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 Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 411, 412, 416, 419, 422, 423, and 424
[CMS-1613-CN]
RIN 0938-AS15
 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
 ACTION: Correction of final rule.
 SUMMARY: This document corrects technical errors that appeared in the final rule with comment period published in the 
                        **Federal Register**
                         on November 10, 2014, entitled “Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Physician-Owned Hospitals: Data Sources for Expansion Exception; Physician Certification of Inpatient Hospital Services; Medicare Advantage Organizations and Part D Sponsors: CMS-Identified Overpayments Associated with Submitted Payment Data.”
 DATES: *Effective Date:*
                         This document is effective February 24, 2015. *Applicability Date:*
                         The corrections noted in this document and posted on the CMS Web site are applicable to payments for services furnished on or after January 1, 2015.
 FOR FURTHER INFORMATION CONTACT: David Rice, (410) 786-6004, hospital outpatient prospective payment system (OPPS) issues. Esther Markowitz, (410) 786-4595, ambulatory surgical center (ASC) payment issues. Marjorie Baldo, (410) 786-4617, OPPS issues related to status indicators (SI) and ambulatory payment classification (APC) changes.


SUPPLEMENTARY INFORMATION:  I. Background In FR Doc. 2014-26146 of November 10, 2014 (79 FR 66770) (hereinafter referred to as the CY 2015 OPPS/ASC final rule with comment period), there were a number of technical errors that are discussed in the Summary of Errors, and further identified and corrected in the Correction of Errors section below. The provisions in this correction notice are applicable to payments for services furnished on or after January 1, 2015, and, therefore, are treated as if they had been included in the CY 2015 OPPS/ASC final rule with comment period (79 FR 66770) appearing in the November 10, 2014 
                    **Federal Register**
                    . II. Summary of Errors and Corrections Posted on the CMS Web site A. Hospital Outpatient Prospective Payment System (OPPS) Corrections In the CY 2015 OPPS/ASC final rule with comment period, for the OPPS cancer hospital payment adjustment (79 FR 66831 through 66832), we finalized a target payment-to-cost ratio (PCR) of 0.89. This target PCR is equal to the weighted average PCR for the other OPPS hospitals included in this dataset (see 79 FR 66832 for more details on the hospitals included in this dataset). Under our longstanding policy, outlier payments are included in the calculation of the weighted average PCR (or “target PCR”) for these hospitals. We have since determined that some outlier payments were not included in the cost report data we used to calculate the target PCR. We have corrected this error and included these outlier payments in the target PCR calculation, which results in a target PCR equal to 0.90 for each cancer hospital. In addition to identifying the error in calculating the target PCR because of missing outlier payments, we determined that certain outlier payments were similarly not included in our calculations for estimated cancer hospital PCRs. We have now corrected this error and included these outlier payments in determining the estimated cancer hospital PCRs. As a result of correcting these two technical errors, the estimated total cancer hospital payment adjustments, which are based on the difference between estimated cancer hospital PCRs and the target PCR is also being corrected in this notice. The revisions to the target PCR and estimated cancer hospital PCRs have decreased our estimate of total cancer hospital payment adjustments by $18.6 million. OPPS cancer hospital payment adjustment payments are budget neutral; therefore, we are updating the budget neutrality adjustment to the OPPS conversion factor for the differential in estimated total cancer hospital payment adjustments of $18.6 million. This additional $18.6 million increases the conversion factor from $74.144 to $74.173, which will slightly increase payment rates for most ambulatory payment classifications (APCs). These revised APC payment rates are reflected in the attached Addenda. We are also making technical corrections to certain healthcare common procedure coding system (HCPCS) codes that appeared in Table 36—HCPCS Codes to Which the CY 2015 Drug-Specific Packaging Determination Methodology Applies (79 FR 66889). Specifically, we are correcting the CY 2015 OPPS status indicators (SI) for HCPCS codes J1070, J1080, J2271, J3120, and J3130 from “N” to “D” to accurately indicate that these codes were deleted on December 31, 2014, and should not have appeared in Table 36. These codes were correctly assigned to OPPS SI “D” in the OPPS Addendum B that was released with the CY 2015 OPPS/ASC final rule. In addition, HCPCS codes J1440 and J1441 were deleted on December 31, 2013, and should not have appeared in Table 36. HCPCS codes J1440 and J1441 were not listed in the OPPS Addendum B that was released with the CY 2015 OPPS/ASC final rule. Also, in Addendum B of the CY 2015 OPPS/ASC final rule with comment period, HCPCS code J7180 (Factor xiii anti-hem factor) was incorrectly assigned a status indicator “N”. Because HCPCS code J7180 is a separately payable drug, we have corrected this error and assigned status indicator “K” and APC 1416. This correction is included in the revised OPPS Addendum B which is posted to the CMS Web site at 
