[Federal Register: September 23, 2005 (Volume 70, Number 184)]
[Notices]
[Page 55863-55885]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr23se05-56]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-9032-N]
Medicare and Medicaid Programs; Quarterly Listing of Program
Issuances--April Through June 2005
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice lists CMS manual instructions, substantive and
interpretive regulations, and other Federal Register notices that were
published from April 2005 through June 2005, relating to the Medicare
and Medicaid programs. This notice provides information on national
coverage determinations (NCDs) affecting specific medical and health
care services under Medicare. Additionally, this notice identifies
certain devices with investigational device exemption (IDE) numbers
approved by the Food and Drug Administration (FDA) that potentially may
be covered under Medicare. This notice also includes listings of all
approval numbers from the Office of Management and Budget for
collections of information in CMS regulations. Finally, this notice
includes a list of Medicare-approved carotid stent facilities.
Section 1871(c) of the Social Security Act requires that we publish
a list of Medicare issuances in the Federal Register at least every 3
months. Although we are not mandated to do so by statute, for the sake
of completeness of the listing, and to foster more open and transparent
collaboration efforts, we are also including all Medicaid issuances and
Medicare and Medicaid substantive and interpretive regulations
(proposed and final) published during this 3-month time frame.
FOR FURTHER INFORMATION CONTACT: It is possible that an interested
party may have a specific information need and not be able to determine
from the listed information whether the issuance or regulation would
fulfill that need. Consequently, we are providing information contact
persons to answer general questions concerning these items. Copies are
not available through the contact persons. (See Section III of this
notice for how to obtain listed material.)
Questions concerning items in Addendum III may be addressed to
Timothy Jennings, Office of Strategic Operations and Regulatory
Affairs, Centers for Medicare & Medicaid Services, C4-26-05, 7500
Security Boulevard, Baltimore, MD 21244-1850, or you can call (410)
786-2134.
Questions concerning Medicare NCDs in Addendum V may be addressed
to Patricia Brocato-Simons, Office of Clinical Standards and Quality,
Centers for Medicare & Medicaid Services, C1-09-06, 7500 Security
Boulevard, Baltimore, MD 21244-1850, or you can call (410) 786-0261.
Questions concerning FDA-approved Category B IDE numbers listed in
Addendum VI may be addressed to John Manlove, Office of Clinical
Standards and Quality, Centers for Medicare & Medicaid Services, S3-26-
10, 7500 Security Boulevard, Baltimore, MD 21244-1850, or you can call
(410) 786-6877.
Questions concerning approval numbers for collections of
information in Addendum VII may be addressed to Jim Wickliffe, Office
of Strategic Operations and Regulatory Affairs,
[[Page 55864]]
Regulations Development and Issuances Group, Centers for Medicare &
Medicaid Services, C5-14-03, 7500 Security Boulevard, Baltimore, MD
21244-1850, or you can call (410) 786-4596.
Questions concerning Medicare-approved carotid stent facilities may
be addressed to Sarah J. McClain, Office of Clinical Standards and
Quality, Centers for Medicare & Medicaid Services, C1-09-06, 7500
Security Boulevard, Baltimore, MD 21244-1850, or you can call (410)
786-2994.
Questions concerning all other information may be addressed to
Gwendolyn Johnson, Office of Strategic Operations and Regulatory
Affairs, Regulations Development Group, Centers for Medicare & Medicaid
Services, C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850,
or you can call (410) 786-6954.
SUPPLEMENTARY INFORMATION:
I. Program Issuances
The Centers for Medicare & Medicaid Services (CMS) is responsible
for administering the Medicare and Medicaid programs. These programs
pay for health care and related services for 39 million Medicare
beneficiaries and 35 million Medicaid recipients. Administration of the
two programs involves (1) furnishing information to Medicare
beneficiaries and Medicaid recipients, health care providers, and the
public and (2) maintaining effective communications with regional
offices, State governments, State Medicaid agencies, State survey
agencies, various providers of health care, all Medicare contractors
that process claims and pay bills, and others. To implement the various
statutes on which the programs are based, we issue regulations under
the authority granted to the Secretary of the Department of Health and
Human Services under sections 1102, 1871, 1902, and related provisions
of the Social Security Act (the Act). We also issue various manuals,
memoranda, and statements necessary to administer the programs
efficiently.
Section 1871(c)(1) of the Act requires that we publish a list of
all Medicare manual instructions, interpretive rules, statements of
policy, and guidelines of general applicability not issued as
regulations at least every 3 months in the Federal Register. We
published our first notice June 9, 1988 (53 FR 21730). Although we are
not mandated to do so by statute, for the sake of completeness of the
listing of operational and policy statements, and to foster more open
and transparent collaboration, we are continuing our practice of
including Medicare substantive and interpretive regulations (proposed
and final) published during the respective 3-month time frame.
II. How To Use the Addenda
This notice is organized so that a reader may review the subjects
of manual issuances, memoranda, substantive and interpretive
regulations, NCDs, and FDA-approved IDEs published during the subject
quarter to determine whether any are of particular interest. We expect
this notice to be used in concert with previously published notices.
Those unfamiliar with a description of our Medicare manuals may wish to
review Table I of our first three notices (53 FR 21730, 53 FR 36891,
and 53 FR 50577) published in 1988, and the notice published March 31,
1993 (58 FR 16837). Those desiring information on the Medicare NCD
Manual (NCDM, formerly the Medicare Coverage Issues Manual (CIM)) may
wish to review the August 21, 1989, publication (54 FR 34555). Those
interested in the revised process used in making NCDs under the
Medicare program may review the September 26, 2003, publication (68 FR
55634).
To aid the reader, we have organized and divided this current
listing into eight addenda:
Addendum I lists the publication dates of the most recent
quarterly listings of program issuances.
Addendum II identifies previous Federal Register documents
that contain a description of all previously published CMS Medicare and
Medicaid manuals and memoranda.
Addendum III lists a unique CMS transmittal number for
each instruction in our manuals or Program Memoranda and its subject
matter. A transmittal may consist of a single or multiple
instruction(s). Often, it is necessary to use information in a
transmittal in conjunction with information currently in the manuals.
Addendum IV lists all substantive and interpretive
Medicare and Medicaid regulations and general notices published in the
Federal Register during the quarter covered by this notice. For each
item, we list the--
[cir] Date published;
[cir] Federal Register citation;
[cir] Parts of the Code of Federal Regulations (CFR) that have
changed (if applicable);
[cir] Agency file code number; and
[cir] Title of the regulation.
Addendum V includes completed NCDs, or reconsiderations of
completed NCDs, from the quarter covered by this notice. Completed
decisions are identified by the section of the NCDM in which the
decision appears, the title, the date the publication was issued, and
the effective date of the decision.
Addendum VI includes listings of the FDA-approved IDE
categorizations, using the IDE numbers the FDA assigns. The listings
are organized according to the categories to which the device numbers
are assigned (that is, Category A or Category B), and identified by the
IDE number.
Addendum VII includes listings of all approval numbers
from the Office of Management and Budget (OMB) for collections of
information in CMS regulations in title 42; title 45, subchapter C; and
title 20 of the CFR.
Addendum VIII includes listings of Medicare-approved
carotid stent facilities. All facilities listed meet CMS's standards
for performing carotid artery stenting for high risk patients.
III. How To Obtain Listed Material
A. Manuals
Those wishing to subscribe to program manuals should contact either
the Government Printing Office (GPO) or the National Technical
Information Service (NTIS) at the following addresses: Superintendent
of Documents, Government Printing Office, ATTN: New Orders, P.O. Box
371954, Pittsburgh, PA 15250-7954, Telephone (202) 512-1800, Fax number
(202) 512-2250 (for credit card orders); or National Technical
Information Service, Department of Commerce, 5825 Port Royal Road,
Springfield, VA 22161, Telephone (703) 487-4630.
In addition, individual manual transmittals and Program Memoranda
listed in this notice can be purchased from NTIS. Interested parties
should identify the transmittal(s) they want. GPO or NTIS can give
complete details on how to obtain the publications they sell.
Additionally, most manuals are available at the following Internet
address: http://cms.hhs.gov/manuals/default.asp.
B. Regulations and Notices
Regulations and notices are published in the daily Federal
Register. Interested individuals may purchase individual copies or
subscribe to the Federal Register by contacting the GPO at the address
given above. When ordering individual copies, it is necessary to cite
either the date of publication or the volume number and page number.
The Federal Register is also available on 24x microfiche and as an
online database through GPO Access. The online database is updated by 6
a.m. each day the Federal Register is published. The database includes
both text and graphics from Volume 59,
[[Page 55865]]
Number 1 (January 2, 1994) forward. Free public access is available on
a Wide Area Information Server (WAIS) through the Internet and via
asynchronous dial-in. Internet users can access the database by using
the World Wide Web; the Superintendent of Documents home page address
is http://www.gpoaccess.gov/fr/index.html, by using local WAIS client
software, or by telnet to swais.gpoaccess.gov, then log in as guest (no
password required). Dial-in users should use communications software
and modem to call (202) 512-1661; type swais, then log in as guest (no
password required).
C. Rulings
We publish rulings on an infrequent basis. Interested individuals
can obtain copies from the nearest CMS Regional Office or review them
at the nearest regional depository library. We have, on occasion,
published rulings in the Federal Register. Rulings, beginning with
those released in 1995, are available online, through the CMS Home
Page. The Internet address is http://cms.hhs.gov/rulings.
D. CMS' Compact Disk-Read Only Memory (CD-ROM)
Our laws, regulations, and manuals are also available on CD-ROM and
may be purchased from GPO or NTIS on a subscription or single copy
basis. The Superintendent of Documents list ID is HCLRM, and the stock
number is 717-139-00000-3. The following material is on the CD-ROM
disk:
Titles XI, XVIII, and XIX of the Act.
CMS-related regulations.
CMS manuals and monthly revisions.
CMS program memoranda.
