[Federal Register Volume 80, Number 54 (Friday, March 20, 2015)]
[Rules and Regulations]
[Pages 14853-14870]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-06427]



[[Page 14853]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 403, 405, 410, 411, 412, 413, 414, 425, 489, 495, and 
498

[CMS-1612-F2]
RIN 0938-AS12


Medicare Program; Revisions to Payment Policies Under the 
Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to 
Identifiable Data for the Center for Medicare and Medicaid Innovation 
Models & Other Revisions to Part B for CY 2015; Corrections

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

ACTION: Final rule; correcting amendment.

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SUMMARY: This document corrects technical errors that appeared in the 
final rule with comment period published in the November 13, 2014 
Federal Register (79 FR 67547-68092) entitled, ``Medicare Program; 
Revisions to Payment Policies under the Physician Fee Schedule, 
Clinical Laboratory Fee Schedule, Access to Identifiable Data for the 
Center for Medicare and Medicaid Innovation Models & Other Revisions to 
Part B for CY 2015.'' The effective date for the rule was January 1, 
2015.

DATES: Effective date: This correcting document is effective March 19, 
2015. Applicability date: The corrections indicated in this document 
are applicable beginning January 1, 2015.

FOR FURTHER INFORMATION CONTACT: Christine Estella, (410) 786-0485, for 
issues related to the physician quality reporting system. Donta Henson, 
(410) 786-1947 for all other issues.

SUPPLEMENTARY INFORMATION: 

I. Background

    In FR Doc. 2014-26183 (79 FR 67547 through 68092) the final rule 
entitled, ``Medicare Program; Revisions to Payment Policies under the 
Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to 
Identifiable Data for the Center for Medicare and Medicaid Innovation 
Models & Other Revisions to Part B for CY 2015'' (hereinafter referred 
to as the CY 2015 PFS final rule with comment period), there were a 
number of technical errors that are identified and corrected in section 
IV., Correction of Errors. These corrections are applicable as of 
January 1, 2015. We note that the Addenda B and C to the CY 2015 PFS 
final rule with comment period as corrected by this correction document 
are available on the CMS Web site at www.cms.gov/PhysicianFeeSched/.

II. Summary of Errors

A. Summary of Errors in the Preamble

    On page 67559, due to errors made in ratesetting, many of the 
values contained in Table 4: Calculation of PE RVUs Under Methodology 
for Selected Codes, are incorrect.
    On page 67562, in Table 8: Codes Affected by Removal of Film 
Inputs, we inadvertently included CPT codes 93320, 93321, and 93325.
    On page 67591, we incorrectly stated that in section II. G. of the 
rule, we address the interim final values and establish CY 2015 inputs 
for the lower gastrointestinal procedures.
    On page 67612, in Table 14: Codes Reviewed by the 2014 Multi-
Specialty Refinement Panel, the work RVUs for CPT codes 43204, 43205, 
and 43233 are incorrect.
    On page 67633, due to a typographical error we referred to CPT code 
41391 rather than CPT code 43391.
    On page 67636, due to a technical error, the final work RVU for 
code 43278 is incorrect.
    On pages 67651 through 67663, in Table 25: CY 2015 Interim Final 
Work RVUS For New/Revised or Potentially Misvalued Codes, the RUC/HCPAC 
recommended work RVUs listed on page 67658 for CPT codes 76932 and 
76948 are incorrect and entries for CPT codes 76940 and 76965 were 
inadvertently omitted from the table.
    On page 67660, the RUC/HCPAC recommended work RVU listed for CPT 
code 92545 is incorrect.
    On page 67668,
    a. We inadvertently omitted G0279 from the list of codes in the 
title of (13).
    b. Due to a typographical error, G0279 is referred to as G-2079.
    c. We inadvertently omitted the phrase ``, whether or not a 2-D 
mammography is furnished'' from the sentence beginning, ``In addition, 
we are creating . . .''
    On page 67669, we inadvertently listed CPT code 93644 in the title 
of (18).
    On page 67671, in Table 28: CY 2015 Interim Final Codes with Direct 
PE Input Recommendations Accepted without Refinement, we inadvertently 
listed CPT code 31620.
    On page 67673, in Table 29: Invoices Received for New Direct PE 
Inputs we inadvertently listed entries associated with CPT code 31620.
    On page 67674, in Table 30: Invoices Received For Existing Direct 
PE Inputs, certain PE direct inputs for CPT code 31627 were 
inadvertently omitted.
    On pages 67678 through 67711, in Table 31: CY 2015 Interim Final 
Codes With Direct PE Input Recommendations Accepted with Refinements, 
due to technical errors, on page 67678, entries associated with CPT 
codes 77061 and 77062 were inadvertently listed; on page 67702, entries 
associated with CPT codes 93320, 93321, and 93325 were inadvertently 
omitted and an input code for CPT code 93880 was inadvertently omitted.
    On page 67726, we incorrectly stated that practitioners do not have 
to use any ``specific content exchange standard.''
    On pages 67741 through 67742, we incorrectly stated the CY 2015 PFS 
conversion factors.
    On page 67742, in Table 45: Calculation of the CY 2015 PFS CF, due 
to corrections being made in this document, the CY 2014 budget 
neutrality adjustment, the CY 2015 CFs, and the percentage changes from 
the CY 2014 CF stated in the table are incorrect.
    On page 67743, due to technical errors, the budget neutrality 
factor, the anesthesia CF in effect from January 1, 2015 through March 
31, 2015, and the anesthesia CF in effect from April 1, 2015 through 
December 31, 2015 are incorrectly stated. The entries in Table 46: 
Calculation of the CY 2015 Anesthesia CF for budget neutrality 
adjustments, CFs and percentage change are inaccurate.
    On pages 67803 and 67804, in Table 52: Individual Quality Cross-
Cutting Measures for the PQRS to Be Available for Satisfactory 
Reporting Via Claims, Registry, and EHR Beginning in 2015, we 
inadvertently listed the incorrect National Quality Strategy (NQS) 
domain for Physician Quality Reporting System (PQRS) Measure 131, Pain 
Assessment and Follow-Up.
    On pages 67848 and 67849, in Table 55: Measures Being Removed from 
the Existing PQRS Measure Set Beginning in 2015, we inadvertently 
omitted adding an ``X'' to the claims reporting option for Physician 
Quality Reporting System (PQRS) Measure 0091/051: Chronic Obstructive 
Pulmonary Disease (COPD): Spirometry Evaluation, Measure 0102/052: 
Chronic Obstructive Pulmonary Disease (COPD): Inhaled Bronchodilator 
Therapy, and Measure 0050/109: Osteoarthritis (OA) Function and Pain 
Assessment.
    On page 67854, in Table 56: Existing Individual Quality Measures 
and Those Included in Measures Groups for the PQRS for Which Measure 
Reporting Updates Will Be Effective Beginning in 2015, we inadvertently 
added an ``X'' to the Group Practice Reporting Option