                    *http://www.cms.gov/​Medicare/​Medicare-Fee-for-Service-Payment/​HospitalOutpatientPPS/​Hospital-Outpatient-Regulations-and-Notices.html.* B. Ambulatory Surgical Center (ASC) Payment System Corrections ASC payment rates are based on the OPPS relative payment weights for the majority of covered surgical procedures and covered ancillary services. For some items, such as device-intensive procedures, the ASC payment rates also take into account the OPPS conversion factor and payment rates. Therefore, corrections to the CY 2015 OPPS conversion factor and payment rates affect the CY 2015 ASC payment rates. To account for geographic wage variation, individual ASC payments are adjusted by applying the pre-floor and pre-reclassified inpatient prospective payment system (IPPS) hospital wage 
                    ( print page 9630)
                    indexes to the labor-related share, which is 50 percent of the ASC payment amount. In other words, the wage index for an ASC is the pre-floor and pre-reclassified IPPS hospital wage index of the CBSA that maps to the CBSA where the ASC is located. The FY 2015 IPPS hospital wage indexes reflect new Office of Management and Budget (OMB) labor market area delineations; therefore, the CY 2015 final ASC wage indexes reflect the new OMB delineations. However, as described in the CY 2015 OPPS/ASC final rule (79 FR 66935 through 66937), we finalized a policy to apply a one-year blended wage index for all ASCs that will experience any decrease in their actual wage index exclusively due to the implementation of the new OMB delineations. Specifically, for ASCs where the CY 2015 ASC wage index with the CY 2015 Core-Based Statistical Areas (CBSAs) is lower than with the CY 2014 CBSAs, the CY 2015 ASC wage index is 50 percent of the ASC wage index based on the CY 2014 CBSA and 50 percent of the ASC wage index based on the new CY 2015 CBSA. We have since determined that the transitional wage index for CY 2015 was calculated incorrectly. We have now recalculated the CY 2015 ASC wage index per the policy finalized in the CY 2015 OPPS/ASC final rule with comment period. Due to these corrections, the final CY 2015 ASC wage index budget neutrality adjustment changes from 0.9998, as originally published (79 FR 66939 and 67023), to 0.9995. Using the final corrected wage index budget neutrality adjustment, the final CY 2015 ASC conversion factor changes from $44.071, as originally published (79 FR 66939, 66940, and 67023), to $44.058. The final CY 2015 ASC conversion factor for ASCs that do not meet the requirements of the ASC Quality Reporting Program changes from $43.202, as originally published (79 FR 66939), to $43.189. The final CY 2015 ASC rates and indicators for certain office-based covered surgical procedures and certain covered ancillary services were impacted due to corrections to the final CY 2015 Medicare Physician Fee Schedule (MPFS) rates. We note that we expect to issue the CY 2015 MPFS corrections in a separate 
                    **Federal Register**
                     document in the near future. For covered office-based surgical procedures, covered ancillary radiology services (except certain nuclear medicine procedures and radiology procedures that use contrast agents), and certain covered ancillary diagnostic tests, the payment rate is the lower of the amount calculated using the ASC standard ratesetting methodology and the MPFS nonfacility practice expense relative value unit-based amount effective January 1, 2015. The corrections discussed in the MPFS correcting document affected some of the final payment indicators and rates for these covered surgical procedures and covered ancillary services. As such, we have corrected these payment indicators and rates based upon the MPFS corrections discussed in the MPFS correcting document. As stated in the preamble and addenda to the CY 2015 OPPS/ASC final rule with comment period (79 FR 66922, 66923, 66931, 66934, and 66939), the ASC payment indicators and rates do not include the effect of the negative update to the MPFS payment rates effective April 1, 2015 under current law. Updates to the ASC rates and payment indicators effective April 1, 2015 will be included in the April 2015 quarterly ASC addenda posted on the CMS Web site. C. Summary of Errors and Corrections to the OPPS and ASC Addenda Posted on the CMS Web site 1. OPPS Addenda Posted on the CMS Web site We are making several minor technical corrections to the OPPS addenda. First, as a result of the cancer hospital payment adjustment