The titles of the Compilation of the Social Security Laws are
current as of January 1, 1999. (Updated titles of the Social Security
Laws are available on the Internet at http://www.ssa.gov/OP_Home/ssact/comp-toc.htm.
) The remaining portions of CD-ROM are updated on a
monthly basis.
Because of complaints about the unreadability of the Appendices
(Interpretive Guidelines) in the State Operations Manual (SOM), as of
March 1995, we deleted these appendices from CD-ROM. We intend to re-
visit this issue in the near future and, with the aid of newer
technology, we may again be able to include the appendices on CD-ROM.
Any cost report forms incorporated in the manuals are included on
the CD-ROM disk as LOTUS files. LOTUS software is needed to view the
reports once the files have been copied to a personal computer disk.
IV. How To Review Listed Material
Transmittals or Program Memoranda can be reviewed at a local
Federal Depository Library (FDL). Under the FDL program, government
publications are sent to approximately 1,400 designated libraries
throughout the United States. Some FDLs may have arrangements to
transfer material to a local library not designated as an FDL. Contact
any library to locate the nearest FDL.
In addition, individuals may contact regional depository libraries
that receive and retain at least one copy of most Federal Government
publications, either in printed or microfilm form, for use by the
general public. These libraries provide reference services and
interlibrary loans; however, they are not sales outlets. Individuals
may obtain information about the location of the nearest regional
depository library from any library. For each CMS publication listed in
Addendum III, CMS publication and transmittal numbers are shown. To
help FDLs locate the materials, use the CMS publication and transmittal
numbers. For example, to find the Medicare NCD publication titled
``Percutaneous Transluminal Angioplasty,'' use CMS-Pub. 100-03,
Transmittal No. 33.
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance, Program No. 93.774, Medicare--
Supplementary Medical Insurance Program, and Program No. 93.714,
Medical Assistance Program)
Dated: September 6, 2005.
Jacquelyn Y. White,
Director, Office of Strategic Operations and Regulatory Affairs.
Addendum I
This addendum lists the publication dates of the most recent
quarterly listings of program issuances.
March 28, 2003 (68 FR 15196)
June 27, 2003 (68 FR 38359)
September 26, 2003 (68 FR 55618)
December 24, 2003 (68 FR 74590)
March 26, 2004 (69 FR 15837)
June 25, 2004 (69 FR 35634)
September 24, 2004 (69 FR 57312)
December 30, 2004 (69 FR 78428)
February 25, 2005 (70 FR 9338)
June 24, 2005 (70 FR 36620)
Addendum II--Description of Manuals, Memoranda, and CMS Rulings
An extensive descriptive listing of Medicare manuals and memoranda
was published on June 9, 1988, at 53 FR 21730 and supplemented on
September 22, 1988, at 53 FR 36891 and December 16, 1988, at 53 FR
50577. Also, a complete description of the former CIM (now the NCDM)
was published on August 21, 1989, at 54 FR 34555. A brief description
of the various Medicaid manuals and memoranda that we maintain was
published on October 16, 1992, at 57 FR 47468.
Addendum III.--Medicare and Medicaid Manual Instructions
[April Through June 2005]
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Transmittal No. Manual/Subject/Publication No.
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Medicare General Information
(CMS--Pub. 100-01)
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20.................... Medicare Authorization to Disclose Personal
Health Information Form and Information to Help
You Fill Out the Medicare Authorization to
Disclose Personal Health Information Form.
21.................... Removal of Medicare Number from Reimbursement
Checks.
22.................... Provider Extract File.
23.................... Procedures for Modifying Shared Systems Edits
and Capturing Audit Trail Data.
24.................... 2005 Scheduled Release for July Updates to
Software Programs and Pricing/Coding Files.
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[[Page 55866]]
Medicare Benefit Policy
(CMS--Pub. 100-02)
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31.................... List of Medicare Telehealth Services
Telehealth Services.
Payment for End-Stage Renal Disease-Related
Services as a Telehealth Service Originating
Site Facility Fee Payment (End-Stage Renal
Disease-Related Services).
32.................... This Transmittal is rescinded and replaced by
Transmittal 33.
33.................... Issued to a specific audience, not posted to the
Internet/Intranet due to the Confidentiality of
Instruction.
34.................... This Transmittal is rescinded and replaced by
Transmittal 36.
35.................... Automated Multi-Channel Chemistry for Continuous
Ambulatory Peritoneal Dialysis and Non-
Continuous Ambulatory Peritoneal Dialysis
Patients.
36.................... Pub. 100-02, Chapter 15, Section 220 and 230
Therapy Services.
Coverage of Outpatient Rehabilitation Therapy
Services (Physical Therapy, and Speech-Language
Pathology Services) Under Medical Insurance.
Conditions of Coverage and Payment for
Outpatient Physical Therapy, Occupational
Therapy or Speech-Language Pathology Services.
Outpatient Therapy Must be Under the Care of a
Physician/Non physician Practitioners (Orders/
Referrals and Need for Care).
Plans of Care for Outpatient Physical Therapy,
Occupational Therapy, or Speech-Language
Pathology Services.
Certification and Recertification of Need for
Treatment and Therapy Plans of Care.
Requirement that Services Be Furnished on an
Outpatient Basis.
Reasonable and Necessary Outpatient
Rehabilitation Therapy Services.
Practice of Physical Therapy, Occupational
Therapy, and Speech-Language Pathology.
Practice of Physical Therapy.
Practice of Occupational Therapy.
Practice of Speech-Language Pathology.
Services Furnished by a Physical or Occupational
Therapist in Private Practice.
Physical Therapy, Occupational Therapy, and
Speech-Language Pathology.
Services Provided Incident to the Services of
Physicians and Non-physician Practitioners.
Therapy Services Furnished Under Arrangements
with Providers and Clinics.
-----------------------
Medicare National Coverage Determinations
(CMS--Pub. 100-03)
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31.................... Positron Emission Tomography (PET) for Brain,
Cervical, Ovarian, Pancreatic, Small Cell Lung,
and Testicular Cancers.
PET Scans.
PET for Perfusion of the Heart.
FDG PET for Lung Cancer.
FDG PET for Esophageal Cancer.
FDG PET for Colorectal Cancer.
FDG PET for Lymphoma.
FDG PET for Melanoma.
FDG PET for Head and Neck Cancers.
FDG PET for Myocardial Viability.
FDG PET for Refractory Seizures.
FDG PET for Breast Cancer.
FDG PET for Thyroid Cancer.
FDG PET for Soft Tissue Sarcoma.
FDG PET for Dementia and Neurodegenerative
Diseases.
FDG PET for Brain, Cervical, Ovarian,
Pancreatic, Small Cell Lung, and Testicular
Cancers.
FDG PET for All Other Cancer Indications Not
Previously Specified.
32.................... Autologous Stem Cell Transplantation.
Stem Cell Transplantation.
33.................... Percutaneous Transluminal Angioplasty.
34.................... Abarelix for the Treatment of Prostate Cancer.
35.................... Continuous Positive Airway Pressure Therapy for
Obstructive Sleep Apnea.
36.................... Smoking and Tobacco-Use Cessation Counseling.
37.................... Mobility Assistive Equipment.
Durable Medical Equipment Reference List.
38.................... Coverage of Colorectal Anti-Cancer Drugs
Included in Clinical Trials Anti-Cancer
Chemotherapy for Colorectal Cancer.
39.................... Cochlear Implantation.
40.................... Coverage of Aprepitant for Chemotherapy-Induced
Emesis.
41.................... Osteogenic Stimulators.
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Medicare Claims Processing
(CMS Pub. 100--04)
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515................... Update to 100-04 and Therapy Code Lists.
Health Common Procedure Coding System Coding
Requirement.
Part B Outpatient Rehabilitation and
Comprehensive Outpatient Rehabilitation.
[[Page 55867]]
Facility Services--General.
Discipline Specific Outpatient Rehabilitation
Modifiers--All Claims.
The Financial Limitation.
Reporting of Service Units With Health Common
Procedure Coding System--Form CMS-1500 and Form
CMS-1450.
516................... Clarification for Outpatient Prospective Payment
System Hospitals Billing.
Initial Preventive Exam.
Outpatient Prospective Payment System Hospitals
Billing.
Advanced Beneficiary Notice as Applied to the
IPPE.
517................... List of Medicare Telehealth Services.
Submission of Telehealth Claims for Distant Site
Practitioners.
Carrier Editing of Telehealth Claims.
518................... This Transmittal is rescinded and replaced by
Transmittal 527.
519................... This Transmittal is rescinded and replaced by
Transmittal 525.
520................... Payment Policy Clarification Regarding the
Healthcare Common Procedure.
Coding System Q3001 Performed in an Ambulatory
Surgery Center.
521................... Hemophilia Blood Clotting Factors.
Billing for Hemophilia Clotting Factors.
522................... Issued to a specific audience, not posted to
Internet/Intranet due to Confidentiality of
Instruction.
523................... Implementation of the Physician Scarcity Area
and Revision to the Health Professional
Shortage Area Payment to a Critical Access
Hospital.
524................... Clarification to the Health Professional
Shortage Area Language in the Medicare Claims
Processing Manual.
Services Eligible for Health Professional
Shortage Area and Physician Scarcity Bonus
Payments.
525................... Flu/PPV Revisions.
Billing Requirements.
Healthcare Common Procedural Coding System and
Diagnosis Codes.
Carrier Payment Requirements.
Roster Claims Submitted to Carriers for Mass
Immunization.
Centralized Billing for Flu and Pneumococcal
(PPV) Vaccines to Medicare.
Common Working File Edits.
Common Working File Edits on Carrier Claims.
526................... Updated Requirements for Autologous Stem Cell
Transplantation.
Autologous Stem Cell Transplantation.
Billing for Stem Cell Transplantation.
Stem Cell Transplantation.
Health Common Procedure Coding System and
Diagnosis Coding Non-Covered Conditions.