[[Page 14854]]

(GPRO) Web Interface reporting option for Physician Quality Reporting 
System (PQRS) Measure 0067/006: Coronary Artery Disease (CAD): 
Antiplatelet Therapy.
    On page 67877, in Table 56: Existing Individual Quality Measures 
and Those Included in Measures Groups for the PQRS for Which Measure 
Reporting Updates Will Be Effective Beginning in 2015, we inadvertently 
added an ``X'' to the claims reporting option and omitted adding an 
``X'' to the registry reporting option for Physician Quality Reporting 
System (PQRS) Measure 0409/205: HIV/AIDS: Sexually Transmitted Disease 
Screening for Chlamydia, Gonorrhea, and Syphilis.
    On page 67988, in Table 93: CY 2015 PFS Final Rule with Comment 
Period Estimated Impact Table: Impacts of Work, Practice Expense, and 
Malpractice RVUs, due to ratesetting errors, the values are inaccurate.
    On page 67991 through 67992, in Table 94: Impact of the Final Rule 
with Comment Period on CY 2014 Payment for Selected Procedures, due to 
ratesetting errors, the stated payment rates are inaccurate.
    On page 67999, the January 1-March 31, 2015 CF, the CY 2015 
national payment amount in the nonfacility setting for CPT code 99203, 
and the beneficiary coinsurance amount are incorrect.

