U.S. Department of Health and Human Services
Health Care Financing Administration

Medicare Program; Physician Fee Schedule for Calendar Year 1995; Payment Policies
and Relative Value Unit Adjustments; Final Rule 

and

Medicare Program; Physician Fee Schedule Update for Calendar Year 1995; 
Physician Volume Performance Standard Rates of Increase for Federal Fiscal Year
1995; Notice  


These files contain the source data for the two documents which appear in the
FEDERAL REGISTER, Volume 59, Number 235, (December 8, 1994), beginning at
page 63410.  The file formats are ASCII and Lotus 123 (.wk1 format).   

Every effort has been made to ensure that these files accurately reflect the final notices
as published in the FEDERAL REGISTER; however, in the event of a discrepancy, the
printed notice is the official version. The availability of the printed version will also allow
anyone using these files to see how the complete documents are assembled.  

A complete set of files for these notices includes the following:

             1README     -         basic documentation on files (this file)        
             HCFA1.TXT  -         ascii format text of RVU document  
             HCFA2.TXT  -         ascii format text of Performance Standard Rates document 
             ADDENDAB.TX1 -  ascii format of Addendum B database, records 1-4999
             ADDENDAB.TX2 -  ascii format of Addendum B database, records 5000-end
             ADDENDAC.TXT -  ascii format of Addendum C database, complete
             ADB_NOTE.TXT  -  ascii format text of Addendum B header material
             ADC_NOTE.TXT  -  ascii format text of Addendum C header material
             ADD-D.WK1 -          Lotus 1-2-3 format file of Addendum D
             ADD-D.FMT  -         Format file for ADD-D.WK1
             ADD-E.WK1 -          Lotus 1-2-3 format file of Addendum E
             ADD-E.FMT  -         Format file for ADD-E.WK1
             ADD-F.WK1 -         Lotus 1-2-3 format file of Addendum F
             ADD-F.FMT  -         Format file for ADD-F.WK1
             ADD-G.WK1 -         Lotus 1-2-3 format file of Addendum G
             ADD-G.FMT  -        Format file for ADD-G.WK1
             TABLE1.WK1 -       Lotus 1-2-3 format file of Table 1
             TABLE1.FMT -       Format file for TABLE1.WK1
             TABLE2.WK1 -       Lotus 1-2-3 format file of Table 2
             TABLE2.FMT -       Format file for TABLE2.WK1
             TABLE3.WK1 -       Lotus 1-2-3 format file of Table 3
             TABLE3.FMT -       Format file for TABLE3.WK1
             TABLE4.WK1 -       Lotus 1-2-3 format file of Table 4
             TABLE4.FMT -        Format file for TABLE4.WK1
             TABLE5.WK1 -       Lotus 1-2-3 format file of Table 5
             TABLE5.FMT -       Format file for TABLE5.WK1
             TABLE6.WK1 -      Lotus 1-2-3 format file of Table 6
             TABLE6.FMT -       Format file for TABLE6.WK1
             

The README file and the files with the extension .TXT, .TX1, and .TX2 are ASCII files.
The files with the extension .WK1 are Lotus 123 worksheets and those with the
extension .FMT are the format files for printing the Lotus worksheets.  

The text from both documents is contained in the ASCII files HCFA1.TXT and
HCFA2.TXT.  The text of the first document is contained in HCFA1.TXT and the second
document is contained in HCFA2.TXT. 

HCFA1.TXT also contains the text for "Addenda A - Explanation and Use of Addenda B
through G."

ADDENDAB.TX1 and ADDENDAB.TX2 and ADDENDAC.TXT contain the files for
Addenda B and C. 

The ADD*.WK1 and TABLE*.WK1 contains the files for Addenda D through G and for
all 6 Tables.

There are six tables contained in "Medicare Program; Physician Fee Schedule for
Calendar Year 1995; Payment Policies and Relative Value Unit Adjustments; Final
Rule:"

Table 1 - Refinement of Proposed RVUs
Table 2 - Work RVU Refinements of Interim and Related RVUs
Table 3 - Prolonged Services
Table 4 - AMA RUC Recommendations and HCFA's Decisions
Table 5 - Preventive Medicine
Table 6 - Anesthesia Codes and Imputed RVUs


Imported into Lotus 1-2-3, TABLE1.WK1 with TABLE1.FMT creates a table entitled
"Refinement of Proposed RVUs," which may be inserted in the text where TABLE 1 -
REFINEMENT OF PROPOSED RVUs appears.

