National Government Services, Inc. Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter

MMR-2007 11AB, November 2007

2008 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payment

Provider Types Affected
Physicians and providers submitting claims to Medicare Administrative Contractors (A/B MAC), carriers, and fiscal intermediaries (FI) for services provided in HPSAs  

Impact on Providers
This article is based on Change Request (CR)

5698, which alerts affected physicians, carriers, A/B MACs and FIs that the new HPSA bonus payment information for 2008 will be available soon. This article is informational only for physicians that the 2008 automated bonus payments applies to claims with dates of service on or after January 1, 2008 through December 31, 2008.  

Background
The Medicare Prescription Drug Improvement and Modernization Act of 2003 (Section 413(b)) mandated an annual update to the automated HPSA bonus payment files, and the Centers for Medicare & Medicaid Services (CMS) creates these new automated HPSA bonus payment files annually. The 2008 HPSA bonus payment file will be used for the automated bonus payment for claims with dates of service on or after January 1, 2008, through December 31, 2008. Physicians and providers should review the CMS Web site to determine whether a HPSA bonus will automatically be paid for services provided in their ZIP code area or whether a modifier must be submitted.

In addition, physicians will find annual HPSA bonus payment files, as they become available, and other important HPSA information at http://www.cms.hhs.gov/hpsapsaphysicianbonuses/ on the CMS Web site.  

Additional Information
The official instruction (CR5698) issued to your Medicare A/B MAC, carrier, or FI is available at http://www.cms.hhs.gov/Transmittals/downloads/R1320CP.pdf on the CMS Web site.

For the CMS information about HPSA/PSA (Physician Bonuses), you may visit: http://www.cms.hhs.gov/HPSAPSAPhysicianBonuses/ on the CMS Web site.

If you have questions, please contact your Medicare A/B MAC, carrier, or FI at their toll-free number which may be found at: http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site.

Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.