Tuesday, 

August 3, 2010 

Book 2 of 3 Books 

Pages 45699–46168 

Part II 

Department of 

Health and Human 

Services 

Centers for Medicare and Medicaid 

42 CFR Parts 410, 416 and 419 

Medicare Program: Changes to the 

Hospital Outpatient Prospective Payment 

System and CY 2010 Payment Rates; 

Changes to the Ambulatory Surgical 

Center Payment System and CY 2010 

Payment Rates; Corrections; Final Rule, 

Notice, and Proposed Rule 


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DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 410, 416, and 419 

[CMS–1414–CN2] 

RIN 0938–AP41 

Medicare Program: Changes to the 

Hospital Outpatient Prospective 

Payment System and CY 2010 Payment 

Rates; Changes to the Ambulatory 

Surgical Center Payment System and 

CY 2010 Payment Rates; Corrections 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Correction of final rule with 

comment period. 

SUMMARY: This document corrects 

technical errors that appeared in the 

final rule with comment period found in 

the Federal Register (FR) on November 

20, 2009, entitled ‘‘Medicare Program: 

Changes to the Hospital Outpatient 

Prospective Payment System and CY 

2010 Payment Rates; Changes to the 

Ambulatory Surgical Center Payment 

System and CY 2010 Payment Rates’’ 

and in the correction document found 

in the Federal Register on December 31, 

2009, entitled ‘‘Medicare Program: 

Changes to the Hospital Outpatient 

Prospective Payment System and CY 

2010 Payment Rates; Changes to the 

Ambulatory Surgical Center Payment 

System and CY 2010 Payment Rates.’’ 

DATES: Effective Date: This document is 

effective on August 3, 2010. 

Applicability Date: The corrections in 

this document are applicable on and 

after January 1, 2010. 

FOR FURTHER INFORMATION CONTACT: 

Alberta Dwivedi, (410) 786–0378. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. E0–26499 of November 20, 

2009 (74 FR 60316) (hereinafter referred 

to as the CY 2010 OPPS/ASC final rule), 

there were several technical and 

typographic errors. Some of these errors 

were corrected in the correction 

document of December 31, 2009 (74 FR 

69502) (hereinafter referred to as the 

December 31, 2009 CY 2010 OPPS/ASC 

correction document). We identified 

additional errors to the practice expense 

(PE) relative value units (RVUs) and the 

conversion factor (CF) for the Medicare 

Physician Fee Schedule (MPFS) in the 

November 25, 2009 Medicare Program; 

Payment Policies Under the Physician 

Fee Schedule and Other Revisions to 

Part B for CY 2010 final rule with 

comment period (74 FR 61738) 

(hereinafter referred to as the CY 2010 

MPFS final rule), which were corrected 

in the May 11, 2010 CY 2010 MPFS 

correction document (75 FR 26350). The 

revised ASC payment system uses the 

PE RVUs and the CF for the MPFS as 

part of the office-based and ancillary 

radiology payment methodology. This 

notice updates the CY 2010 OPPS/ASC 

final rule to include these additional 

corrections. 

The provisions in this correction 

document are effective as if they had 

been included in the CY 2010 OPPS/ 

ASC final rule appearing in the 

November 20, 2009 Federal Register (74 

FR 60316). Accordingly, the corrections 

are effective January 1, 2010. 

II. Summary of Errors 

A. Errors in the December 31, 2009 

Correction 

In the December 31, 2009 CY 2010 

OPPS/ASC correction document, we 

republished Addendum AA on pages 

69505 through 69629 and Addendum 

BB on pages 69630 through 69675 to 

take into account updated CY 2010 

MPFS information. As required under 

§ 416.171(d), the revised ASC payment 

system limits payment for office-based 

procedures and covered ancillary 

radiology services to the lesser of the 

ASC rate or the amount calculated by 

multiplying the nonfacility PE RVUs for 

the service by the CF under the MPFS. 

However, the MPFS CF and PE RVUs 

listed for some CPT codes in Addendum 

B to the CY 2010 MPFS final rule (74 

FR 62017) were incorrect due to certain 

technical errors and, consequently, were 

corrected in a December 10, 2009 

correction document to the CY 2010 

MPFS final rule (74 FR 65450). Since 

the ASC payment amounts for officebased procedures and covered ancillary 

radiology services are determined using 

the amounts in the MPFS final rule, we 

corrected the CY 2010 payment amounts 

for ASC procedures and services using 

the corrected MPFS amounts in the 

December 31, 2009 CY 2010 OPPS/ASC 

correction document. 

Additional technical and 

typographical errors were discovered in 

the CY 2010 MPFS final rule, as well as 

the December 10, 2009 CY 2010 MPFS 

correction document. These changes 

were corrected in the May 11, 2010 CY 

2010 MPFS correction document (75 FR 

26350). That correction document: 

• Made corrections to the PE and 

malpractice (MP) RVUs to align their 

values to the final CY 2010 MPFS 

policies for PE and MP RVUs; and 

• Made corrections to the CF 

resulting from corrections to the PE and 

MP RVUs to align their values with the 

final CY 2010 MPFS policies for PE and 

MP RVUs, taking into consideration 

comments received from the public and 

further review following display of the 

CY 2010 MPFS final rule. 

We refer readers to the May 11, 2010 

CY 2010 MPFS correction document (75 

FR 26350) for more information on the 

changes made to the MPFS. 

