluronate, per 20 to 25 mg dose for intra-articular injection0.00191598
J7320Hylan G-F 20, 16 mg, for intra articular injection0.00149854
J9000Doxorubicin hCL, 10 mg0.00235846
J9001Doxorubicin hydrochloride, all lipid formulations, 10 mg0.00032536
J9031BCG (Intravesical) per instillation0.00049267
J9040Bleomycin sulfate, 15 units0.00003728
J9045Carboplatin, 50 mg0.00570096
J9050Carmustine, 100 mg0.00000890
J9060Cisplatin, powder or solution, per 10 mg0.00095393
J9062Cisplatin, 50 mg0.00025430
J9065Injection, cladribine, per 1 mg0.00008142
J9070Cyclophosphamide, 100 mg0.00062691
J9080Cyclophosphamide, 200 mg0.00004968
J9090Cyclophosphamide, 500 mg0.00008125
J9091Cyclophosphamide, 1.0 gram0.00005049
J9092Cyclophosphamide, 2.0 gram0.00000530
J9093Cyclophosphamide, lyophilized, 100 mg0.00092680
J9094Cyclophosphamide, lyophilized, 200 mg0.00009190
J9095Cyclophosphamide, lyophilized, 500 mg0.00017696
J9096Cyclophosphamide, lyophilized, 1.0 gram0.00013977
J9097Cyclophosphamide, lyophilized, 2.0 gram0.00001360
J9098Cytarabine liposome, 10 mg0.00000817
J9100Cytarabine, 100 mg0.00013010
J9110Cytarabine, 500 mg0.00002076
J9130Dacarbazine, 100 mg0.00009429
J9140Dacarbazine, 200 mg0.00007024
J9150Daunorubicin, 10 mg0.00000490
J9170Docetaxel, 20 mg0.00257221
J9178Injection, epirubicin hCL, 2 mg0.00121917
J9181Etoposide, 10 mg0.00231466
J9182Etoposide, 100 mg0.00053112
J9185Fludarabine phosphate, 50 mg0.00030647
J9190Fluorouracil, 500 mg0.00396193
J9200Floxuridine, 500 mg0.00000409
J9201Gemcitabine hCL, 200 mg0.00496182
J9202Goserelin acetate implant, per 3.6 mg0.00288597
J9206Irinotecan, 20 mg0.00319095
J9208Ifosfamide, 1 gm0.00007892
J9209Mesna, 200 mg0.00036868
J9211Idarubicin hydrochloride, 5 mg0.00000318
J9213Interferon, ALFA-2A, recombinant, 3 million units0.00008082
J9214Interferon, ALFA-2B, recombinant, 1 million units0.00675198
J9219Leuprolide acetate implant, 65 mg0.00006526
J9245Injection, melphalan hydrochloride, 50 mg0.00000159
J9250Methotrexate sodium, 5 mg0.00186700
J9260Methotrexate sodium, 50 mg0.00051449
J9263Injection, oxaliplatin, 0.5 mg0.07318565
J9265Paclitaxel, 30 mg0.00556692
J9268Pentostatin, per 10 mg0.00000645
J9280Mitomycin, 5 mg0.00004077
J9290Mitomycin, 20 mg0.00003481
J9291Mitomycin, 40 mg0.00006143
J9293Injection, mitoxantrone hydrochloride, per 5 mg0.00025120
J9310Rituximab, 100 mg0.00409565
J9320Streptozocin, 1 gm0.00000673
J9340Thiotepa, 15 mg0.00002452
J9350Topotecan, 4 mg0.00018268
J9355Trastuzumab, 10 mg0.00543348
J9360Vinblastine sulfate, 1 mg0.00035813
J9370Vincristine sulfate, 1 mg0.00019751
J9375Vincristine sulfate, 2 mg0.00011515
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J9390Vinorelbine tartrate, per 10 mg0.00111035
J9395Injection, fulvestrant, 25 mg0.00126670
J9600Porfimer sodium, 75 mg0.00000030
Q3025Injection, interferon BETA-1A, 11 mcg for intramuscular use0.00078263

IV. Waiver of Proposed Rulemaking and Delay in Effective Date

We ordinarily publish a notice of proposed rulemaking in the Federal Register to provide a period for public comment before the provisions of a rule take effect in accordance with section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive the notice and comment procedures if the Secretary finds, for good cause, that the notice and comment process is impracticable, unnecessary or contrary to the public interest, and incorporates a statement of the finding and the reasons therefore in the rule. We can also waive the 30-day delay in effective date under the APA (5 U.S.C. 553(d)) when there is good cause to do so and we publish in the rule an explanation of our good cause.

This correcting amendment addresses technical errors and omissions made in FR Doc. 05-22160, entitled “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006 and Certain Provisions Related to the Competitive Acquisition Program of Outpatient Drugs and Biologicals Under Part B,” which appeared in the Federal Register on November 21, 2005 (70 FR 70116) and was made effective January 1, 2006. The provisions of this final rule with comment period have been previously subjected to notice and comment procedures. These corrections are consistent with the discussion and text and do not make substantive changes to the CY 2006 published rule. As such, this correcting amendment is intended to ensure the CY 2006 final rule with comment accurately reflects the policy adopted. Therefore, we find that undertaking further notice and comment procedures to incorporate these corrections into the final rule with comment is unnecessary and contrary to the public interest.

For the same reasons, we are also waiving the 30-day delay in effective date for this correcting amendment. We believe that it is in the public interest to ensure that the CY 2006 final rule with comment accurately states our policy on physician fee schedule and other Part B payment policies, and provisions related to the competitive acquisition program of outpatient drugs and biologicals under Part B. Therefore, delaying the effective date of these corrections beyond the January 1, 2006 effective date of the final rule with comment period would be contrary to the public interest. In so doing, we find good cause to waive the 30-day delay in the effective date.

Start Signature

(Catalog of Federal Domestic Assistance Program No. 93.774, Medicare—Supplementary Medical Insurance Program)

Dated: February 7, 2006.

Ann C. Agnew,

Executive Secretary to the Department.

End Signature End Supplemental Information

[FR Doc. 06-1711 Filed 2-23-06; 8:45 am]

BILLING CODE 4120-01-P