B. Summary and Correction of Errors in the Addenda on the CMS Web Site

    Due to the errors identified and summarized in section II.A and B 
of this correction document, we are correcting errors in the work, PE 
or MP RVUs (or combinations of these RVUs) in Addendum B: CY 2015 
Relative Value Units (RVUs) And Related Information Used In Determining 
Final Medicare Payments and Addendum C: CY 2015 Interim Final Relative 
Value Units (RVUs). We note that corrections to the RVUs for codes with 
identified errors affect additional codes due to the budget neutrality 
and relativity of the PFS. These errors are corrected in the revised 
Addenda B and C available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
    In addition to the errors identified in section II.A. of this 
correction document, the following errors occur in the addenda.
    Due to a technical error in the creation of the direct PE database, 
nonfacility PE RVUs were created and displayed in Addendum B (and 
Addendum C, if applicable) for the following CPT codes: 21811, 21812, 
21813, 22858, 33418, 33951, 33952, 33953, 33954, 33955, 33956, 33957, 
33958, 33959, 33962, 33963, 33964, 33965, 33966, 33969, 33984, 33985, 
33986, 33987, 33988, 33989, 37218, 43180, 44380, 44382, 66179, and 
66184. These errors are corrected in the revised Direct PE Input 
Database available on the CMS Web site at www.cms.gov//PhysicianFeeSched/. Resulting changes to the PE RVUs are reflected in 
the corrected Addendum B (and Addendum C, if applicable) available on 
the CMS Web site at www.cms.gov//PhysicianFeeSched/.
    Due to technical errors in the creation of the direct PE database, 
some or all of the PE inputs were inadvertently omitted for CPT codes 
22510, 22511, 22512, 22513, 22514, 22515, 31620, 33951, 33952, 33953, 
33954, 33955, 33956, 33957, 33958, 33959, 33962, 33963, 33964, 33969, 
33984, 33985, 33986, 33988, 33989, 58541, 58542, 58543, 58544, 58570, 
58571, 58572, 64486, 64487, 64488, 64489, 70496, 70498, 76700, 76705, 
77080, 88348, 93260, 93261, and 93644. These errors are corrected in 
the revised Direct PE Input Database available on the CMS Web site at 
www.cms.gov//PhysicianFeeSched/.
    Due to technical errors in the creation of the direct PE database, 
the incorrect inputs were used for creating PE RVUs for CPT codes 
20982, 31620, 31627, 32998, 33262, 32998, 41530, 50592, 64600, 64605, 
64610, 64633, 64634, 64635, 64636, 93925, 93880, and 93990. These 
errors are corrected in the revised Direct PE Input Database available 
on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
    Due to a technical error, we incorrectly displayed in Addenda B and 
C PE RVUs in a nonfacility setting for CPT codes 33270, 33271, 33272, 
and 33273. The PE RVUs for these codes in a non-facility setting have 
been removed in the corrected Addenda B and C available on the CMS Web 
site at www.cms.gov//PhysicianFeeSched/.
    Due to a technical error, HCPCS codes 33330, 33474, 61610, and 
61870 were inadvertently left out of Addendum B. These codes are 
reflected in the corrected Addendum B available on the CMS Web site at 
www.cms.gov//PhysicianFeeSched/.
    Due to a technical error, the average risk factor, and not the 
specialty risk factor that we indicated that we were using in the 
preamble, was applied when calculating the MP RVUs for CPT codes 33620 
and 33622. As a result, the MP RVUs listed in Addendum B are incorrect 
for these codes. We have corrected these errors in the corrected 
Addendum B available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
    Due to a technical error, the incorrect work RVUs were applied in 
calculating the MP RVUs for CPT codes 33418 and 33419. As a result, the 
MP RVUs listed in Addenda B and C are incorrect for these codes. We 
have corrected these errors in the corrected Addenda B and C available 
on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
    Due to a technical error, the incorrect CY 2015 work RVUs are 
included in Addendum B (and Addendum C, if applicable) for the 
following codes: 43191, 43192, 43193, 43194, 43195, 43196, 43197, 
43198, 43200, 43201, 43202, 43204, 43205, 43211, 43212, 43214, 43215, 
43229, 43232, 43233, 43235, 43236, 43238, 43239, 43242, 43247, 43253, 
43254, 43257, 43266, 43270, 43274, 43276, 43278, 58541, 58542, 58543, 
58544, 58570, 58571, 58572, 58573, 71275, 76930, 76932, 76948, 92545, 
93315, 93317, 93318, and 95973. The correct CY 2015 work RVUS for these 
codes are reflected in the corrected Addenda B and C available on the 
CMS Web site at www.cms.gov//PhysicianFeeSched/.
    Due to a technical error in the creation of the direct PE database, 
PE RVUs for the facility setting were created and are displayed in 
Addendum B for HCPCS code 77372 and Addenda B and C for HCPCS code 
G0277. These technical errors are corrected in Addenda B and C 
available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
    Due to technical errors in the creation of the direct PE database, 
direct PE inputs were inadvertently included for CPT code 99183 and are 
reflected in the PE RVUs shown in Addenda B and C. This error is 
corrected in the Direct PE Input Database available on the CMS Web site 
at www.cms.gov//PhysicianFeeSched/. The corrected PE RVUS are included 
in Addenda B and C available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
    Due to a technical error, in Addendum B, work and MP RVUs for CPT 
codes 99487 and 99489 were inadvertently included. The work and MP RVUs 
for these codes have been removed in the corrected Addendum B available 
on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
    Due to a technical error in the creation of the direct PE database, 
PE RVUs were not created for CPT code 99490 in the facility setting. 
The correct PE RVU for this code is reflected in the corrected Addendum 
B available on the CMS Web site at www.cms.gov//PhysicianFeeSched/.
    Due to a technical error, HCPCS codes G9407 through G9472 are 
inadvertently included in Addendum B. These codes

[[Page 14855]]

have been removed in the corrected Addendum B available on the CMS Web 
site at www.cms.gov//PhysicianFeeSched/.

C. Summary of Errors in the Regulations Text

    On page 68002 of the CY 2015 PFS final rule with comment period, we 
made a technical error in Sec.  410.26(b)(5). In this paragraph, we 
inadvertently omitted language to limit the applicability of the 
exception that allows general, rather than direct, supervision of 
transitional care management services furnished incident to a 
practitioner's professional services to the non-face-to-face aspects of 
the service.