correction and subsequent budget neutrality adjustment corrections, we have updated Addenda A, B, and C to reflect corrected APC payment rates. Secondly, CPT codes 88342, 88344, and 88366, were incorrectly assigned to OPPS SI “E” and “N”. Because these services may be separately payable in certain instances, we have corrected this error. Specifically, we are correcting the OPPS SI and APC assignments for CPT code 88342 to “Q1” and APC 0433; for CPT code 88344 to “Q1” and APC 0433; and for CPT code 88366 to “Q1” and APC 0342. We have updated OPPS Addendum B to reflect these corrected SIs. Further, the 24 codes listed below were assigned to incorrect OPPS SIs. The correct OPPS SIs are listed in the table below. Because these changes were too late to include in the January 2015 Integrated Outpatient Code Editor (IOCE), they will be included in the April 2015 IOCE update retroactive to January 1, 2015. HCPCS code
Short descriptor
CY 2015 
                             OPPS SI
CY 2015 
                             OPPS APC0356T
Insrt drug device for iop
Q1
069886592
Syphilis test non-trep qual
A86593
Syphilis test non-trep quant
A86631
Chlamydia antibody
A86632
Chlamydia igm antibody
A86780
Treponema pallidum
A87110
Chlamydia culture
A87270
Chlamydia trachomatis ag if
A87320
Chylmd trach ag eia
A87341
Hepatitis b surface ag eia
A87490
Chylmd trach dna dir probe
A87491
Chylmd trach dna amp probe
A87590
N.gonorrhoeae dna dir prob
A87591
N.gonorrhoeae dna amp prob
A87800
Detect agnt mult dna direc
A87810
Chylmd trach assay w/optic
A87850
N. gonorrhoeae assay w/optic
A88380
Microdissection laser
N88381
Microdissection manual
N88387
Tiss exam molecular study
N93895
Carotid intima atheroma eval
EG0461
Immunohisto/cyto chem 1st st
DG0462
Immunohisto/cyto chem add
DV2760
Scratch resistant coating
E( print page 9631)V2762
Polarization, any lens
EV2786
Occupational multifocal lens
EV2797
Vis item/svc in other code
E
 We are correcting the OPPS SI for CPT code 0356T to “Q1” since this is the SI assigned to APC 0698. In addition, we are correcting the OPPS SI for CPT codes 86592 through 87850 to “A” to indicate that these preventive services are paid separately in another Medicare payment system other than the OPPS. Further, we are correcting the OPPS SI for CPT codes 88380, 88381, and 88387 to “N” to indicate that these services are packaged. We are also correcting the OPPS SI for CPT code 93895 to “E” to indicate that this service is non-covered. We are correcting the OPPS SI for HCPCS codes G0461 and G0462 to “D” to indicate that these codes were deleted on December 31, 2014. Also, we are correcting the OPPS SI for HCPCS codes V2760, V2762, V2786, and V2797 to “E” to indicate that these items are non-covered under the OPPS. To view the corrected CY 2015 OPPS payment rates that result from these technical corrections, we refer readers to the Addenda and supporting files that are posted on the CMS Web site at: 
                    *http://www.cms.gov/​Medicare/​Medicare-Fee-for-Service-Payment/​HospitalOutpatientPPS/​index.html.*
                     Select “CMS-1613-CN” from the list of regulations. All corrected Addenda for this correcting document are contained in the zipped folder titled “2015 OPPS Final Rule Addenda” at the bottom of the page for CMS-1613-CN. 2. Ambulatory Surgical Center (ASC) Payment System Addenda Posted on the CMS Web site As a result of the technical corrections described in Section II.B. and IV. of this correction notice, we have updated Addenda AA and BB to reflect the final corrected payment rates and indicators for CY 2015 for ASC covered surgical procedures and covered ancillary services. To view the corrected final CY 2015 ASC payment rates and indicators that result from these technical corrections, we refer readers to the Addenda and supporting files that are posted on the CMS Web site at: 
                    *http://www.cms.gov/​Medicare/​Medicare-Fee-for-Service-Payment/​ASCPayment/​ASC-Regulations-and-Notices.html.*
                     Select “CMS-1613-CN” from the list of regulations. All corrected ASC addenda for this correcting document are contained in the zipped folder entitled “Addendum AA, BB, DD1, DD2, and EE” at the bottom of the page for CMS-1613-CN. The corrected final CY 2015 ASC wage index file and updated public use files are also posted on this Web page. III. Waiver of Proposed Rulemaking, 60-Day Comment Period, and Delay of Effective Date Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA), the agency is required to publish a notice of the proposed rule in the 
                    **Federal Register**
                     before the provisions of a rule take effect. Similarly, section 1871(b)(1) of the Act requires the Secretary to provide for notice of the proposed rule in the 
                    **Federal Register**