527................... New Coding for FDG PET Scans and Billing
Requirements for Specific.
Indications of Cervical Cancer.
Positron Emission Tomography Scans--General
Information.
Billing Instructions.
Use of Gamma Cameras and Full Ring and Partial
Ring Pet Scanners for Positron Emission
Tomography Scans.
Positron Emission Tomography Scan Qualifying
Conditions and Health.
Common Procedure Coding System/Common Procedural
Terminology Code Chart.
Appropriate Common Procedural Terminology Codes
Effective for Positron.
Emission Tomography Scan Services Performed on
or After January 28, 2005.
Expanded Coverage of Positron Emission
Tomography Scans for Breast Cancer Effective
for Services on or After October 1, 2002.
Coverage of Positron Emission Tomography Scans
for Thyroid Cancer.
Coverage of Positron Emission Tomography Scans
for Dementia and Neurodegenerative Diseases.
Billing Requirements for Positron Emission
Tomography Scans for Specific Indications of
Cervical Cancer for Services Performed on or
After January 28, 2005.
Billing Requirements for Positron Emission
Tomography Scans for Non-Covered Conditions.
528................... July 2005 Quarterly Average Sales Price (ASP)
Medicare Part B Drug Pricing File, Effective
July 1, 2005.
529................... Update to Current National Uniform Billing
Committee Codes.
General Instructions for Completion of Form CMS-
1450 for Billing.
530................... Billing Requirements for Physician Services
Rendered in Method II Critical Access Hospital.
Payment for Inpatient Services Furnished by a
Critical Access Hospital.
Optional Method for Outpatient Services: Cost-
Based Facility Services Plus 115 Percent Fee
Schedule Payment for Professional Services.
Billing and Payment in a Physician Scarcity
Area.
531................... Percutaneous Transluminal Angioplasty (Effective
March 17, 2005).
532................... Abarelix for Treatment of Prostate Cancer.
533................... Modification to the Common Working File (CWF)
Edit Process for Non-Assigned Medicaid
Coordination of Benefits Agreement (COBA)
Crossover Claims.
Consolidated Claims Crossover Process.
534................... Changes to the Laboratory National Coverage
Determination Edit Software for July 2005.
535................... Modification to Appeals Language on Medicare
Summary Notice.
Appeals Section.
Back of the Medicare Summary Notice--Carriers
and Intermediaries.
Carrier Spanish Medicare Summary Notice Back.
Intermediary Spanish MSN Back.
[[Page 55868]]
536................... July Quarterly Update for 2005 Durable Medical
Equipment, Prosthetics, Orthotics & Supplies
Fee Schedule.
537................... Instructions for Downloading the Medicare Zip
Code File.
538................... New Waived Tests.
539................... Expansion of Various Alpha and Numeric Fields
with in the Outpatient Prospective Payment
System Outpatient Code Editor.
540................... Addition to Chapter 6 of the Claims Processing
Manual--Skilled Nursing Facility Inpatient Part
A Billing: SNF Prospective Payment System
Pricer Software.
Skilled Nursing Facility Prospective Payment
System Pricer Software Input/Output Record
Layout.
Skilled Nursing Facility Prospective Payment
System Rate Components Decision Logic Used by
the Pricer on Claims.
Annual Updates to the Skilled Nursing Facility
Pricer.
541................... Correction to the use of Group Codes for The
Enforcement of Mandatory Electronic Submission
of Medicare Claims Enforcement.
542................... Modification of Roster Billing for Mass
Immunizers Billing for Inpatient Part B
Services (Type of Bills 12x and 22x).
Claims Submitted to Intermediaries for Mass
Immunizations of Influenza and PPV.
543................... Healthcare Provider Taxonomy Code Update.
544................... Modification of FISS Edits for Colorectal Cancer
Screening Services (HCPCS Codes G0104, G0106,
G0107, G0120, and G0328) Furnished at Skilled
Nursing Facilities.
Common Working Files Edits.
545................... The Teaching Adjustment for Inpatient
Psychiatric Facility Prospective Payment
System.
546................... Number of Durable Medical Equipment Prosthetic,
Orthotic & Supplies Pricing Files That Must Be
Maintained Online for Medicare--Durable Medical
Equipment Regional Carrier, Fiscal Intermediary
and Regional Home Health Intermediary Only.
Online Pricing Files for Durable Medical
Equipment Prosthetic, Orthotics & Supplies.
547................... This Transmittal is rescinded and replaced by
Transmittal 556.
548................... New Healthcare Common Procedure Coding System
(HCPCS) Codes and Systems Edits for Supplies
and Accessories for Ventricular Assist Devices.
549................... Update to the Place of Service Code Set to Add a
Code for Pharmacy Place of Service Codes and
Definitions.
550................... Issued to a specific audience, not posted to
Internet/Intranet due to Confidentiality of
Instruction.
551................... Dispensing/Supply Fee Code, Payment, and Common
Working File Editing for Immunosuppressive
Drugs.
Pharmacy Supplying Fee.
552................... Changing the Order of Medicare System Edits
Affecting Hospice Claims.
Submitting Bills In Sequence for a Continuous
Inpatient Stay or Course of Treatment.
553................... Expansion of State Codes for Office of Standard
& Certification Automated Retrieval System
Provider Numbers.
554................... Issued to a specific audience, not posted to
Internet/Intranet due to Sensitivity of
Instruction.
555................... Fiscal Intermediary Reporting of Add-on-Payments
That Do Not Result in a Specific Increase or
Decrease in the Amount Reported as Payable for
a Claim Or a Service on a Remittance Advice.
General Remittance Completion Requirements.
556................... Revision to the Health Professional Shortage
Area and Physician Scarcity Area Payment Rules.
Services Eligible for Health Professional
Shortage Area and Physician Scarcity Bonus
Payments.
557................... This Transmittal is rescinded and replaced by
Transmittal 566.
558................... July Update to the 2005 Medicare Physician Fee
Schedule Database.
559................... Override of Automated Health Professional
Shortage Area and/or Physician Scarcity Area
Bonus Payments for Globally Billed Services.
560................... Issued to a specific audience, not posted to
Internet/Intranet due to Confidentiality of
Instruction.
561................... New April 2005 Quarterly ASP Medicare Part B
Drug Pricing File and Revisions to January 2005
Quarterly ASP Medicare Part B Drug Pricing
File.
562................... Smoking and Tobacco-Use Cessation Counseling
Services.
Health Common Procedure Coding System and
Diagnosis Coding.
Carrier Billing Requirements.
Fiscal Intermediary Billing Requirements.
Remittance Advice Notices.
Medicare Summary Notices.
Post-Payment Review for Smoking and Tobacco-Use
Cessation Counseling Services.
563................... Quarterly Update to Correct Coding Initiative
(CCI) Edits, Version 11.2, Effective July 1,
2005.
564................... July Update to the Medicare Outpatient Code
Editor (OCE) Version 20.3 for Bills From
Hospitals That Are Not Paid Under The
Outpatient Prospective Payment System.
565................... This Transmittal is rescinded and replaced by
Transmittal 583.
566................... This Transmittal is rescinded and replaced by
Transmittal 573.
567................... Coverage of Colorectal Anti-Cancer Drugs
Included in Clinical Trials.
568................... July Quarterly Update to 2005 Annual Update of
Health Common Procedure Codes System Codes Used
for Skilled Nursing Facility Consolidated
Billing Enforcement.
569................... This Transmittal is rescinded and replaced by
Transmittal 572.
570................... Common Working File: Addition of Disease
Management Auxiliary File.
571................... This Transmittal is rescinded and replaced by
Transmittal 575.
572................... July 2005 Outpatient Prospective Payment System
Code Editor Specifications Version 6.2.
573................... Clarifying Manual Instructions for Coding and
Payment for Drug Administration Under the
Hospital Outpatient Prospective Payment System.
Billing and Payment for Drugs and Drug
Administration.
Coding and Payment for Drugs and Biologicals.
Separately Payable Drugs.
Packaged Drugs.
Pass-Through Drugs.
Non-Pass Through Drugs.
[[Page 55869]]
Coding and Payment for Drug Administration.
General.
Administration of Chemotherapy Drugs by
Infusion.
Administration of Chemotherapy Drugs by a Route
Other Than Infusion.
Administration of Non-Chemotherapy Drugs by
Infusion.
Administration of Non-Chemotherapy Drugs by a
Route Other Than Infusion.
Use of Modifier 59.
Billing for Infusion Hours.
574................... Mobility Assistive Equipment.
575................... New Remittance Advice Message for Referred
Clinical Diagnostic/Purchased Diagnostic
Service Duplicate Claims.
576................... Correction to Chapter 17, Section 80.2.3, MSN/
ANSI X12N Denial Message for Anti-Emetic Drugs.
577................... This Transmittal is rescinded and replaced by
Transmittal 594.
578................... Update-Long Term Care Hospital Prospective
Payment System Rate Year 2006.
Provider Specific File.
Facility Level Adjustments.
Inputs/Outputs to Pricer.
579................... Update to the National Council for Prescription
Drug Program Batch Standard 1.1 Billing Request
Companion Document.
580................... New Healthcare Common Procedure Coding System
(HCPCS) Drug Codes.
581................... This Transmittal is rescinded and replaced by
Transmittal 587.
582................... New Remittance Advice (RA) Message for Referred
Clinical Diagnostic/Purchased Diagnostic
Service Duplicate Claims.
583................... Access Process for HIPAA 270/271.
X12N Health Care Eligibility Benefit Inquiry and
Response 270/271.
Implementation.
Background.
Eligibility Workflow.
Health Care Claim Status Category Codes and
Health Care Codes for Use with The Health Care
Claim Status Request and Response ASC X12N 276/
277.
584................... Update of Health Common Procedure Coding System
Codes and File Names, Descriptions and
Instructions for Retrieving the 2005 Ambulatory
Surgery Center Health Common Procedure Coding
System Additions, Deletions and Master Listing.
