On October 27, 2005, CMS posted on their web site the 2006 Healthcare Common Procedure Coding file. This file contains significant changes for Radiopharmaceuticals; specifically it contains 34 New, 24 revised and 44 deleted Radiopharmaceutical HCPCS codes effective January 1, 2006. More details and this file are located on the CMS web site under the Alpha-Numeric HCPCS page.

2006 HOPPS Final Rule On November 2, 2005, CMS posted on their web site, Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates. This final rule with comment period responds to the comments for the proposed rule published July 25, 2005 and the public comments on the November 15, 2004 final rule pertaining to the ambulatory payment classification group assignments identified in Addendum B identified with the new interim (NI) comment indicator. Changes are effective January 1, 2006. Comments to the payment classification assigned to HCPCS codes identified in Addendum B with the NI comment code and other areas specified through the preamble are due January 9, 2006. Comments may be sent electronically to CMS E-Comments.

This 2006 final rule and details are located on the CMS web site under the Hospital Outpatient Prospective Payment System page.

MHCCC Decembers Tip will address radiopharmaceutical payment and what status indicator "H" means for Hospital administrators.

Physician Fee Schedule for Calendar Year 2006 Additionally, on November 2, 2005 CMS posted on their web site, Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006 and Certain Provisions Related to the Competitive Acquisition Program of Outpatient Drugs and Biologicals Under Part B. This rule addresses Medicare Part B payment policy, including the physician fee schedule that are applicable for calendar year (CY) 2006; and finalizes certain provisions of the interim final rule to implement the Competitive Acquisition Program (CAP) for Part B Drugs. It also revised Medicare Part B payment and related polices regarding: physician work; practice expense (PE) and malpractice relative value units (RVUs); multiple diagnostic imaging procedures (CMS implemented a 25% reduction in place of the proposed 50% reduction); covered outpatient drugs and biologicals; and physician referrals for nuclear medicine services and supplies to health care entities with which they have financial relationships, as well as, other items. Changes are effective January 1, 2006 unless otherwise noted in the rule. Comments may be sent electronically to CMS E-Comments. This 2006 final rule and details are located on the CMS web site under the Physician Fee Schedule page.