                     and provide a period of not less than 60 days for public comment. In addition, section 553(d) of the APA, and section 1871(e)(1)(B)(i) of the Act mandate a 30-day delay in effective date after issuance or publication of a rule. Sections 553(b)(B) and 553(d)(3) of the APA provide for exceptions from the notice and comment and delay in effective date APA requirements; in cases in which these exceptions apply, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the Act provide exceptions from the notice and 60-day comment period and delay in effective date requirements of the Act as well. Section 553(b)(B) of the APA and section 1871(b)(2)(C) of the Act authorize an agency to dispense with normal rulemaking requirements for good cause if the agency makes a finding that the notice and comment process are impracticable, unnecessary, or contrary to the public interest. In addition, both section 553(d)(3) of the APA and section 1871(e)(1)(B)(ii) of the Act allow the agency to avoid the 30-day delay in effective date where such delay is contrary to the public interest and an agency includes a statement of support. In our view, this correcting document does not constitute a rulemaking that would be subject to these requirements. This correcting document corrects technical errors in the preamble, addenda, payment rates, and tables included or referenced in the CY 2015 OPPS/ASC final rule with comment period. The corrections contained in this document are consistent with, and do not make substantive changes to, the policies and payment methodologies that were adopted subjected to notice and comment procedures in the CY 2015 OPPS/ASC final rule with comment period. As a result, the corrections made through this correcting document are intended to ensure that the CY 2015 OPPS/ASC final rule with comment period accurately reflects the policies adopted in that rule. Even if this were a rulemaking to which the notice and comment and delayed effective date requirements applied, we find that there is good cause to waive such requirements. Undertaking further notice and comment procedures to incorporate the corrections in this document into the CY 2015 OPPS/ASC final rule with comment period or delaying the effective date would be contrary to the public interest because it is in the public's interest for providers and suppliers to receive appropriate payments in as timely a manner as possible, and to ensure that the CY 2015 OPPS/ASC final rule with comment period accurately reflects our policies as of the date they take effect and are applicable. Further, such procedures would be unnecessary, because we are not altering the payment methodologies or policies, but rather, we are simply correctly implementing the policies that we previously proposed, received comment on, and subsequently finalized. This correcting document is intended solely to ensure that the CY 2015 OPPS/ASC final rule with comment period accurately reflects these payment methodologies and policies. For these reasons, we believe we have good cause to waive the notice and comment and effective date requirements. IV. Correction of Errors In FR Doc. 2014-26146 of November 10, 2014 (79 FR 66770), make the following corrections: Correction of Errors in the Preamble 1. On page 66776, second column, second bullet, lines 11 and 17, the figure “0.89” is corrected to read “0.90”. 2. On page 66777, third column, first paragraph under column heading (4), line 11, the figure “2.3” is corrected to read “2.4”. 3. On page 66825, a. Second column, (1) First partial paragraph, lines 6 through 14, remove the last two 
                    ( print page 9632)
                    sentences of the paragraph and add the following sentence in its place: “The CY 2015 estimated cancer hospital payment adjustments result in a budget neutral adjustment factor of 1.0004 to the conversion factor for the cancer hospital payment adjustment.” (2) Second full paragraph, (a) Line 17, the figure “$72.692” is corrected to read “$72.690”. (b) Line 19, the figure “−$1.484” is corrected to read “−$1.483”. b. Third column, (1) First full paragraph, line 13, the figure “$72.661” is corrected to read “$72.690”. (2) Last paragraph, line 10, the figure “$74.144” is corrected to read “$74.173”. 4. On page 66826, first column, first partial paragraph, (a) Line 2, the figure “1.0000” is corrected to read “1.0004”. (b) Line 7, the figure “$74.144” is corrected to read “$74.173”. 5. On page 66832, a. First column, first partial paragraph, (1) Line 3, the figure “89” is corrected to read “90”. (2) Lines 5 and 11, the figure “0.89” is corrected to read “0.90”. b. Second column, (1) First partial paragraph, line 4, the figure “0.89” is corrected to read “0.90”. (2) First full paragraph, lines 4 and 9, the figure “0.89 is corrected to read “0.90”. c. Third column, first partial paragraph, (1) Line 3, the figure “89” is corrected to read “90”. (2) Lines 5 and 11, the figure “0.89” is corrected to read “0.90”. d. Table 14—Estimated CY 2015 Hospital-Specific Payment Adjustment For Cancer Hospitals To Be Provided At Cost Report Settlement, the table is corrected to read as follows: Table 14—Estimated CY 2015 Hospital-Specific Payment Adjustment for Cancer Hospitals To Be Provided at Cost Report Settlement
Provider No.