585................... This Transmittal is rescinded and replaced by
Transmittal 599.
586................... Modifications to the National Coordination of
Benefits Agreement File.
Transfer and Financial Reporting Processes.
Consolidation of the Claims Crossover Process.
Coordination of Benefits Agreement Detailed
Error Notification Process.
587................... New Location for Contractor ID Number on
Medicare Summary Notices.
Title Section of the Medicare Summary Notice.
588................... Coverage of Colorectal Anti-Cancer Drugs
Included in Clinical Trials.
589................... Cochlear Implantation.
Billing Requirements for Expanded Coverage of
Cochlear Implantation.
Intermediary Billing Procedures.
Applicable Bill Types.
Special Billing Requirements for Intermediaries.
Intermediary Payment Requirements.
Carrier Billing Procedures.
Healthcare Common Procedural Coding System.
590................... Aprepitant for Chemotherapy-Induced Emesis.
Oral Anti-Emetic Drugs Used as Full Replacement
for Intravenous Anti-Emetic.
Drugs as Part of a Cancer Chemotherapeutic
Regimen.
Health Common Procedure Coding System Codes for
Oral Anti-Emetic Drugs.
Billing and Payment Instructions for Fiscal
Intermediaries.
591................... Medicare Contractor Annual Update of the
International Classification of Diseases, Ninth
Revision, Clinical Modification.
592................... Social Security Administration Data for
Incarcerated Beneficiaries.
593................... Disposition of Misdirected Claims to the
Carrier.
A Local Carrier Receives a Claim for a United
Mine Workers of America Beneficiary.
594................... Preliminary Instructions: Expedited
Determinations/Reviews for Original Medicare.
Coordination With the Quality Improvement
Organization.
Limitation on Liability (LOL) Under Sec. 1879
Where Medicare Claims Are Disallowed.
Hospital-Issued Notices of Noncoverage.
Determining Beneficiary Liability in Claims for
Ancillary and Outpatient Services.
Application of Limitation on Liability to
Skilled Nursing Facility and Hospital Claims
for Services Furnished in Noncertified or
Inappropriately Certified Beds.
Determining Liability for Services Furnished in
a Noncertified Skilled Nursing Facility or
Hospital Bed.
595................... This Transmittal is rescinded and replaced by
Transmittal 598.
596................... Indian Health Service or Tribal Hospitals
Including Critical Access Hospital Payment
Methodology for Inpatient Social Admissions and
Outpatient Services Occurring During Concurrent
Stays.
597................... Coverage and Billing for Ultrasound Stimulation
for Nonunion Fracture Healing Coverage
Requirements.
Intermediary Billing Requirements.
Bill Types.
Carrier and Intermediary Billing Instructions.
Durable Medical Equipment Regional Carrier
Billing Instructions.
[[Page 55870]]
598................... Implementation of Carrier Guidelines for End
Stage Renal Disease.
Reimbursement for Automated Multi-Channel
Chemistry Tests.
(Supplemental to Change Request 2813).
Automated Multi-Channel Chemistry Tests for End
Stage Renal Disease.
Beneficiaries--Fiscal Intermediaries.
Claims Processing for Separately Billable Tests
for End Stage Renal Disease Beneficiaries.
599................... July 2005 Update of the Hospital Outpatient
Prospective Payment System.
600................... New Healthcare Common Procedure Coding System
Drug Codes.
-----------------------
Medicare Secondary Payer
(CMS--Pub. 100-05)
------------------------------------------------------------------------
28.................... Working Aged Exception for Small Employers in
Multi-Employer Group Health Plans.
29.................... Assignment of Non-Payment/Denial Code Specific
to the Recovery Audit Contractor Created Group
Health Plan Occurrences.
Identification of Recovery Audit Contractor
Created Group Health Plan Records.
30.................... Process to Address Freedom of Information and
Subpoena Requests.
Handling Freedom of Information and Subpoena
Duces Tecum Received In the Medicare Secondary
Payer Units .
-----------------------
Medicare Financial Management
(CMS--Pub. 100-06)
------------------------------------------------------------------------
67.................... Notice of New Interest Rate for Medicare
Overpayments and Underpayments.
68.................... Instructions for Affiliated Contractors Involved
in the Recovery Audit Contractor Demonstration.
Affiliated Contractor and Program Safeguard
Contractor Interaction with the Non-Medicare
Secondary Payer Recovery Audit Contractors.
Non-Medicare Secondary Payer Recovery Audit
Contractors.
Program Safeguard Contractor Communication with
the Recovery Audit Contractors.
Overview of the Recovery Audit Contractor
Process.
Full Program Safeguard Contractor Requirements
Surrounding Recovery.
Audit Contractor Non-Medicare Secondary Payer
Identification Process.
Providing Suppressed Cases to the Recovery Audit
Contractor Database.
Adjusting the Claim.
Disputing/Disagreeing with a Recovery Audit
Contractor Decision.
Handling Overpayment and Underpayments Resulting
from the Recovery.
Audit Contractor Findings.
Underpayments.
Setting up an Accounts Receivable.
Recoupments Received on a Recovery Audit
Contractor Initiated Overpayment.
Extended Repayments Received on a Recovery Audit
Contractor Initiated Overpayment.
Handling Appeals Resulting from Recovery Audit
Contractor Initiated Denials.
Referrals to the Department of Treasury.
Tracking Overpayments and Appeals.
Tracking Overpayments.
Tracking Appeals.
Reporting Administrative Costs Directly
Associated with the Recovery Audit.
Contractor Demonstration Project.
Potential Fraud.
Affiliated Contractor/Full Program Safeguard
Contractor Requirements.
Involving Recovery Audit Contractor Information
Dissemination.
Contacting Non-Responders.
Voluntary Refunds.
Working with the Recovery Audit Contractor
Evaluation Contractor.
69.................... Update to Debt Collection System (DCS) User
Guide .
-----------------------
Medicare State Operations Manual
(CMS--Pub. 100-07)
------------------------------------------------------------------------
06.................... Expansion of State Codes for OSCAR Provider
Numbers.
Provider Identification Number.
Home Health Agency Branch Identification
Numbers.
Outpatient Physical Therapy Extension
Identification Numbers.
07.................... This Transmittal is rescinded and replaced by
Transmittal 8.
08.................... Revision of Appendix PP--Section 483.25(d)--
Urinary Incontinence, Tags F315 and F316.
-----------------------
Medicare Program Integrity
(CMS--Pub. 100-08)
------------------------------------------------------------------------
107................... Updated Chapter 1 to Reflect Changes in Program
Requirements.
Types of Claims for Which Contractors Are
Responsible.
Quality of Care Issues.
[[Page 55871]]
The Medicare Medical Review Program.
Goal of the Medical Review Program.
Medical Review Manager.
Annual Medical Review/Local Provider Education
Training Strategy.
Data Analysis and Information Gathering.
Problem Identification & Prioritization.
Intervention Planning.
Program Management.
Budget and Workload Management.
Staffing and Workforce Management.
Local Provider Education and Training Program.
Local Provider Education Training Activities.
One-on-One Provider Education.
Education Delivered to a Group of Providers.
Education Delivered via Electronic Media.
Description of Methods of Education.
Proactive Local Educational Meetings.
Comprehensive Educational Interventions.
Comparative Billing Report Education.
Frequently Asked Question Regarding Local
Education Issues.
Bulletin Articles/Advisories Regarding Local
Education Issues.
Scripted Response Documents on Local Education
Issues.
Local Provider Education Training Staff.
108................... Change in Statistical Sampling Instructions.
General Purpose.
The Purpose of Statistical Sampling.
Steps for Conducting Statistical Sampling.
Determining When Statistical Sampling May be
Used.
Consultation With a Statistical Expert.
Use of Other Sampling Methodologies.
Probability Sampling.
Selection of Period for Review.
Defining the Universe, the Sampling Unit, and
the Sampling Frame.
Composition of the Universe.
The Sampling Unit.
Stratified Sampling.
Cluster Sampling.
Random Number Selection.
Determining Sample Size.
Documentation of Sampling Methodology.
Documentation of Universe and Frame.
Worksheets.
Informational Copies to GTL, Co-GTL, SME or CMS
RO.
The Point Estimate.
Actions Performed Following Selection of
Provider or Supplier and Sample.
Notification of Provider or Supplier of the
Review and Selection of the Review Site
Written Notification of the Review.
Determining Review Site.
109................... Updated Standard System Changes for Provider
Enrollment Chain Ownership System and Multi-
Carrier System.
110................... Revise CERT Shared Systems Modules to Retrieve
Claims Files Using Only Internal Control Number
as a Key.
111................... Revising the Fiscal Intermediary Standard System
Shared System.
112................... Requirement that Part B/Carriers Submit All
Provider Addresses to the Comprehensive Error
Rate Testing Program Contractor.
113................... Shared System Maintainer Hours for PECOS
Problems and/or Implementation Changes.
114................... Change in Statistical Sampling Instructions.
General Purpose.
The Purpose of Statistical Sampling.
Steps for Conducting Statistical Sampling.
Determining When Statistical Sampling May Be
Used.
Consultation With a Statistical Expert.
Use of Other Sampling Methodologies.
Probability Sampling.
Selection of Period for Review.
Defining the Universe, the Sampling Unit, and
the Sampling Frame.
Composition of the Universe.
The Sampling Unit.
Stratified Sampling.
Cluster Sampling......
Random Number Selection.
Determining Sample Size.
Documentation of Sampling Methodology.
[[Page 55872]]
Documentation of Universe and Frame.
Worksheets.
Informational Copies to GTL, Co-GTL, SME or CMS
RO.
The Point Estimate.
Actions Performed Following Selection of
Provider or Supplier and Sample.
Notification of Provider or Supplier of the
Review and Selection of the Review Site.
Written Notification of the Review.
Determining Review Site.
-----------------------
Medicare Contractor Beneficiary and Provider Communications
(CMS--Pub. 100-09)
------------------------------------------------------------------------
09.................... Additions and Corrections to Provider Inquiry
and Provider Communications Program
Requirements.