III. Waiver of Proposed Rulemaking and Delay in 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 correction document does not constitute a 
rulemaking that would be subject to these requirements. This correction 
document corrects technical errors in the CY 2015 PFS final rule with 
comment period and the corresponding addenda posted on the CMS Web 
site. 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 PFS final rule with comment period. As a 
result, the corrections made through this correction document are 
intended to ensure that the CY 2015 PFS 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 PFS final rule with comment period or delaying the 
effective date of the corrections would be contrary to the public 
interest because it is in the public interest to ensure that the CY 
2015 PFS final rule with comment period accurately reflects our final 
policies as soon as possible following the date they take effect. 
Further, such procedures would be unnecessary, because we are not 
altering the payment methodologies or policies, but rather, we are 
simply correcting the Federal Register document to reflect the policies 
that we previously proposed, received comment on, and subsequently 
finalized. This correcting document is intended solely to ensure that 
the CY 2015 PFS final rule with comment period accurately reflects 
these policies. For these reasons, we believe there is good cause to 
waive the requirements for notice and comment and delay in effective 
date.

IV. Correction of Errors

    In FR Doc. 2014-26183 of November 13, 2014 (79 FR 67547), make the 
following corrections:

A. Correction of Errors in the Preamble

    1. On page 67559, in Table 4: Calculation of PE RVUs Under 
Methodology for Selected Codes, the table is corrected to read as 
follows:


[[Page 14856]]



                                                              Table 4--Calculation of PR RVUs Under Methodology for Selected Codes
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                             99213
                                                                                             Office    33533 CABG,  71020 Chest    71020-TC     71020-26    93000 ECG,   93005 ECG,   93010 ECG,
     Factor (CF) (2nd part)             Step              Source            Formula        visit, est   arterial,    x-ray non-    Chest x-     Chest x-    complete,     tracing,   report non-
                                                                                              non-        single      facility    ray, non-    ray, non-       non-         non-       facility
                                                                                            facility     facility                  facility     facility     facility     facility
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(1) Labor cost (Lab)...........  Step 1...........  AMA..............  .................        13.32        77.52         5.74         5.74            0          5.1          5.1            0
(2) Supply cost (Sup)..........  Step 1...........  AMA..............  .................         2.98         7.34         0.53         0.53            0         1.19         1.19            0
(3) Equipment cost (Eqp).......  Step 1...........  AMA..............  .................         0.17         0.58         6.92         6.92            0         0.09         0.09            0
(4) Direct cost (Dir)..........  Step 1...........  .................     '%=(1)+(2)+(3)        16.48        85.45        13.19        13.19            0         6.38         6.38            0
(5) Direct adjustment (Dir.      Steps 2-4........  See footnote *...  .................       0.5953       0.5953       0.5953       0.5953       0.5953       0.5953       0.5953       0.5953
 Adj.).
(6) Adjusted Labor.............  Steps 2-4........  '%=Labor * Dir          '%=(1) * (5)         7.93        46.15         3.42         3.42            0         3.04         3.04            0
                                                     Adj.
(7) Adjusted Supplies..........  Steps 2-4........  '%=Eqp * Dir Adj.       '%=(2) * (5)         1.78         4.37         0.32         0.32            0         0.71         0.71            0
(8) Adjusted Equipment.........  Steps 2-4........  '%=Sup * Dir Adj.       '%=(3) * (5)          0.1         0.35         4.12         4.12            0         0.05         0.05            0
(9) Adjusted Direct............  Steps 2-4........  .................     '%=(6)+(7)+(8)         9.81        50.87         7.85         7.85            0          3.8          3.8            0
(10) Conversion Factor (CF)....  Step 5...........  PFS..............  .................      35.8228      35.8228      35.8228      35.8228      35.8228      35.8228      35.8228      35.8228
(11) Adj. labor cost converted.  Step 5...........  '%=(Lab * Dir            '%=(6)/(10)         0.22         1.29          0.1          0.1            0         0.08         0.08            0
                                                     Adj)/CF.
(12) Adj. supply cost converted  Step 5...........  '%=(Sup * Dir            '%=(7)/(10)         0.05         0.12         0.01         0.01            0         0.02         0.02            0
                                                     Adj)/CF.
(13) Adj. equipment cost         Step 5...........  '%=(Eqp * Dir            '%=(8)/(10)            0         0.01         0.11         0.11            0            0            0            0
 converted.                                          Adj)/CF.
(14) Adj. direct cost converted  Step 5...........  .................  '%=(11)+(12)+(13)         0.27         1.42         0.22         0.22            0         0.11         0.11            0
(15) Work RVU..................  Setup File.......  PFS..............  .................         0.97        33.75         0.22            0         0.22         0.17            0         0.17
(16) Dir_pct...................  Steps 6,7........  Surveys..........  .................         0.25         0.17         0.29         0.29         0.29         0.29         0.29         0.29
(17) Ind_pct...................  Steps 6,7........  Surveys..........  .................         0.75         0.83         0.71         0.71         0.71         0.71         0.71         0.71
(18) Ind. Alloc. Formula (1st    Step 8...........  See Step 8.......  .................  (14)/(16) *  (14)/(16) *  (14)/(16) *  (14)/(16) *  (14)/(16) *  (14)/(16) *  (14)/(16) *  (14)/(16) *
 part).                                                                                          (17)         (17)         (17)         (17)         (17)         (17)         (17)         (17)
(19) Ind. Alloc. (1st part)....  Step 8...........  .................             See 18         0.83         6.73         0.53         0.53            0         0.26         0.26            0
(20) Ind. Alloc. Formula (2nd    Step 8...........  See Step 8.......  .................         -15%         -15%     %(15+11)         -11%         -15%     %(15+11)         -11%         -15%
 part).
(21) Ind. Alloc. (2nd part)....  Step 8...........  .................             See 20         0.97        33.75         0.32          0.1         0.22         0.25         0.08         0.17
(22) Indirect Allocator (1st +   Step 8...........  .................       '%=(19)+(21)          1.8        40.48         0.85         0.63         0.22         0.52         0.35         0.17
 2nd).
(23) Indirect Adjustment (Ind.   Steps 9-11.......  See Footnote * *.  .................       0.3829       0.3829       0.3829       0.3829       0.3829       0.3829       0.3829       0.3829
 Adj.).
(24) Adjusted Indirect           Steps 9-11.......  '%=Ind Alloc *     .................         0.69         15.5         0.33         0.24         0.08          0.2         0.13         0.07
 Allocator.                                          Ind Adj.
(25) Ind. Practice Cost Index    Steps 12-16......  .................  .................         1.07         0.75         0.99         0.99         0.99         0.91         0.91         0.91
 (IPCI).
(26) Adjusted Indirect.........  Step 17..........  '%= Adj.Ind Alloc     '%=(24) * (25)         0.74        11.64         0.32         0.24         0.08         0.18         0.12         0.06
                                                     * PCI.
(27) Final PE RVU..............  Step 18..........  '%=(Adj Dir + Adj   '%=((14)+(26)) *         1.01        12.99         0.54         0.46         0.08         0.29         0.23         0.06
                                                     Ind) * Other Adj.        Other Adj)
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Note: PE RVUs in Table 4, row 27, may not match Addendum B due to rounding.
* The direct adj = [current pe rvus * CF * avg dir pct]/[sum direct inputs] = [step2]/[step3]
* * The indirect adj = [current pe rvus * avg ind pct]/[sum of ind allocators] = [step9]/[step10]
Note: The use of any particular conversion factor (CF) in Table 4 to illustrate the PE Calculation has no effect on the resulting RVUs.


