[Federal Register: May 28, 2004 (Volume 69, Number 104)]
[Notices]
[Page 30658-30659]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr28my04-59]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-1266-N]
Medicare Program; Public Meeting in Calendar Year 2004 for New
Clinical Laboratory Tests Payment Determinations
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice of meeting.
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SUMMARY: This notice announces a public meeting to discuss payment
determinations for specific new Physicians' Current Procedural
Terminology (CPT) codes for clinical laboratory tests. The meeting
provides a forum for interested individuals to make oral presentations
and submit written comments on the new codes that will be included in
Medicare's Clinical Laboratory Fee Schedule for calendar year 2005 that
will be effective on January 1, 2005. Discussion is directed toward
technical issues relating to payment determinations for a specified
list of new clinical laboratory codes. The development of the codes for
clinical laboratory tests is largely performed by the CPT Editorial
Panel and will not be discussed at the CMS meeting.
DATES: The public meeting is scheduled for Monday, July 26, 2004 from
10 a.m. to 4 p.m., e.s.t.
ADDRESSES: The meeting will be held at the Centers for Medicare &
Medicaid Services (CMS) Auditorium located at 7500 Security Boulevard,
Baltimore, Maryland 21244.
Registration: Registration Procedures: Beginning June 28, 2004
registration may be completed on-line at http://www.cms.hhs.gov/paymentsystems.
The following information must be submitted when
registering: name, company name, address, telephone number, and e-mail
address. When registering, individuals who want to make a presentation
must also specify for which new clinical laboratory test code(s) they
will be presenting. A confirmation will be sent upon receipt of the
registration. Registration Deadline: Individuals must register by July
22, 2004. If on-line registration is not used, individuals may register
by phone at (410) 786-4601 or fax to the attention of Anita Greenberg
at (410) 786-0169.
FOR FURTHER INFORMATION CONTACT: Anita Greenberg (410) 786-4601.
SUPPLEMENTARY INFORMATION:
I. Background
Section 531(b) of the Medicare, Medicaid, and SCHIP Benefits
Improvement and Protection Act of 2000 (BIPA), Pub. L. 106-554,
mandated procedures that permit public consultation for payment
determinations for new clinical laboratory tests under Part B of title
XVIII of the Social Security Act (the Act) in a manner consistent with
the procedures established for implementing coding modifications for
International Classification of Diseases. The procedures and public
meeting announced in this notice for new clinical laboratory tests are
in accordance with the procedures published to implement section 531(b)
of BIPA in the Federal Register at 66 FR 58743 on November 23, 2001.
Also, section 942(b) of the Medicare Prescription Drug, Improvement,
and Modernization Act of 2003, Pub. L. 108-173, amended section
1833(h)(8)(B)(iii) of the Act to require that we convene a public
meeting to receive comments and recommendations (and data on which
recommendations are based) for establishing payment amounts for new
clinical laboratory tests. The public meeting is intended to provide
expert input on the nature of new clinical laboratory tests and receive
recommendations to either crosswalk or gap-fill for payment. Decisions
regarding payment for the newly created Physicians' Current Procedural
Terminology (CPT) codes will not be made at this meeting. A summary of
the new codes and the payment recommendations that are presented during
the public meeting will be posted on our Web site by September 10, 2004
and can be accessed at http://www.cms.hhs.gov/paymentsystems. The
summary will also display our tentative payment determinations, and
interested parties may submit written comments on the tentative payment
determinations by September 24, 2004 to the address specified in the
summary.
II. Presentations
This meeting is open to the public. The on-site check-in for
visitors will be held from 9:30 a.m. to 10 a.m., followed by opening
remarks. Registered presenters may discuss and recommend payment
determinations for specific new CPT codes for the 2004 Clinical
Laboratory Fee Schedule. A newly created CPT code can either represent
a refinement or modification of existing test methods or a
substantially new test method. The newly created CPT codes for the
calendar year 2004 will be listed at the following Web site http://www.cms.hhs.gov/paymentsystems
on or after June 28, 2004.
Oral presentations must be brief, and must be accompanied by three
written
[[Page 30659]]
copies. Presenters may also make copies available for approximately 50
meeting participants. Presenters must address the new test code(s) and
descriptor, the test purpose and method, costs, charges, and a
recommendation with rationale for one of two methods (crosswalking or
gap-fill) for determining payment for new clinical laboratory codes.
The first method, called crosswalking, a new test is determined to be
similar to an existing test, multiple existing test codes, or a portion
of an existing test code. The new test code is then assigned the
related existing local fee schedule amounts and resulting national
limitation amount. The second method, called gap-filling, is used when
no comparable, existing test is available. When using this method,
instructions are provided to each Medicare carrier to determine a
payment amount for its geographic area(s) for use in the first year,
and the carrier-specific amounts are used to establish a national
limitation amount for following years. For each new clinical laboratory
test code, a determination must be made to either crosswalk or to gap-
fill, and, if crosswalking is appropriate, to know what tests to which
to crosswalk.
III. General Information
The meeting will be held in a Federal government building;
therefore, Federal security measures are applicable. In order to gain
access to the building and grounds, participants must bring a
government-issued photo identification and a copy of their registration
confirmation. Security measures include inspection of vehicles, at
entrance to the grounds, and the requirement for persons to pass
through a metal detector when entering the building. All items brought
to CMS, whether personal or for the purpose of demonstration or to
support a presentation, are subject to inspection.
Special Accommodation: Persons attending the meeting who are
hearing or visually impaired and have special requirements, or who have
a condition that requires special assistance, must provide this
information upon registering for the meeting.
Authority: Section 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 42 U.S.C. 1395hh)
(Catalog of Federal Domestic Assistance Program No. 93.774,
Medicare--Supplementary Medical Insurance Program)
Dated: May 10, 2004.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 04-11240 Filed 5-27-04; 8:45 am]
BILLING CODE 4120-01-P