10.................... This Transmittal is rescinded and replaced by
Transmittal 11.
11.................... FY 2005 Beneficiary Telephone Customer Services.
Beneficiary Services.
Guidelines for Beneficiary Telephone Services
(Activity Code 13005).
Toll Free Network Services.
Publication of Toll Free Numbers.
Call Handling Requirements.
Customer Service Assessment and Management
System Reporting Requirements.
Customer Service Representative Training.
Quality Call Monitoring.
Disclosure of Information (Adherence to the
Privacy Act and the Health Insurance
Portability and Accountability Act Privacy
Rule).
Second Level Screening of Beneficiary and
Provider Inquiries (Activity Code 13201).
Second Level Screening of Provider Inquiries
(Miscellaneous Code 13201/01).
Medicare Customer Service Next Generation
Desktop.
Publication Requests.
Medicare Participating Physicians and Suppliers
Directory.
Transfer of Part A Telephone/Written Inquiries
Workload.
Guidelines for Handling Beneficiary Written
Inquiries (Activity Code 13002).
Contractor Guidelines for High Quality Written
Responses to Inquiries Surveys.
Guidelines for High Quality Walk-In Services.
Customer Service Plans (Activity Code 13004).
Beneficiary Internet Web Sites.
-----------------------
Medicare Managed Care
(CMS--Pub. 100-16)
------------------------------------------------------------------------
00.................... None.
-----------------------
Medicare Business Partners Systems Security
(CMS--Pub. 100-17)
------------------------------------------------------------------------
00.................... None
-----------------------
Demonstrations
(CMS--Pub. 100-19)
------------------------------------------------------------------------
22.................... Assignment of Non-Payment/Denial Code Specific
to the Recovery Audit Contractor Created Group
Health Plan Occurrences.
23.................... This Transmittal is rescinded and replaced by
25.
24.................... Instructions for Affiliated Contractors Involved
in the Recovery Audit Contractor Demonstration.
25.................... Low Vision Rehabilitation Demonstration.
-----------------------
One Time Notification
(CMS--Pub. 100-20)
------------------------------------------------------------------------
147................... Medicare Health Insurance Portability &
Accountability Act Electronic Claims Report--
Second Reporting Timeframe Extension.
148................... Revised Coding Guidelines for Drug
Administration Codes.
149................... Requirements for Voided, Canceled, and Deleted
Claims.
150................... Shared System Maintainer Hours for Resolution of
Problems Detected During Health Insurance
Portability and Accountability Act Transaction
Release Testing.
151................... Common Working File Calculation of Next Eligible
Date for Preventive Services.
152................... Issued to a specific audience, not posted to
Internet/Intranet due to Confidentiality of
Instruction.
153................... This Transmittal is rescinded and replaced by
Transmittal 155.
154................... Correction 2005 Clinical Laboratory Travel Fee
(P9603 P9604).
155................... Payment to Ambulatory Surgery Centers for New
CPT Code 66711.
156................... New Patient Status Code to Define Discharges or
Transfers to a Critical Access Hospital.
157................... CD-ROM Initiative for Distribution of the Annual
Disclosure, ``Dear Doctor'' Letter and
Participation Enrollment Material.
158................... Instructions for Fiscal Intermediaries to
Process Payment Adjustments Resulting from Data
Assessment and Verification Program Safeguard
Contractor Medical Review.
[[Page 55873]]
159................... Requirements for Voided, Canceled, and Deleted
Claims.
160................... Issued to a specific audience, not posted to
Internet/Intranet due to Confidentiality of
Instruction.
------------------------------------------------------------------------
Addendum IV.--Regulation Documents Published in the Federal Register
[April through June 2005]
----------------------------------------------------------------------------------------------------------------
FR Vol. 70
Publication date Page No. CFR Parts affected File code Title of regulation
----------------------------------------------------------------------------------------------------------------
April 1, 2005............... 16754 421 and 413........ CMS-1213-CN............ Medicare Program;
Prospective Payment
System for Inpatient
Psychiatric
Facilities;
Correction.
April 1, 2005............... 16720 403, 405, 410, 411, CMS-1429-F2............ Medicare Program;
414, 418, 424, Revisions to Payment
484, and 486. Policies Under the
Physician Fee Schedule
for Calendar Year
2005: Correcting
Amendment.
April 7, 2005............... 17697 ................... CMS-5029-N............. Medicare Program; Rural
Hospice Demonstration.
April 8, 2005............... 18028 ................... CMS-1296-N2............ Medicare Program;
Request for
Nominations to the
Advisory Panel on
Ambulatory Payment
Classification Groups;
Extension of
Nominations Deadline.
April 12, 2005.............. 19090 ................... CMS-5033-N6............ Medicare Program;
Cancellation of the
April 13, 2005
Advisory Board Meeting
on the Demonstration
of a Bundled Case-Mix
Adjusted Payment
System for End-Stage
Renal Disease
Services.
April 22, 2005.............. 20916 ................... CMS-4107-N............. Medicare Program;
Request for
Nominations for the
Advisory Panel on
Medicare Education.
April 25, 2005.............. 21146 45 CFR Part 146.... CMS-2151-F............. Final Regulations for
Health Coverage
Portability for Group
Health Plans and Group
Health Insurance
Issuers Under HIPAA
Titles I and IV;
Correction.
April 29, 2005.............. 22394 418................ CMS-1286-P............. Medicare Program;
Proposed Hospice Wage
Index for Fiscal Year
2006.
April 29, 2005.............. 22321 ................... CMS-1314-N............. Medicare Program;
Meeting of the
Practicing Physicians
Advisory Council, May
23, 2005.
April 29, 2005.............. 22320 ................... CMS-5033-N4............ Medicare Program;
Meeting of the
Advisory Board on the
Demonstration of a
Bundled Case-Mix
Adjusted Payment
System for End-Stage
Disease Services--May
24, 2005.
April 29, 2005.............. 22317 ................... CMS-2207-N............. Medicare, Medicaid, and
CLIA Programs;
Clinical Laboratory
Improvement Amendments
of 1988; Continuance
of Exemption of
Laboratories Licensed
by the State of
Washington.
May 4, 2005................. 23690 416................ CMS-1478-IFC........... Medicare Program;
Update of Ambulatory
Surgical Center List
of Covered Procedures.
May 4, 2005................. 23306 405, 412, 413, 415, CMS-1500-P............. Medicare Program;
419, 422, and 485. Proposed Changes to
the Hospital Inpatient
Prospective Payment
Systems and Fiscal
Year 2006 Rates.
May 6, 2005................. 24168 412................ CMS-1483-F............. Medicare Program;
Prospective Payment
System for Long-Term
Care Hospitals: Annual
Payment Rate Updates,
Policy Changes, and
Clarification.
May 18, 2005................ 28541 ................... CMS-1269-N4............ Medicare Program;
Emergency Medical
Treatment and Labor
Act (EMTALA Technical
Advisory Group (TAG)
Meeting--June 15, 2005
through June 17, 2005.
May 19, 2005................ 29070 424................ CMS-1282-P............. Medicare Program;
Prospective Payment
System and
Consolidated Billing
for Skilled Nursing
Facilities for FY
2006.
May 24, 2005................ 29765 ................... CMS-2214-N............. Medicaid Program;
Establishment of the
Medicaid Commission
and Request for
Nominations for
Members.
May 25, 2005................ 30188 412................ CMS-1290-P............. Medicare Program;
Inpatient
Rehabilitation
Facility Prospective
Payment System for FY
2006.
May 27, 2005................ 30840 418................ CMS-3844-P............. Medicare and Medicaid
Programs; Hospice
Conditions of
Participation.
May 27, 2005................ 30734 ................... CMS-1293-N............. Medicare Program;
Public Meeting in
Calendar Year 2005 for
New Clinical
Laboratory Tests
Payment
Determinations.
May 27, 2005................ 30733 ................... CMS-4095-N............. Medicare Program;
Meeting of the
Advisory Panel on
Medicare Education,
June 21, 2005.
May 27, 2005................ 30731 ................... CMS-3144-N............. Medicare Program;
Calendar Year 2005
Review of the
Appropriateness of
Payment Amounts for
New Technology
Intraocular Lenses
(NTIOLs) Furnished by
Ambulatory Surgical
Centers (ASCs).
[[Page 55874]]
May 27, 2005................ 30640 413................ CMS-1199-IFC........... Medicare Program;
Electronic Submission
of Cost Reports:
Revision to Effective
Date of Cost Reporting
Period.
June 17, 2005............... 35204 400 and 421........ CMS-6030-P2............ Medicare Program;
Medicare Integrity
Program, Fiscal
Intermediary and
Carrier Functions, and
Conflict of Interest
Requirements.
June 24, 2005............... 36642 ................... CMS-5033-N5............ Medicare Program;
Meeting of the
Advisory Board on the
Demonstration of a
Bundled Case-Mix
Adjusted Payment
System for End-Stage
Renal Disease
Services--July 14
through July 15, 2005.
June 24, 2005............... 36640 ................... CMS-1480-N............. Medicare Program;
Inpatient
Rehabilitation
Facility Compliance
Criteria.
June 24, 2005............... 36620 ................... CMS-9028-N............. Medicare and Medicaid
Programs; Quarterly
Listing of Program
Issuances--January
through March 2005.
June 24, 2005............... 36615 ................... CMS-2219-N............. State Children's Health
Insurance Program;
Final Allotments to
States, the District
of Columbia, and U.S.
Territories and
Commonwealths for
Fiscal Year 2006.
June 24, 2005............... 36613 ................... CMS-5022-N............. Medicare Program;
Solicitation for
Applications for the
Medical Adult Day-Care
Services
Demonstration.
June 24, 2005............... 36533 416................ CMS-1478-CN............ Medicare Program;
Update of Ambulatory
Surgical Center List
of Covered Procedures;
Correction.