[[Page 14857]]

    2. On page 67562, in Table 8: Codes Affected by Removal of Film 
Inputs, the following listed entries are removed.

------------------------------------------------------------------------
               HCPCS                           Short descriptor
------------------------------------------------------------------------
93320..............................  Doppler echo exam heart
93321..............................  Doppler echo exam heart
93325..............................  Doppler color flow add-on
------------------------------------------------------------------------

    3. On page 67591, third column, first full paragraph, line 10, the 
sentence ``In section II.G. of this CY 2015 PFS final rule with comment 
period, we address interim final values and establish CY 2015 inputs 
for the lower gastrointestinal procedures, many of which are also 
listed in Appendix G.'' is corrected to read ``In section II.G. of this 
CY 2015 PFS final rule with comment period, we note that we are 
delaying the adoption of the new code set for lower gastrointestinal 
procedures until CY 2016; many of these codes are also listed in 
Appendix G.''
    4. On page 67612, in Table 14: Codes reviewed by the 2014 Multi-
Specialty Refinement Panel, the entries for CPT codes 43204, 43205 and 
43233 are corrected to read as follows:

----------------------------------------------------------------------------------------------------------------
                                                                                 Refinement
   HCPCS code           Descriptor        CY 2014  interim  RUC  recommended    panel  median   CY 2015 work RVU
                                           final  work RVU      work RVU           rating
----------------------------------------------------------------------------------------------------------------
43204...........  Injection of dilated               2.40              2.89              2.77              2.43
                   esophageal veins
                   using an endoscope.
43205...........  Tying of esophageal                2.51              3.00              2.88              2.54
                   veins using an
                   endoscope.
43233...........  Balloon dilation of                4.05              4.45              4.26              4.17
                   esophagus, stomach,
                   and/or upper small
                   bowel using an
                   endoscope.
----------------------------------------------------------------------------------------------------------------

    5. On page 67633, third column, first full paragraph, line 14, the 
phrase ``CPT code 41391,'' is corrected to read ``CPT code 43391,''.
    6. On page 67636, third column, first partial paragraph, lines 24 
through 25, the sentence ``The final work RVU for CPT code 43278 is 
8.'' is corrected to read ``The final work RVU for CPT code 43278 is 
8.02.''
    7. On pages 67651 through 67663, in Table 25: CY 2015 Interim Final 
Work RVUS For New/Revised or Potentially Misvalued Codes, the listed 
entries on page 67658 are corrected to read:

----------------------------------------------------------------------------------------------------------------
                                                                RUC/HCPAC
   HCPCS code         Long descriptor       CY 2014 WRVU    recommended work  CY 2015 work RVU      CMS time
                                                                   RVU                             refinement
----------------------------------------------------------------------------------------------------------------
76932...........  Ultrasonic guidance                    C             0.67              0.67                No
                   for endomyocardial
                   biopsy, imaging
                   supervision and
                   interpretation.
76940...........  Ultrasound guidance                2.00              2.00              2.00                No
                   for, and monitoring
                   of, parenchymal
                   tissue ablation.
76948...........  Ultrasonic guidance                0.38              0.38              0.38                No
                   for aspiration of
                   ova, imaging
                   supervision and
                   interpretation.
76965...........  Ultrasonic guidance                1.34              1.34              1.34                No
                   for interstitial
                   radioelement
                   application.
----------------------------------------------------------------------------------------------------------------

    8. On page 67660, in Table 25: CY 2015 Interim Final Work RVUS For 
New/Revised or Potentially Misvalued Codes, the listed entry is 
corrected to read:

----------------------------------------------------------------------------------------------------------------
                                                                RUC/HCPAC
   HCPCS code         Long descriptor       CY 2014 WRVU    recommended work  CY 2015 work RVU      CMS time
                                                                   RVU                             refinement
----------------------------------------------------------------------------------------------------------------
92545...........  Oscillating tracking               0.23              0.25              0.25                No
                   test, with recording.
----------------------------------------------------------------------------------------------------------------

    9. On page 67668,
    a. First column, line 1, the title ``(13) Breast Tomosynthesis (CPT 
codes 77061, 77062, and 77063)'' is corrected to read ``(13) Breast 
Tomosynthesis (CPT codes 77061, 77062, 77063 and G2079)''.
    b. Second column, line 19, the phrase ``a new code, G-2079'' is 
corrected to read ``a new code, G0279''.
    c. Second column, line 27, is corrected by adding ``whether or not 
a 2-D mammography is furnished'' after the phrase ``diagnostic breast 
tomosynthesis''.
    10. On page 67669, second column, lines 8 through 11, we are 
correcting the title ``(18) Interventional Transesophageal 
Echocardiography (TEE) (CPT Codes 93312, 93313, 93314, 93315, 93316, 
93317, 93318, 93355, and 93644)'' to read ``(18) Interventional 
Transesophageal Echocardiography (TEE) (CPT Codes 93312, 93313, 93314, 
93315, 93316, 93317, 93318, and 93355).''
    11. On page 67671, in Table 28: CY 2015 Interim Final Codes with 
Direct PE Input Recommendations Accepted without Refinements, the 
following listed entry is removed:

------------------------------------------------------------------------
               HCPCS                           Short descriptor
------------------------------------------------------------------------
31620..............................  Endobronchial us add-on
------------------------------------------------------------------------

    12. On page 67673, in Table 29: Invoices Received for New Direct PE 
Inputs, the following listed entries for CPT code 31620 are removed:

[[Page 14858]]



--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                           Non-facility allowed services
                                                                                                               Number of     for HCPCS codes using this
           CPT/HCPCS codes                    Item name            CMS code            Average price            invoices    item (or projected services
                                                                                                                                for new CPT codes*)
--------------------------------------------------------------------------------------------------------------------------------------------------------
31620...............................  Flexible dual-channeled          EQ361   $160,260.06..................           6                            107
                                       EBUS bronchoscope, with
                                       radial probe.
31620...............................  Video system, Ultrasound         ER099   $13,379.57...................           6                            107
                                       (processor, digital
                                       capture, monitor,
                                       printer, cart).
31620...............................  EBUS, single use                     SC10$145.82......................           5                            107
                                       aspiration needle, 21 g.
31620...............................  Balloon for Bronchosopy          SD294   $28.68.......................           4                            107
                                       Fiberscope.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    13. On page 67674, Table 30: Invoices Received for Existing Direct 
PE Inputs, the list entries for CPT code 31627 are corrected by adding 
the following:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                          Non-facility
                                                                                                                            Number of   allowed services
         CPT/HCPCS codes               Item name         CMS code       Current price        Updated price      % Change    invoices    for HCPCS codes
                                                                                                                                        using this item
--------------------------------------------------------------------------------------------------------------------------------------------------------
31627...........................  sensor, patch,             SD235   $1.10..............  $3.00..............        173           2                 37
                                   bronchosopy (for
                                   kit, locatable
                                   guide) (patient).
31627...........................  system,                    EQ326   $137,800.00........  $189,327.66........         37           4                 37
                                   navigational
                                   bronchoscopy
                                   (superDimension).
31627...........................  kit, locatable             SA097   $995.00............  $1,063.67..........          7           3                 37
                                   guide, ext.
                                   working channel, w-
                                   b-scope adapter.
--------------------------------------------------------------------------------------------------------------------------------------------------------


[[Page 14859]]

