MMA - Third Update to the 2004 Medicare Physician Fee Schedule Database Full Replacement of CR 3415: CR 3415 Is Rescinded

Provider Types Affected
Physicians, providers, and suppliers

Provider Action Needed
Physicians, providers, and suppliers should note the changes to the Medicare Physician Fee Schedule Database and identify those changes that affect their practice.

Background
Payment files were issued to carriers based upon the November 7, 2003 and January 7, 2004 Final Rules. This instruction amends those payment files and replaces CR 3415.

CR 3415 included changes to the Professional Component/Technical Component (PC/TC) indicator for Current Procedural Terminology (CPT) codes 96400, 96408, 96425, 96520, and 96530 from a 5 to 0.

Implementation
The implementation date for this instruction is October 4, 2004.

Additional Information
The actual changes to the fee schedule involve numerous CPT/HCPCS codes, and the actual effective dates vary. These changes to the revised 3rd Update to the 2004 Medicare Physician Fee Schedule Database are described in the following table.

Changes to Revised 3rd Update to the 2004 Medicare Physician Fee Schedule Database

For complete details, please see the official instruction issued to your carrier and intermediary regarding this change. That instruction may be viewed by going to: http://www.cms.hhs.gov/Transmittals/ .

From that Web page, look for CR3505 in the CR NUM column on the right, and click on the file for that CR.

If you have any questions, please contact your carrier or intermediary at their toll-free number, which may be found at: http://www.cms.hhs.gov/MedlearnProducts/downloads/CallCenterTollNumDirectory.pdf .

Disclaimer
Medlearn Matters articles are prepared as a service to the public and are not intended to grant rights or impose obligations. Medlearn Matters articles 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.

For more information, visit the Medlearn Matters Web page at: http://www.cms.hhs.gov/MedlearnMattersArticles/ .

Pub. 100-4, Transmittal #: 306, CR # 3505
Medlearn Matters Number: MM3505

Effective Date: January 1, 2004
Implementation Date: October 4, 2004

Additional Information Provided by Empire Medicare Services

Third Update to the 2004 MPFSDB - Fee Changes

The following fees for new codes will be implemented on October 4, 2004 effective for dates of service on or after October 1, 2004, unless otherwise noted.

* These fees are effective for dates of service on or after September 15, 2004.

 Posted: 10/12/2004

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