June 30, 2005............... 37700 401 and 405........ CMS-4064-IFC2.......... Medicare Program;
Changes to the
Medicare Claims Appeal
Procedures: Correcting
Amendment to an
Interim Final Rule.
----------------------------------------------------------------------------------------------------------------
Addendum V--National Coverage Determinations
[January Through March 2005]
A national coverage determination (NCD) is a determination by the
Secretary with respect to whether or not a particular item or service
is covered nationally under Title XVIII of the Social Security Act, but
does not include a determination of what code, if any, is assigned to a
particular item or service covered under this title, or determination
with respect to the amount of payment made for a particular item or
service so covered. We include below all of the NCDs that were issued
during the quarter covered by this notice. The entries below include
information concerning completed decisions as well as sections on
program and decision memoranda, which also announce pending decisions
or, in some cases, explain why it was not appropriate to issue an NCD.
We identify completed decisions by the section of the NCDM in which the
decision appears, the title, the date the publication was issued, and
the effective date of the decision. Information on completed decisions
as well as pending decisions has also been posted on the CMS Web site
at http://cms.hhs.gov/coverage.
National Coverage Determinations
[April Through June 2005]
----------------------------------------------------------------------------------------------------------------
NCDM Effective
Title section TN no. Issue date date
----------------------------------------------------------------------------------------------------------------
PET for 6 Cancers (Brain, Ovarian, 220.14 R31NCD...................... 04/01/05 01/28/05
Testicular, Small-Cell Lung, Pancreatic,
Cervical).
Autologous Stem Cell Transplantations for 110.8.1 R32NCD...................... 04/15/05 03/15/05
Amyloidosis.
Percutaneous Transluminal Angioplasty (PTA) 20.7 R33NCD...................... 04/22/05 03/17/05
Abarelix/Plenaxis for Treatment of Prostate 110.19 R34NCD...................... 04/25/05 03/15/05
Cancer.
Continuous Positive Airway Pressure (CPAP) 240.4 R35NCD...................... 05/06/05 04/04/05
for Obstructive Sleep Apnea (OSA).
Smoking and Tobacco Use Cessation 210.4 R36NCD...................... 05/20/05 03/22/05
Counseling.
Mobility Assistive Equipment (MAE)......... 280.3 R37NCD...................... 05/05/05 03/25/05
Anti-Cancer Chemotherapy for Colorectal 110.17 R38NCD...................... 06/17/05 01/28/05
Cancer.
Cochlear Implantation...................... 50.3 R39NCD...................... 06/24/05 04/04/05
Aprepitant for Chemotherapy-Induced Emesis. 110.18 R40NCD...................... 06/24/05 04/04/05
Osteogenic Stimulators..................... 150.2 R41NCD...................... 06/24/05 04/27/05
----------------------------------------------------------------------------------------------------------------
Addendum VI.--FDA-Approved Category B IDEs
[April Through June 2005]
Under the Food, Drug, and Cosmetic Act (21 U.S.C. 360c) devices
fall into one of three classes. To assist CMS under this categorization
process, the FDA assigns one of two categories to each FDA-approved
IDE. Category A refers to experimental IDEs, and Category B refers to
non-experimental IDEs. To obtain more information about the classes or
categories, please refer to the Federal Register notice published on
April 21, 1997 (62 FR 19328).
The following list includes all Category B IDEs approved by FDA
during the second quarter, April through June 2005.
IDE/Category: B012305, B012314, B012410, G000119, G000165, G020211,
G030161, G030165, G030219, G030230, G030263, G040078, G040102, G040158,
[[Page 55875]]
G040168, G040172, G040184, G040214, G040229, G050002, G050012, G050034,
G050042, G050045, G050049, G050050, G050052, G050053, G050056, G050058,
G050059, G050061, G050062, G050063, G050066, G050070, G050074, G050075,
G050077, G050078, G050083, G050084, G050085, G050088, G050089, G050089,
G050090, G050091, G050094, G050096, G050097, G050099, G050101, G050102,
G050105, G050106, G050110, G960204, G970145, G980102, G990106, G990216.
Addendum VII.--Approval Numbers for Collections of Information
Below we list all approval numbers for collections of information
in the referenced sections of CMS regulations in Title 42; Title 45,
Subchapter C; and Title 20 of the Code of Federal Regulations, which
have been approved by the Office of Management and Budget:
------------------------------------------------------------------------
Approved CFR Sections in Title
42, Title 45, and Title 20
(Note: Sections in Title 45 are
OMB Control No. preceded by ``45 CFR,'' and
sections in Title 20 are
preceded by ``20 CFR'')
------------------------------------------------------------------------
0938-0008.............................. 414.40, 424.32, 424.44
0938-0022.............................. 413.20, 413.24, 413.106
0938-0023.............................. 424.103
0938-0025.............................. 406.28, 407.27
0938-0027.............................. 486.100-486.110
0938-0033.............................. 405.807
0938-0035.............................. 407.40
0938-0037.............................. 413.20, 413.24
0938-0041.............................. 408.6, 408.22
0938-0042.............................. 410.40, 424.124
0938-0045.............................. 405.711
0938-0046.............................. 405.2133
0938-0050.............................. 413.20, 413.24
0938-0062.............................. 431.151, 435.1009, 440.220,
440.250, 442.1, 442.10-442.16,
442.30, 442.40, 442.42,
442.100-442.119, 483.400-
483.480, 488.332, 488.400,
498.3-498.5
0938-0065.............................. 485.701-485.729
0938-0074.............................. 491.1-491.11
0938-0080.............................. 406.7, 406.13
0938-0086.............................. 420.200-420.206, 455.100-
455.106
0938-0101.............................. 430.30
0938-0102.............................. 413.20, 413.24
0938-0107.............................. 413.20, 413.24
0938-0146.............................. 431.800-431.865
0938-0147.............................. 431.800-431.865
0938-0151.............................. 493.1405, 493.1411, 493.1417,
493.1423, 493.1443, 493.1449,
493.1455, 493.1461, 493.1469,
493.1483, 493.1489
0938-0155.............................. 405.2470
0938-0170.............................. 493.1269-493.1285
0938-0193.............................. 430.10-430.20, 440.167
0938-0202.............................. 413.17, 413.20
0938-0214.............................. 411.25, 489.2, 489.20
0938-0236.............................. 413.20, 413.24
0938-0242.............................. 442.30, 488.26
0938-0245.............................. 407.10, 407.11
0938-0246.............................. 431.800-431.865
0938-0251.............................. 406.7
0938-0266.............................. 416.41, 416.47, 416.48, 416.83
0938-0267.............................. 410.65, 485.56, 485.58, 485.60,
485.64, 485.66
0938-0269.............................. 412.116, 412.632, 413.64,
413.350, 484.245
0938-0270.............................. 405.376
0938-0272.............................. 440.180, 441.300-441.305
0938-0273.............................. 485.701-485.729
0938-0279.............................. 424.5
0938-0287.............................. 447.31
0938-0296.............................. 413.170, 413.184
0938-0301.............................. 413.20, 413.24
0938-0302.............................. 418.22, 418.24, 418.28, 418.56,
418.58, 418.70, 418.74,
418.83, 418.96, 418.100
0938-0313.............................. 489.11, 489.20
0938-0328.............................. 482.12, 482.13, 482.21, 482.22,
482.27, 482.30, 482.41,
482.43, 482.45, 482.53,
482.56, 482.57, 482.60,
482.61, 482.62, 482.66,
485.618, 485.631
0938-0334.............................. 491.9, 491.10
0938-0338.............................. 486.104, 486.106, 486.110
0938-0354.............................. 441.60
0938-0355.............................. 442.30, 488.26
0938-0357.............................. 409.40-409.50, 410.36, 410.170,
411.4-411.15, 421.100, 424.22,
484.18, 489.21
0938-0358.............................. 412.20-412.30
0938-0359.............................. 412.40-412.52
0938-0360.............................. 488.60
0938-0365.............................. 484.10, 484.11, 484.12, 484.14,
484.16, 484.18, 484.20,
484.36, 484.48, 484.52
0938-0372.............................. 414.330
0938-0378.............................. 482.60-482.62
0938-0379.............................. 442.30, 488.26
0938-0382.............................. 442.30, 488.26
0938-0386.............................. 405.2100-405.2171
[[Page 55876]]
0938-0391.............................. 488.18, 488.26, 488.28
0938-0426.............................. 476.104, 476.105, 476.116,
476.134
0938-0429.............................. 447.53
0938-0443.............................. 473.18, 473.34, 473.36, 473.42
0938-0444.............................. 1004.40, 1004.50, 1004.60,
1004.70
0938-0445.............................. 412.44, 412.46, 431.630,
456.654, 466.71, 466.73,
466.74, 466.78
0938-0447.............................. 405.2133
0938-0448.............................. 405.2133, 45 CFR 5, 5b; 20 CFR
Parts 401, 422E
0938-0449.............................. 440.180, 441.300-441.310