    14. On pages 67678 through 67711, in Table 31: CY 2015 Interim 
Final Codes With Direct PE Input Recommendations Accepted with 
Refinements, we are correcting the table by
    a. On page 67687, deleting the following listed entries:
    [GRAPHIC] [TIFF OMITTED] TR20MR15.015
    

[[Page 14860]]


    b. On page 67702, correcting the bottom half of the table to read:
    [GRAPHIC] [TIFF OMITTED] TR20MR15.016
    

[[Page 14861]]


[GRAPHIC] [TIFF OMITTED] TR20MR15.017

    15. On page 67726, first column, second full paragraph, lines 6 
through 8, the phrase ``with a clarification that practitioners do not 
have to use any specific content exchange standard in CY 2015.'' is 
corrected to read ``with a clarification that practitioners do not have 
to use any specific exchange or transfer standard in CY 2015.''
    16. On page 67741, first column, first paragraph, we are correcting 
the entire paragraph to read:
    The CY 2015 PFS CF for January 1, 2015 through March 31, 2015 is 
$35.7547. The CY 2015 PFS CF for April 1, 2015 through December 31, 
2015 is $28.1872. The CY 2015 national average anesthesia CF for 
January 1, 2015 through March 31, 2015 is $22.4968. The CY 2015 
national average anesthesia CF for April 1, 2015 through December 31, 
2015 is $17.7454.
    17. On page 67742, third column, first partial paragraph,
    a. Line 3, the phrase ``by 0.06 percent'' is corrected to read ``by 
0.19 percent''.
    b. Third column, first full paragraph, line 8, the figure 
``$35.8013.'' is corrected to read ``$35.7547.''
    c. Third column, second full paragraph, line 6, the figure 
``$28.2239.'' is corrected to read ``$28.1872.''
    d. Third column, second full paragraph, line 9, the phrase ``21.2 
percent'' is corrected to read ``21.3 percent''.
    18. On page 67742, in Table 45: Calculation of the CY 2015 PFS CF, 
the table is corrected to read as follows:

               Table 45--Calculation of the CY 2015 PFS CF
------------------------------------------------------------------------
 
------------------------------------------------------------------------
                 January 1, 2015 through March 31, 2015
------------------------------------------------------------------------
Conversion Factor in effect in CY   ....................        $35.8228
 2014.
------------------------------------------------------------------------
Update............................  0.0 percent (1.00)..  ..............
CY 2015 RVU Budget Neutrality       -0.19 percent         ..............
 Adjustment.                         (0.9981).
CY 2015 Conversion Factor (1/1/     ....................        $35.7547
 2015 through 3/31/2015).
------------------------------------------------------------------------
                 April 1, 2015 through December 31, 2015
------------------------------------------------------------------------
Conversion Factor in effect in CY   ....................        $35.8228
 2014.

[[Page 14862]]

 
CY 2014 Conversion Factor had       ....................        $27.2006
 statutory increases not applied.
CY 2015 Medicare Economic Index...  0.8 percent (1.008).  ..............
CY 2015 Update Adjustment Factor..  3.0 percent (1.03)..  ..............
CY 2015 RVU Budget Neutrality       -0.19 percent         ..............
 Adjustment.                         (0.9981).
CY 2015 Conversion Factor (4/1/     ....................        $28.1872
 2015 through 12/31/2015).
Percent Change in Conversion        ....................          -21.3%
 Factor on 4/1/2015 (relative to
 the CY 2014 CF).
Percent Change in Update (without   ....................          -21.2%
 budget neutrality adjustment) on
 4/1/2015 (relative to the CY 2014
 CF).
------------------------------------------------------------------------

    19. On page 67743,
    a. First column, first full paragraph, line 5, the sentence ``After 
applying the 0.9994 budget'' is corrected to read ``After applying the 
0.9981 budget''.
    b. Second column, line 2, the figure ``$22.5550.'' is corrected to 
read ``$22.4968.''
    c. Third column, line 12, the figure ``$17.7913.'' is corrected to 
read ``$17.7454.''
    d. Table 46: Calculation of the CY 2015 Anesthesia CF is corrected 
to read as follows:

           Table 46--Calculation of the CY 2015 Anesthesia CF
------------------------------------------------------------------------
 