In summary, addenda AA and BB in 

the December 31, 2009 CY 2010 OPPS/ 

ASC correction document contained 

errors in the rates for surgical 

procedures designated as office-based 

and for covered ancillary radiology 

procedures which are corrected in this 

notice. 

B. Correction of Errors in the December 

31, 2010 Correction 

The changes to the MPFS impacted 

multiple codes within Addenda AA and 

BB. Therefore, we are republishing 

Addenda AA and BB, which were 

republished on pages 69505 through 

69629 and 69630 through 69675 of the 

December 31, 2009 CY 2010 OPPS/ASC 

correction document to take into 

account the updated CY 2010 MPFS 

information. The ASC payment amounts 

for office-based procedures and covered 

ancillary radiology services are 

determined using the MPFS final 

calendar year CF and PE RVUs. We 

must correct the CY 2010 payment 

amounts for covered office-based 

procedures and covered ancillary 

radiology services using the final CY 

2010 corrected MPFS values. The 

revised rates continue to reflect the 

negative update to the MPFS for CY 

2010 based on current law at the time 

of publication of the CY 2010 MPFS 

final rule and the corrections to the 

RVUs and CFs. The corrected payment 

amounts are reflected in Addenda AA 

and BB to this correction document and 

also are posted on the CMS Web site at: 

http://www.cms.gov/ASCPayment. 

We note that the Department of 

Defense Appropriations Act, 2010 (Pub. 

L. 111–118), the Temporary Extension 

Act of 2010 (Pub. L. 111–144), and the 

Continuing Extension Act of 2010 (Pub. 

L. 111–157) extended a zero percent 

update for the MPFS from January 1, 

2010 through May 31, 2010. We are 

publishing a notice around the same 

time as this correction document 

announcing certain provision of the 

Patient Protection and Affordable Care 

Act (Affordable Care Act), as amended 

by the Health Care and Education 

Reconciliation Act of 2010 (HCERA), for 

CY 2010. Because the changes required 

by the Affordable Care Act and HCERA 

are effective January 1, 2010, and 

because the public laws listed above 


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authorize a zero percent update for the 

MPFS for CY 2010 through May 31, 

2010, the notice incorporates a zero 

percent update for MPFS payment. If 

Congress chooses not to extend the zero 

percent MPFS update beyond May 31, 

2010 or chooses to revise the MPFS 

update to be something other than zero, 

we will recalculate the payment rates 

presented in that notice based on the CY 

2010 MPFS payment rates calculated 

using the revised update factor. 

The payment rates presented in this 

correction document technical 

corrections made to the CY 2010 OPPS/ 

ASC final rule and will not be used for 

payment. The payment rates presented 

in the notice being published around 

the same time as this correction 

document are the final ASC payment 

rates from January 1, 2010, through May 

31, 2010. We recalculated the ASC 

payment rates, including budget 

neutrality calculations, in that notice to 

reflect changes created by the 

Affordable Care Act and HCERA, and 

the technical corrections addressed in 

this correction document. 

IV. Waiver of Proposed Rulemaking 

and Delay in Effective Date 

We ordinarily publish a notice of 

proposed rulemaking in the Federal 

Register to provide a period for public 

comment before the provisions of a 

notice such as this take effect, in 

accordance with the Administrative 

Procedure Act (APA) (5 U.S.C. 553(b)). 

We also ordinarily provide a 30-day 

delay in the effective date of the 

provisions of a notice in accordance 

with the APA (5 U.S.C. 553(d)). 

However, we can waive both the notice 

and comment procedures and the 30- 

day delay in the effective date if the 

Secretary finds, for good cause, that it is 

impracticable, unnecessary or contrary 

to the public interest to follow the 

notice and comment procedures or to 

comply with the 30-day delay in the 

effective date, and incorporates a 

statement of the finding and the reasons 

therefor in the notice. This correction 

document merely provides technical 

corrections to the CY 2010 OPPS/ASC 

final rule, as corrected by the December 

31, 2009 CY 2010 OPPS/ASC correction 

document, that was effective on January 

1, 2010. The provisions of the CY 2010 

OPPS/ASC final rule were promulgated 

through notice and comment 

rulemaking, and the corrections 

contained in this document do not make 

substantive changes to the policies or 

payment methodologies that were 

finalized in the CY 2010 OPPS/ASC 

final rule. In addition, we believe it is 

in the public interest to have the correct 

information and to have it as soon as 

possible and not delay its 

dissemination. For the reasons stated 

above, we find that both notice and 

comment procedures and the 30-day 

delay in effective date for this correction 

document are unnecessary and contrary 

to the public interest. Therefore, we find 

there is good cause to waive notice and 

comment procedures and the 30-day 

delay in effective date for this correction 

document. 

(Catalog of Federal Domestic Assistance 

Program No. 93.774, Medicare— 

Supplementary Medical Insurance Program) 

Dated: June 24, 2010. 

Dawn L. Smalls, 

Executive Secretary to the Department. 

Therefore, CMS is republishing 

Addenda AA and BB, which were 

republished on pages 69505 through 

69629 and 69630 through 69675 of the 

December 31, 2009, CY 2010 OPPS/ASC 

correction document to take into 

account the updated CY 2010 MPFS 

information. 


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[FR Doc. 2010–16043 Filed 7–2–10; 2:30 pm] 

BILLING CODE 4120–01–P 


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