0938-0454.............................. 424.20
0938-0456.............................. 412.105
0938-0463.............................. 413.20, 413.24, 413.106
0938-0467.............................. 431.17, 431.306, 435.910,
435.920, 435.940-435.960
0938-0469.............................. 417.126, 422.502, 422.516
0938-0470.............................. 417.143, 417.800-417.840, 422.6
0938-0477.............................. 412.92
0938-0484.............................. 424.123
0938-0501.............................. 406.15
0938-0502.............................. 433.138
0938-0512.............................. 486.304, 486.306, 486.307
0938-0526.............................. 475.102, 475.103, 475.104,
475.105, 475.106
0938-0534.............................. 410.38, 424.5
0938-0544.............................. 493.1-493.2001
0938-0564.............................. 411.32
0938-0565.............................. 411.20-411.206
0938-0566.............................. 411.404, 411.406, 411.408
0938-0573.............................. 412.230, 412.256
0938-0578.............................. 447.534
0938-0581.............................. 493.1-493.2001
0938-0599.............................. 493.1-493.2001
0938-0600.............................. 405.371, 405.378, 413.20
0938-0610.............................. 417.436, 417.801, 422.128,
430.12, 431.20, 431.107,
434.28, 483.10, 484.10,
489.102
0938-0612.............................. 493.801, 493.803, 493.1232,
493.1233, 493.1234, 493.1235,
493.1236, 493.1239, 493.1241,
493.1242, 493.1249, 493.1251,
493,1252, 493.1253, 493.1254,
493.1255, 493.1256, 493.1261,
493.1262, 493.1263, 493.1269,
493.1273, 493.1274, 493.1278,
493.1283, 493.1289, 493.1291,
493.1299
0938-0618.............................. 433.68, 433.74, 447.272
0938-0653.............................. 493.1771, 493.1773, 493.1777
0938-0657.............................. 405.2110, 405.2112
0938-0658.............................. 405.2110, 405.2112
0938-0667.............................. 482.12, 488.18, 489.20, 489.24
0938-0679.............................. 410.38
0938-0685.............................. 410.32, 410.71, 413.17, 424.57,
424.73, 424.80, 440.30, 484.12
0938-0686.............................. 493.551-493.557
0938-0688.............................. 486.304, 486.306, 486.307,
486.310, 486.316, 486.318,
486.325
0938-0690.............................. 488.4-488.9, 488.201
0938-0691.............................. 412.106
0938-0692.............................. 466.78, 489.20, 489.27
0938-0701.............................. 422.152
0938-0702.............................. 45 CFR 146.111, 146.115,
146.117, 146.150, 146.152,
146.160, 146.180
0938-0703.............................. 45 CFR 148.120, 148.124,
148.126, 148.128
0938-0714.............................. 411.370-411.389
0938-0717.............................. 424.57
0938-0721.............................. 410.33
0938-0723.............................. 421.300-421.318
0938-0730.............................. 405.410, 405.430, 405.435,
405.440, 405.445, 405.455,
410.61, 415.110, 424.24
0938-0732.............................. 417.126, 417.470
0938-0734.............................. 45 CFR 5b
0938-0739.............................. 413.337, 413.343, 424.32,
483.20
0938-0742.............................. 422.300-422.312
0938-0749.............................. 424.57
0938-0753.............................. 422.000-422.700
0938-0754.............................. 441.151, 441.152
0938-0758.............................. 413.20, 413.24
0938-0760.............................. Part 484 Subpart E, 484.55
0938-0761.............................. 484.11, 484.20
0938-0763.............................. 422.1-422.10, 422.50-422.80,
422.100-422.132, 422.300-
422.312, 422.400-422.404,
422.560-422.622
0938-0770.............................. 410.2
0938-0778.............................. 422.64, 422.111
0938-0779.............................. 417.126, 417.470, 422.64,
422.210
0938-0781.............................. 411.404-411.406, 484.10
0938-0786.............................. 438.352, 438.360, 438.362,
438.364
0938-0787.............................. 406.28, 407.27
[[Page 55877]]
0938-0790.............................. 460.12, 460.22, 460.26, 460.30,
460.32, 460.52, 460.60,
460.70, 460.71, 460.72,
460.74, 460.80, 460.82,
460.98, 460.100, 460.102,
460.104, 460.106, 460.110,
460.112, 460.116, 460.118,
460.120, 460.122, 460.124,
460.132, 460.152, 460.154,
460.156, 460.160, 460.164,
460.168, 460.172, 460.190,
460.196, 460.200, 460.202,
460.204, 460.208, 460.210
0938-0792.............................. 491.8, 491.11
0938-0798.............................. 413.24, 413.65, 419.42
0938-0802.............................. 419.43
0938-0818.............................. 410.141, 410.142, 410.143,
410.144, 410.145, 410.146,
414.63
0938-0829.............................. 422.568
0938-0832.............................. Parts 489 and 491
0938-0833.............................. 483.350-483.376
0938-0841.............................. 431.636, 457.50, 457.60,
457.70, 457.340, 457.350,
457.431, 457.440, 457.525,
457.560, 457.570, 457.740,
457.750, 457.810, 457.940,
457.945, 457.965, 457.985,
457.1005, 457.1015, 457.1180
0938-0842.............................. 412.23, 412.604, 412.606,
412.608, 412.610, 412.614,
412.618, 412.626, 413.64
0938-0846.............................. 411.352-411.361
0938-0857.............................. Part 419
0938-0860.............................. Part 419
0938-0866.............................. 45 CFR Part 162
0938-0872.............................. 413.337, 483.20
0938-0873.............................. 422.152
0938-0874.............................. 45 CFR Parts 160 and 162
0938-0878.............................. Part 422 Subpart F & G
0938-0883.............................. 45 CFR Parts 160 and 164
0938-0884.............................. 405.940
0938-0887.............................. 45 CFR 148.316, 148.318,
148.320
0938-0897.............................. 412.22, 412.533
0938-0907.............................. 412.230, 412.304, 413.65
0938-0910.............................. 422.620, 422.624, 422.626
0938-0911.............................. 426.400, 426.500
0938-0916.............................. 483.16
0938-0920.............................. 438.6, 438.8, 438.10, 438.12,
438.50, 438.56, 438.102,
438.114, 438.202, 438.206,
438.207, 438.240, 438.242,
438.402, 438.404, 438.406,
438.408, 438.410, 438.414,
438.416, 438.710, 438.722,
438.724, 438.810
0938-0921.............................. 414.804
0938-0931.............................. 45 CFR Part 142.408, 162.408,
and 162.406
0938-0933.............................. 438.50
0938-0934.............................. 403.766
0938-0936.............................. 423
0938-0940.............................. 484 and 488
0938-0944.............................. 422.250, 422.252, 422.254,
422.256, 422.258, 422.262,
422.264, 422.266, 422.270,
422.300, 422.304, 422.306,
422.308, 422.310, 422.312,
422.314, 422.316, 422.318,
422.320, 422.322, 422.324,
423.251, 423.258, 423.265,
423.272, 423.279, 423.286,
423.293, 423.301, 423.308,
423.315, 423.322, 423.329,
423.336, 423.343, 423.346,
423.350
0938-0950.............................. 405.910
0938-0951.............................. 423.48
0938-0953.............................. 405.1200 and 405.1202
------------------------------------------------------------------------
Addendum VIII
Medicare-Approved Carotid Stent Facilities
[April Through June 2005]
On March 17, 2005, we issued our decision memorandum on carotid
artery stenting. We determined that carotid artery stenting with
embolic protection is reasonable and necessary only if performed in
facilities that have been determined to be competent in performing the
evaluation, procedure, and follow-up necessary to ensure optimal
patient outcomes. We have created a list of minimum standards for
facilities modeled in part on professional society statements on
competency. All facilities must at least meet our standards in order to
receive coverage for carotid artery stenting for high risk patients.
April 1, 2005
Bon Secours St. Mary's Hospital
5801 Bremo Road
Richmond, VA 23226
Medicare Provider 490059
Clear Lake Regional Medical Center
500 Medical Center Blvd
Webster, TX 77598
Medicare Provider 450617
Louisiana Heart Hospital
64030 Louisiana Highway 434
Lacombe, LA 70445
Medicare Provider 190250
Phoenix Baptist Hospital
Cardiac Catheterization Laboratory/Interventional Radiology Suite
200 West Bethany Home Road
Phoenix, AZ 85015
Medicare Provider 030030
Saint Joseph Medical Center
Twelfth and Walnut Streets
P.O. Box 316
Reading, PA 19603-0316
Medicare Provider 390096
St. Francis Hospital & Health Centers
1600 Albany Street
Beech Grove, IN 46107
Medicare Provider 150033
University of Pennsylvania Medical Center-Presbyterian
39th and Market Streets
Philadelphia, PA 19104
Medicare Provider 390223
April 4, 2005
Emory University Hospital
1364 Clifton Road, NE
Atlanta, GA 30322
Medicare Provider 110010
Hoag Memorial Hospital Presbyterian
One Hoag Drive
Newport Beach, CA 92663
Medicare Provider 050224
Lakeland Hospital
1234 Napier Avenue
St. Joseph, MI 49085
Medicare Provider 230021
[[Page 55878]]
April 7, 2005
The Baldwin County Eastern Shore
Health Care Authority
d/b/a Thomas Hospital
750 Morphy Avenue
Fairhope, AL 36532
Medicare Provider 010100
Martha Jefferson Hospital
459 Locust Avenue
Charlottesville, VA 22902
Medicare Provider 490077
Mercy Medical Center
701 10th Street SE.
