[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR416.200]



[Page 820]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 416_AMBULATORY SURGICAL SERVICES--Table of Contents

 

 Subpart F_Adjustment in Payment Amounts for New Technology Intraocular 

             Lenses Furnished by Ambulatory Surgical Centers

 

Sec. 416.200  Application of the payment adjustment.



    (a) CMS recognizes the IOL(s) that define a new technology subset 

for purposes of this subpart as belonging to the class of new technology 

IOLs for a period of 5 years effective from the date that CMS recognizes 

the first new technology IOL for a payment adjustment.

    (b) Any IOL that CMS subsequently recognizes as belonging to a new 

technology subset receives the new technology payment adjustment for the 

remainder of the 5-year period established with CMS's recognition of the 

first IOL in the subset.

    (c) Beginning 5 years after the effective date of CMS's initial 

recognition of a new technology subset, payment adjustments cease for 

all IOLs that CMS designates as belonging to that subset and payment 

reverts to the standard payment rate set under section 

1833(i)(2)(A)(iii) of the Act for IOL insertion procedures performed in 

ASCs.

    (d) ASCs that furnish an IOL designated by CMS as belonging to the 

class of new technology IOLs must submit claims using specific billing 

codes to receive the new technology IOL payment adjustment.