Hospital name
Estimated 
                             percentage  
                             increase in  
                             OPPS Payments  
                             for CY 2015050146
City of Hope Comprehensive Cancer Center
16.1050660
USC Norris Cancer Hospital
23.2100079
Sylvester Comprehensive Cancer Center
12.7100271
H. Lee Moffitt Cancer Center & Research Institute
20.5220162
Dana-Farber Cancer Institute
47.3330154
Memorial Sloan-Kettering Cancer Center
42.4330354
Roswell Park Cancer Institute
19.2360242
James Cancer Hospital & Solove Research Institute
32.7390196
Fox Chase Cancer Center
19.7450076
M.D. Anderson Cancer Center
49.4500138
Seattle Cancer Care Alliance
43.6
 6. On page 66889, Table 36—HCPCS Codes To Which The CY 2015 Drug-Specific Packaging Determination Methodology Applies, the table is corrected to read as follows: Table 36—HCPCS Codes to Which the CY 2015 Drug-Specific Packaging Determination Methodology Applies
CY 2015 HCPCS code
CY 2015 long descriptor
CY 2015 SIC9257
Injection, bevacizumab, 0.25 mg
KJ9035
Injection, bevacizumab, 10 mg
KJ1020
Injection, methylprednisolone acetate, 20 mg
NJ1030
Injection, methylprednisolone acetate, 40 mg
NJ1040
Injection, methylprednisolone acetate, 80 mg
NJ1460
Injection, gamma globulin, intramuscular, 1 cc
NJ1560
Injection, gamma globulin, intramuscular over 10 cc
NJ1642
Injection, heparin sodium, (heparin lock flush), per 10 units
NJ1644
Injection, heparin sodium, per 1000 units
NJ1840
Injection, kanamycin sulfate, up to 500 mg
NJ1850
Injection, kanamycin sulfate, up to 75 mg
NJ2270
Injection, morphine sulfate, up to 10 mg
NJ2788
Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)
NJ2790
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)
NJ2920
Injection, methylprednisolone sodium succinate, up to 40 mg
NJ2930
Injection, methylprednisolone sodium succinate, up to 125 mg
NJ3471
Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units)
NJ3472
Injection, hyaluronidase, ovine, preservative free, per 1000 usp units
NJ7030
Infusion, normal saline solution , 1000 cc
NJ7040
Infusion, normal saline solution, sterile (500 ml = 1 unit)
NJ7050
Infusion, normal saline solution , 250 cc
NJ7502
Cyclosporine, oral, 100 mg
NJ7515
Cyclosporine, oral, 25 mg
NJ8520
Capecitabine, oral, 150 mg
K( print page 9633)J8521
Capecitabine, oral, 500 mg
KJ9250
Methotrexate sodium, 5 mg
NJ9260
Methotrexate sodium, 50 mg
N
 7. On page 66917, third column, remove the first full paragraph and add the following paragraph in its place: “For the new Category III CPT codes implemented in July 2014 through the quarterly update CR, as shown below in Table 43, we are not finalizing the “Z2” payment indicator that we proposed for CPT codes 0348T, 0349T, and 0350T or the “R2” payment indicator that we proposed for CPT code 0356T. For CY 2015, these codes will be conditionally packaged under the OPPS when provided with a significant procedure (status indicator “Q1”). With the exception of device removal procedures (as discussed in section XII.D.1.b. of this final rule with comment period), HCPCS codes that are conditionally packaged under the OPPS are always packaged (payment indicator “N1”) under the ASC payment system. Therefore, the final CY 2015 ASC payment indicator for CPT codes 0348T, 0349T, 0350T, and 0356T is “N1” for CY 2015. 8. On page 66918, Table 43—New Category III CPT Codes for Covered Surgical Procedures or Covered Ancillary Services Implemented in July 2014, the table is corrected to read as follows: Table 43—New Category III CPT Codes for Covered Surgical Procedures or Covered Ancillary Services Implemented in July 2014
CY 2014 
                             CPT code
CY 2015
                             CPT code
CY 2015 long descriptor
Final CY 2015 
                             ASC payment indicator0348T
0348T
Radiologic examination, radiostereometric analysis (RSA); spine, (includes, cervical, thoracic and lumbosacral, when performed)
N10349T
0349T
Radiologic examination, radiostereometric analysis (RSA); upper extremity(ies), (includes shoulder, elbow and wrist, when performed)
N10350T
0350T
Radiologic examination, radiostereometric analysis (RSA); lower extremity(ies), (includes hip, proximal femur, knee and ankle, when performed)
N10356T
0356T
Insertion of drug-eluting implant (including punctal dilation and implant removal when performed) into lacrimal canaliculus, each
N1N1 = Packaged service/item; no separate payment made.