------------------------------------------------------------------------
                 January 1, 2015 through March 31, 2015
------------------------------------------------------------------------
CY 2014 National Average            ....................        $22.6765
 Anesthesia CF.
------------------------------------------------------------------------
Update............................  0.0 percent (1.00)..  ..............
CY 2015 RVU Budget Neutrality       -0.19 percent         ..............
 Adjustment.                         (0.9981).
CY 2015 Anesthesia Fee Schedule     -0.00494 percent      ..............
 Practice Expense Adjustment.        (0.99506).
CY 2015 National Average            ....................        $22.4968
 Anesthesia CF (1/1/2015 through 3/
 31/2015).
------------------------------------------------------------------------
                 April 1, 2015 through December 31, 2015
------------------------------------------------------------------------
2014 National Average Anesthesia    ....................        $22.6765
 Conversion Factor in effect in CY
 2015.
2014 National Anesthesia            ....................        $17.2283
 Conversion Factor had Statutory
 Increases Not Applied.
CY 2015 Medicare Economic Index...  0.8 percent (1.008).  ..............
CY 2015 Update Adjustment Factor..  3.0 percent (1.03)..  ..............
CY 2015 Budget Neutrality Work and  -0.19 percent         ..............
 Malpractice Adjustment.             (0.9981).
CY 2015 Anesthesia Fee Schedule     -0.00494 percent      ..............
 Practice Expense Adjustment.        (0.99506).
CY 2015 Anesthesia Fee Schedule     -0.00494 percent      ..............
 Practice Expense Adjustment.        (0.99506).
CY 2015 Anesthesia Conversion       ....................        $17.7454
 Factor (4/1/2015 through 12/31/
 2015).
Percent Change from 2014 to 2015    ....................          -21.7%
 (4/1/2015 through 12/31/2015).
------------------------------------------------------------------------

    20. On page 67803, last row, in Table 52: Individual Quality Cross-
Cutting Measures for the PQRS to Be Available for Satisfactory 
Reporting Via Claims, Registry, and EHR Beginning in 2015, the listed 
entry is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR20MR15.007


[[Page 14863]]


BILLING CODE 4120-01-P
    21. On page 67848, the last two rows, and the first row on page 
67849, in Table 55: Measures Being Removed from the Existing PQRS 
Measure Set Beginning in 2015, the listed are corrected to read as 
follows:
[GRAPHIC] [TIFF OMITTED] TR20MR15.008


[[Page 14864]]


    22. On page 67854, the second row, in Table 56: Existing Individual 
Quality Measures and Those Included in Measures Groups for the PQRS for 
Which Measure Reporting Updates Will Be Effective Beginning in 2015, 
the listed entry is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR20MR15.009


[[Page 14865]]


    23. On page 67877, second row, in Table 56: Existing Individual 
Quality Measures and Those Included in Measures Groups for the PQRS for 
Which Measure Reporting Updates Will Be Effective Beginning in 2015, 
the listed entry is corrected to read as follows:
BILLING CODE 4120-01-C
[GRAPHIC] [TIFF OMITTED] TR20MR15.010

    24. On page 67988, in Table 93: CY 2015 PFS Final Rule with Comment 
Period Estimated Impact Table: Impacts of Work, Practice Expense, and 
Malpractice RVUs, the table is corrected to read as follows:

[[Page 14866]]

[GRAPHIC] [TIFF OMITTED] TR20MR15.013


[[Page 14867]]


    25. On page 67991 through 67992, in Table 94: Impact of Final Rule 
with Comment Period on CY 2015 Payment for Selected Procedures the 
table is corrected to read as follows:
BILLING CODE 4120-01-P
[GRAPHIC] [TIFF OMITTED] TR20MR15.014


[[Page 14868]]


[GRAPHIC] [TIFF OMITTED] TR20MR15.011


[[Page 14869]]


[GRAPHIC] [TIFF OMITTED] TR20MR15.012

    27. On page 67999, third column, first full paragraph,
    a. Line 18, the figure ``35.8013,'' is corrected to read 
``35.7547,''.
    b. Line 21, the figure ``$109.19,'' is corrected to read 
``$108.18,''.
    c. Line 23, the phrase ``this service would be $21.84.'' is 
corrected to read ``this service would be $21.74.''

[[Page 14870]]

List of Subjects in 42 CFR Part 410

    Health facilities, Health professions, Kidney diseases, 
Laboratories, Medicare, Reporting and recordkeeping requirements, Rural 
areas, X-rays.

    Accordingly, 42 CFR chapter IV is corrected by making the following 
correcting amendments to part 410:

PART 410--SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS

0
1. The authority citation for part 410 continues to read as follows:

    Authority: Secs. 1102, 1834, 1871, 1881, and 1893 of the Social 
Security Act (42 U.S.C. 1302, 1395m, 1395hh, and 1395ddd.

0
2. Section 410.26 is amended by revising paragraph (b)(5) to read as 
follows:


Sec.  410.26  Services and supplies incident to a physician's 
professional services: Conditions.

* * * * *
    (b) * * *
    (5) In general, services and supplies must be furnished under the 
direct supervision of the physician (or other practitioner). Chronic 
care management services and transitional care management services 
(other than the required face-to-face visit) can be furnished under 
general supervision of the physician (or other practitioner) when they 
are provided by clinical staff incident to the services of a physician 
(or other practitioner). The physician (or other practitioner) 
supervising the auxiliary personnel need not be the same physician (or 
other practitioner) upon whose professional service the incident to 
service is based.
* * * * *

    Dated: March 13, 2015.
C'Reda Weeden,
Executive Secretary to the Department, Department of Health and Human 
Services.
[FR Doc. 2015-06427 Filed 3-19-15; 8:45 am]
 BILLING CODE 4120-01-C