Tables 2 through 6 may be reconstructed and inserted similarly.

There are seven addenda to "Medicare Program; Physician Fee Schedule for Calendar
Year 1995; Payment Policies and Relative Value Unit Adjustments; Final Rule " lettered
A through G:  

Addendum A--Explanation and Use of Addenda B through G
Addendum B--1995 Relative Value Units (RVUs) and Related Information Used in
Determining Medicare Payments for 1995
Addendum C--Codes with Interim RVUs
Addendum D--1995 Geographic Practice Cost Indices by Medicare Carrier and Locality
Addendum E--1996 Geographic Practice Cost Indices by Medicare Carrier and Locality
Addendum F--Procedure Codes Subject to the Site-of-Service Differential
Addendum G--Reference Set with 1995 Work RVUs.

Addendum A is an ASCII text file and is totally contained in the narrative text. 

Addendum B is entitled 1995 RELATIVE VALUE UNITS RVUs AND RELATED
INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 1995. The
tabular data for Addendum B is contained in two comma-delimited ASCII files.  There
are 10,314 records in the files, each with ten fields.  The field descriptions are:

     Field Name                   Field Type     Width
     ----------------------            ----------        ----------------------
     HCPCS*                         Character        5
     Modifier                          Character        2
     Status                             Character        1
     Description                     Character        80
     Work RVUs                     Numeric          6 (2 decimal places)
     Practice Expense RVUs  Numeric          6 (2 decimal places)
     Malpractice RVUs           Numeric          6 (2 decimal places)
     Total RVUs                      Numeric         6 (2 decimal places)
     Global Period                  Character       3
     Update                            Character       1

     TOTAL                                                    116 Characters

     *All numeric CPT HCPCS copyright 1994 American Medical Association

The fields in these files are separated by commas.  Data from all fields are enclosed in
quotation marks and may contain commas.  Unused spaces at the end of character
fields are dropped.  The first row of the file consists of the field names as provided
above.

A sample record in the comma delimited ASCII format appears below: 

"10040","","A","ACNE SURGERY","1.35","0.32","0.03","1.70"," 010"," S" 

In tabular form this record translates as follows:

     Field Name                       Field Type     Content
     ----------------------                ----------     ------------
     HCPCS*                            Character      10040
     Modifier                             Character      [blank]
     Status                                Character      A
     Description                        Character      ACNE SURGERY
     Work RVUs                       Numeric        1.35
     Practice Expense RVUs    Numeric        0.32
     Malpractice RVUs             Numeric        0.03
     Total RVUs                       Numeric        1.70
     Global Period                   Character      010
     Update                              Character      S

     *All numeric CPT HCPCS copyright 1994 American Medical Association

The two comma delimited files for Addendum B are ADDENDAB.TX1 and
ADDENDAB.TX2. The first file contains HCPCS from 10040 to 4999 and
the second contains HCPCS 5010 to V5364. Both files are located on Disk 2.

The file ADB_NOTE.TXT contains the header material, including the field names, for
Addendum B.

Addendum C, entitled CODES WITH INTERIM RVUs, is an ascii format file.  Its
structure is the same as Addendum B.  That is; it is comma-delimited database of ten
fields with the same field names, in the same order.  The first row of the file consists of
the field names as given above for Addendum B. 

The file ADC_NOTE.TXT contains the header material, including the field names, for
Addendum C.

Addenda D, E, F, and G are Lotus 1-2-3 format files.

This information is being distributed on The Federal Bulletin Board to facilitate its use
by the public.  Both the Health Care Financing Administration and the Government
Printing Office are interested in receiving comments on the utility of the material in its
present machine readable form and suggestions for improvements if other FEDERAL
REGISTER material is disseminated on electronic format in the future.  Your comments
can be addressed to:
     
     Office of Electronic Information Dissemination Services (EIDS)
     Mail Stop SDE
     U.S. Government Printing Office
     Washington, DC 20401

     Telephone:  (202) 512-1530
     FAX:        (202) 512-1262
     help@eids05.eids.gpo.gov


These files are also available as a set of three 3.5" HD diskettes for $20.  To order, call
(202) 512-1530 or fax (202) 512-1262 or write: Superintendent of Documents, Attn:
Electronic Products Coordinator, PO Box  37082, Washington, DC  20013-7082.

To order the printed version for $8, call (202) 512-1800 or fax (202) 512-2250 or write:
Superintendent of Documents, PO Box 371954,  Pittsburgh, PA  15250-7954. 
(Paper edition: GPO Stock Number 069-001-00081-5)