 9. On page 66939, a. Second column, last paragraph, line 10, the figure “0.9998” is corrected to read “0.9995”. b. Third column, first partial paragraph, (1) Line 6, the figure “$44.071” is corrected to read “$44.058”. (2) Line 11, the figure “0.9998” is corrected to read “0.9995”. (3) Line 21, the figure “$43.202” is corrected to read “$43.189”. (4) Line 26, the figure “0.9998” is corrected to read “0.9995”. 10. On page 66940, first column, second full paragraph, line 6, the figure “$44.071” is corrected to read “$44.058”. 11. On page 66962, second column, first full paragraph, a. Line 12, the figure “$72.661” is corrected to read “$72.690”. b. Line 14, the figure “$74.144” is corrected to read “$74.173”. 12. On page 67019, a. Second column, first paragraph, (1) Line 3, the figure “(4,006)” is corrected to read “(4,007)”. (2) Line 31, the figure “(3,871)” is corrected to read “(3,782)”. b. Third column, remove the entire fourth paragraph, which begins with “There is no difference in impact” and add the following paragraph in its place: “The impacts reflect slightly smaller total cancer hospital payment adjustments as a result of the updated target PCR and updated estimated cancer hospital PCRs for 2015.” 13. On page 67020, a. First column, first full paragraph under column 5 heading, (1) Line 10, the figures “3.4 and 4.2” are corrected to read “3.5 and 4.3” respectively. (2) Line 14, the figure “3.2” is corrected to read “3.3”. b. Second column, first partial paragraph, line 9, the figure “$74.144” is corrected to read “$74.173”. c. Third column, (1) First partial paragraph, last line, the figure “2.3” is corrected to read “2.4”. (2) First full paragraph, line 11, the figures “0.9 to 2.1” are corrected to read “1.0 to 2.2” respectively. (3) Second full paragraph, line 4, the figure “3.1” is corrected to read “3.2”. (4) Last paragraph, (a) Line 7, the figure “1.7” is corrected to read “1.8”. (b) Line 9, the figure “2.1” is corrected to read “2.2”. 14. On pages 67020 through 67022, Table 49—Estimated Impact of the CY 2015 Changes for the Hospital Outpatient Prospective Payment System, the table is corrected to read as follows:
                    ( print page 9634) Table 49—Estimated Impact of the Proposed CY 2015 Changes for the Hospital Outpatient Prospective Payment System
Number of hospitals
APC
                             recalibration 
                             (all changes)
New wage index and
                             provider 
                             adjustments
All budget neutral changes
                             (combined cols 2, 3) with market basket update
All budget neutral changes and update
                             (column 4) with frontier wage index adjustment
All changes(1)
(2)
(3)
(4)
(5)
(6)ALL FACILITIES *
4,007
0.0
0.0
2.2
2.3
2.3ALL HOSPITALS
3,872
0.0
0.0
2.3
2.4
2.3(excludes hospitals permanently held harmless and CMHCs)URBAN HOSPITALS
3,008
0.0
0.0
2.3
2.4
2.4LARGE URBAN (GT 1 MILL.)
1,646
0.1
0.2
2.5
2.5
2.6OTHER URBAN (LE 1 MILL.)
1,362
0.0
−0.1
2.1
2.3
2.1RURAL HOSPITALS
863
0.0
−0.3
1.9
2.2
1.9SOLE COMMUNITY
376
0.1
−0.2
2.2
2.6
2.2OTHER RURAL
487
−0.2
−0.3
1.7
1.7
1.6BEDS (URBAN):0-99 BEDS
1,067
0.0
0.0
2.3
2.5
2.3100-199 BEDS
856
0.0
0.0
2.2
2.3
2.3200-299 BEDS
458
−0.1
0.1
2.3
2.4
2.3300-499 BEDS
410
−0.1
0.1
2.3
2.4
2.3500 + BEDS
217
0.3
−0.1
2.5
2.4
2.5BEDS (RURAL):0-49 BEDS
345
0.1
−0.2
2.2
2.4
2.250-100 BEDS
315
0.3
−0.3
2.3
2.5
2.2101-149 BEDS
116
−0.3
−0.1
1.9
2.1
1.8150-199 BEDS
46
−0.4
−0.4
1.4
2.2
1.5200 + BEDS
41
−0.3
−0.4
1.6
1.5
1.5VOLUME (URBAN):LT 5,000 Lines
544
−1.7
−0.3
0.3
0.5
0.55,000-10,999 Lines
135
−0.8
−0.2
1.3
1.4
1.411,000-20,999 Lines
117
−1.5
0.0
0.7
1.2
0.921,000-42,999 Lines
228
−0.7
0.0
1.6
1.5
1.642,999-89,999 Lines
526
−0.3
0.0
1.9
2.0
2.0GT 89,999 Lines
1,458
0.1
0.0
2.4
2.5
2.4VOLUME (RURAL):LT 5,000 Lines
34
−3.8
−0.3
−1.8
1.1
−2.05,000-10,999 Lines
27
−1.8
−0.5
−0.1
1.1
0.011,000-20,999 Lines
42
−1.1
−0.3
0.9
0.9
1.021,000-42,999 Lines
161
0.2
−0.3
2.2
2.8
2.2GT 42,999 Lines
599
0.0
−0.3
2.0
2.2
1.9REGION (URBAN):NEW ENGLAND
152
1.1
0.2
3.5
3.5
3.5MIDDLE ATLANTIC
361
0.5
0.5
3.2
3.2
3.3SOUTH ATLANTIC
482
−0.2
−0.3
1.8
1.7
1.8EAST NORTH CENT.
473
0.1
−0.1
2.2
2.2
2.2EAST SOUTH CENT.
179
−0.9
−0.5
0.9
0.9
0.9WEST NORTH CENT.
194
0.0
−0.2
2.0
3.3
2.1WEST SOUTH CENT.
527
−0.7
−0.5
1.1
1.0
1.1MOUNTAIN
203
0.0
−0.1
2.2
2.5
2.2PACIFIC
389
0.3
1.1
3.7
3.6
3.7PUERTO RICO
48
−0.4
0.3
2.1
2.1
2.0REGION (RURAL):NEW ENGLAND
23
1.6
−0.1
3.7
3.6
3.7MIDDLE ATLANTIC
58
0.8
0.2
3.3
3.3
3.2SOUTH ATLANTIC
130
−0.6
−0.5
1.1
1.1
1.0EAST NORTH CENT
120
0.0
0.0
2.2
2.2
2.2EAST SOUTH CENT
165
−0.8
−0.5
1.0
1.0
0.9WEST NORTH CENT
101
0.2
−0.2
2.2
3.5
2.2WEST SOUTH CENT
181
−0.7
−0.8
0.8
0.7
0.7MOUNTAIN
61
0.7
−0.4
2.5
4.3
2.7PACIFIC
24
0.8
0.9
4.0
4.0
3.9TEACHING STATUS:NON-TEACHING
2,839
−0.2
0.0
2.0
2.1
2.0MINOR
706
−0.2
−0.1
2.0
2.2
2.0MAJOR
326
0.7
0.1
3.1
3.1
3.2DSH PATIENT PERCENT:0
21
0.0
0.3
2.6
2.6
2.6GT 0-0.10
328
0.3
0.2
2.7
2.8
2.7( print page 9635)0.10-0.16
334
0.1
0.0
2.4
2.5
2.40.16-0.23
680
0.1
0.0
2.3
2.4
2.30.23-0.35
1,076
0.0
0.0
2.2
2.4
2.2GE 0.35
824
0.1
0.1
2.3
2.3
2.5DSH NOT AVAILABLE **
608
−3.6
0.0
−1.4
−1.3
−1.4URBAN TEACHING/DSH:TEACHING & DSH
938
0.2
0.0
2.5
2.6
2.5NO TEACHING/DSH
1,477
−0.2
0.1
2.1
2.2
2.1NO TEACHING/NO DSH
18
−0.1
0.4
2.5
2.5
2.5DSH NOT AVAILABLE **
575
−3.3
0.1
−0.9
−0.9
−1.0TYPE OF OWNERSHIP:VOLUNTARY
2,006
0.1
0.0
2.4
2.5
2.4PROPRIETARY
1,322
−0.4
−0.1
1.7
1.9
1.8GOVERNMENT
543
−0.1
−0.1
2.1
2.1
2.2CMHCs
72
0.0
−0.5
1.8
1.8
1.3Column (1) shows the total number of hospitals and/or CMHCs.Column (2) shows the impact of all final CY 2015 OPPS APC policies and compares those to the CY 2014 OPPS.Column (3) shows the budget neutral impact of updating the wage index by applying the final FY 2015 hospital inpatient wage index, including all hold harmless policies and transitional wages. The final rural adjustment continues our current policy of 7.1 percent so the budget neutrality factor is 1. The budget neutrality adjustment for the cancer hospital adjustment is 1.004.Column (4) shows the impact of all budget neutrality adjustments and the addition of the proposed 2.2 percent OPD fee schedule update factor (2.9 percent reduced by 0.5 percentage points for the final productivity adjustment and further reduced by 0.2 percentage point in order to satisfy statutory requirements set forth in the Affordable Care Act).Column (5) shows the impact of all budget neutral changes and the non-budget neutral impact of applying the frontier State wage adjustment in CY 2015.Column (6) shows the additional adjustments to the conversion factor resulting from a change in the pass-through estimate, adding estimated outlier payments, and applying payment wage indexes.* These 4,007 providers include children and cancer hospitals, which are held harmless to pre-BBA amounts, and CMHCs.** Complete DSH numbers are not available for providers that are not paid under IPPS, including rehabilitation, psychiatric, and long-term care hospitals.
 15. On page 67022, second column, first full paragraph, a. Line 13, the figure “1.7” is corrected to read “1.8”. b. Line 16, the figure “1.7” is corrected to read “1.8”. c. Line 19, the figure “−0.4” is corrected to read “−0.5”. 16. On page 67023, second column, first partial paragraph, a. Line 12, the figure “0.9998” is corrected to read “0.9995”. b. Last line, the figure “$44.071” is corrected to read “$44.058”. 17. On page 67024, third column (top third of the page above Table 50), first partial paragraph, line 1, replace “9” with “11”. 18. On pages 67024 through 67025, Table 51—Estimated Impact of the CY 2015 Update to the ASC Payment System on Aggregate Payments for Selected Procedures, the table is corrected to read as follows: Table 51—Estimated Impact of the CY 2015 Update to the ASC Payment System on Aggregate Payments for Selected Procedures
CPT/HCPCS code
Short descriptor
Estimated CY 2014 ASC payments (in millions)
Estimated CY 2015 percent change(1)
(2)
(3)
(4)66984
Cataract surg w/iol, 1 stage
$1,131
−143239
Upper GI endoscopy, biopsy
170
1145380
Colonoscopy and biopsy
167
745385
Lesion removal colonoscopy
107
766982
Cataract surgery, complex
93
−164483
Inj foramen epidural l/s
90
062311
Inject spine l/s (cd)
79
045378
Diagnostic colonoscopy
72
766821
After cataract laser surgery
63
364493
Inj paravert f jnt l/s 1 lev
47
0G0105
Colorectal scrn; hi risk ind
45
1( print page 9636)64635
Destroy lumb/sac facet jnt
45
−563650
Implant neuroelectrodes
41
4G0121
Colon ca scrn not hi rsk ind
41
164590
Insrt/redo pn/gastr stimul
38
−115823
Revision of upper eyelid
35
263685
Insrt/redo spine n generator
34
2929827
Arthroscop rotator cuff repr
34
164721
Carpal tunnel surgery
32
−129881
Knee arthroscopy/surgery
30
−129824
Shoulder arthroscopy/surgery
27
129880
Knee arthroscopy/surgery
25
−143235
Uppr gi endoscopy diagnosis
23
1062310
Inject spine c/t
23
029823
Shoulder arthroscopy/surgery
22
152000
Cystoscopy
22
1G0260
Inj for sacroiliac jt anesth
21
045384
Lesion remove colonoscopy
21
767042
Vit for macular hole
21
126055
Incise finger tendon sheath
19
−2
 Dated: February 18, 2015. C'Reda Weeden, Executive Secretary to the Department, Department of Health and Human Services.


[FR Doc. 2015-03760 Filed 2-23-15; 8:45 am] BILLING CODE 4120-01-P