Cedar Rapids, IA 52403
Medicare Provider 160079
Mount Sinai Medical Center
4300 Alton Road
Miami Beach, FL 33140
Medicare Provider 100034
Skyline Medical Center
3441 Dickerson Pike
Nashville, TN 37207
Medicare Provider 440006
Union Memorial Hospital
201 East University Parkway
Baltimore, MD 21218-2895
Medicare Provider 210024
April 12, 2005
Baptist Hospital East
4000 Kresage Way
Louisville, KY 40207
Medicare Provider 180130
Baptist Hospital of East Tennessee
137 Blount Avenue
Knoxville, TN 37920
Medicare Provider 440019
Borgess Medical Center
1521 Gull Road
Kalamazoo, MI 49048
Medicare Provider 020117
The Cleveland Clinic Foundation
9500 Euclid Avenue
Cleveland, OH 44195
Medicare Provider 360180
Good Samaritan Hospital
1225 Wilshire Boulevard
Los Angeles, CA 90017
Medicare Provider 050471
Good Samaritan Hospital
2425 Samaritan Drive
San Jose, CA 95124
Medicare Provider 050380
Harbor-UCLA Medical Center
1000 West Carson Street
Torrance, CA 90502
Medicare Provider 050376
Hunterdon Medical Center
2100 Wescott Drive
Flemington, NJ 08822
Medicare Provider 310005
Jewish Hospital
200 Abraham Flexner Way
Louisville, KY 40202
Medicare Provider 180040
Mercy Health Center
4300 West Memorial Road
Oklahoma City, OK 73120-8304
Medicare Provider 370013
Mercy Medical Center
1111 6th Avenue
Des Moines, IA 50314
Medicare Provider 160083
Methodist Hospital
300 West Huntington Drive
P.O. Box 60016
Arcadia, CA 91066-6016
Medicare Provider 050238
North Austin Medical Center
12221 MoPac Expressway North
Austin, TX 78758
Medicare Provider 450809
Ochsner Clinic Foundation
Department of Cardiology
1514 Jefferson Highway
New Orleans, LA 70121-2483
Medicare Provider 190036
Princeton Baptist Medical Center
701 Princeton Avenue, SW
Birmingham, AL 35211-1399
Medicare Provider 010103
Resurrection Medical Center
7435 West Talcott
Chicago, IL 60631
Medicare Provider 140117
South Austin Hospital
901 W. Ben White
Austin, TX 78704
Medicare Provider 450713
St. Patrick Hospital and Health Sciences Center
500 West Broadway
Missoula, MT 59802
Medicare Provider 270014
April 14, 2005
Fort Walton Beach Medical Center
1000 Mar Walt Drive
Fort Walton Beach, FL 32547
Medicare Provider 100223
York Hospital
15 Hospital Drive
York, ME 03909
Medicare Provider 200020
April 18, 2005
Alexian Brothers Medical Center
800 W. Biesterfield Road
Elk Grove Village, IL 60007
Medicare Provider 140258
Arizona Heart Hospital
1930 E. Thomas Road
Phoenix, AZ 85106
Medicare Provider 030102
Baptist Memorial Hospital
6019 Walnut Grove Road
Memphis, TN 38102
Medicare Provider 440048
CHRISTUS St. Frances Cabrini Hospital
3330 Masonic Drive
Alexandria, LA 71301
Medicare Provider 190019
Eastern Main Medical Center
489 State Street
P.O. Box 404
Bangor, ME 04402-0404
Medicare Provider 200033
Good Samaritan Hospital
375 Dixmyth Avenue
Cincinnati, OH 45220-2489
Medicare Provider 360134
Iowa Methodist Medical Center
1200 Pleasant Street
Des Moines, IA 50309
Medicare Provider 160082
Lutheran Hospital of Indiana
7950 West Jefferson Boulevard
Fort Wayne, IN 46804
Medicare Provider 150017
Moses H. Cone Memorial Hospital
1200 N. Elm Street
Greensboro, NC 27401
Medicare Provider 340091
Robert Packer Hospital
One Guthrie Square
Sayre, PA 18840-1698
Medicare Provider 390079
Spectrum Health Hospital
100 Michigan Street NE.
Grand Rapids, MI 49503
Medicare Provider 230038
St. Luke's Medical Center
2900 W. Oklahoma Avenue
P.O. Box 2901
Milwaukee, WI 53201-2901
Medicare Provider 520138
April 19, 2005
Harper-Hutzel Hospital
3990 John R Street
Detroit, MI 48201
Medicare Provider 230104
North Florida Regional Medical Center
6500 Newberry Road
Gainesville, FL 32605
Medicare Provider 100204
Sinai-Grace Hospital
6071 W. Outer Drive
Detroit, MI 48235
Medicare Provider 230024
Sioux Valley Hospital USD Medical Center
1305 W. 18th Street
Sioux Falls, SD 57117-5039
Medicare Provider 430027
St. Anthony's Hospital
1200 7th Avenue North
St. Petersburg, FL 33705
Medicare Provider 100067
St. John's Regional Medical Center
2727 McClelland Boulevard
Joplin, MO 64804-1694
Medicare Provider 260001
St. Luke's
915 East First Street
Duluth, MN 55805
Medicare Provider 240047
St. Thomas Hospital
4220 Harding Road
Nashville, TN 37205
Medicare Provider 440082
Strong Memorial Hospital
601 Elmwood Avenue,
Box 679
Rochester, NY 14642
Medicare Provider 330285
UC Davis Cardiac Cath Lab/UC Davis Medical Center
2315 Stockton Blvd
Sacramento, CA 95817
Medicare Provider 050599
April 20, 2005
Baptist Medical Center South
2105 East South Boulevard
P.O. Box 11010
Montgomery, AL 36111-0010
Medicare Provider 010023
Forsyth Medical Center
[[Page 55879]]
3333 Silas Creek Parkway
Winston Salem, NC 27103
Medicare Provider 340014
Harris Methodist Fort Worth Hospital
1301 Pennsylvania Avenue
Fort Worth, TX 76104
Medicare Provider 450135
Jupiter Medical Center
1210 S. Old Dixie Hwy
Jupiter, FL 33458
Medicare Provider 100253
Kent Hospital
455 Toll Gate Road
Warwick, RI 02886
Medicare Provider 410009
Lawnwood Medical Center, Inc.
d/b/a Lawnwood Regional Medical Center and Heart Institute
1700 South 23rd Street
Fort Pierce, FL 34950
Medicare Provider 100246
LDS Hospital
8th Avenue and C Street
Salt Lake City, UT 84143
Medicare Provider 460010
Riverside Methodist Hospital
3535 Olentangy River Road
Columbus, OH 43214
Medicare Provider 360006
Rush University Medical Center
1725 West Harrison Street
Suite 364
Chicago, IL 60612-3824
Shady Grove Adventist Hospital
9901 Medical Center Drive
Rockville, MD 20850
Medicare Provider 210057
St. Mary's Hospital and Medical Center
2635 North Seventh Street
P.O. Box 1628
Grand Junction, CO 81501
Medicare Provider 060023
Terrebonne General Medical Center
8166 Main Street
Houma, LA 70360
Medicare Provider 190008
The Valley Hospital
223 N. Van Dien Avenue
Ridgewood, NJ 07450-2736
Medicare Provider 310012
April 26, 2005
Baptist Montclair Medical Center
800 Montclair Road
Birmingham, AL 35213
Medicare Provider 010104
Caritas St. Elizabeth's Medical Center
736 Cambridge Street
Boston, MA 02135-2997
Medicare Provider 220036
Fresno Heart Hospital
15 E. Audubon Drive
Fresno, CA 93720
Medicare Provider 050732
Fountain Valley Regional Hospital and Medical Center
17100 Euclid Street
P.O. Box 8010
Fountain Valley, CA 92708
Medicare Provider 050570
Mountain View Regional Medical Center
4311 E. Lohman Avenue
Las Cruces, NM 88011
Medicare Provider 320085
Northwestern Memorial Hospital
251 East Huron Street
Chicago, IL 60611
Medicare Provider 140281
SSM St. Joseph Health Center
300 First Capitol Drive
St. Charles, MO 63301
Medicare Provider 260005
St. Elizabeth Medical Center
South Unit
1 Medical Village Drive
Edgewood, KY 41017
Medicare Provider 180035
Wyoming Valley Health Care System
575 North River Street
Wilkes Barre, PA 18764
Medicare Provider 390137
April 27, 2005
Baptist Hospital-Pensacola
1000 West Moreno Street
P.O. Box 17500
Pensacola, FL 32522-7500
Medicare Provider 100093
Central Baptist Hospital
1740 Nicholasville Road
Lexington, KY 40503
Medicare Provider 180103
Charleston Area Medical Center
3200 MacCorkle Avenue, SE.
Charleston, WV 25304
Medicare Provider 510022
Dartmouth Hitchcock Medical Center
One Medical Center Drive
Lebanon, NH 03756
Medicare Provider 300003
Doylestown Hospital
595 West State Street
Doylestown, PA 18901
Medicare Provider 390203
Good Samaritan Hospital
255 Lafayette Avenue
Suffern, NY 10901
Medicare Provider 330158
Hackensack University Medical Center
30 Prospect Avenue
Hackensack, NJ 07601
Medicare Provider 310001
Medical College of Ohio
3000 Arlington Avenue
Toledo, OH 43614
Medicare Provider 360048
Memorial Hospital Jacksonville
3625 University Boulevard, South
Jacksonville, FL 32216
Medicare Provider 100179
[The] Ortenzio Heart Center at Holy Spirit
503 North 21st Street
Camp Hill, PA 17011-2288
Medicare Provider 390004
OSF Saint Francis Medical Center
530 N.E. Glen Oak Avenue
Peoria, IL 61637
Medicare Provider 140067
Saint Luke's Hospital of Kansas City
4401 Wornall Road
Kansas City, MO 64111
Medicare Provider 360138
Saints Memorial Medical Center
1 Hospital Drive
Lowell, MA 01852-1389
Medicare Provider 220082
St. John Hospital and Medical Center
22151 Moross Road
Detroit, MI 48236
Medicare Provider 230165
Union Hospital
1606 North Seventh Street
Terre Haute, IN 47804-2780
Medicare Provider 150023
University Health System
4502 Medical Drive
San Antonio, TX 78229
Medicare Provider 450213
Washoe Medical Center
75 Pringle Way
Reno, NV 89502
Medicare Provider 290001
Willis Knighton Bossier
2400 Hospital Drive,
Bossier City, LA 71111
Medicare Provider 190236
Willis Knighton Medical Center
2600 Greenwood Road
Shreveport, LA 71103
Medicare Provider 190111
May 3, 2005
Advocate Christ Medical Center
4440 West 95th Street
Oak Lawn, IL 60453
Medicare Provider 140208
Aurora Sinai Medical Center
945 N. 12th Street
Milwaukee, WI 53201
Medicare Provider 520064
Cascade Healthcare Community
d/b/a St. Charles Medical Center Bend
2500 N.E. Neff Road
Bend, OR 97701
Medicare Provider 380040
CJW Medical Center
Chippenham Hospital
7101 Jahnke Road
Richmond, VA 23225
Medicare Provider 490112
Kaleida Health
Millard Fillmore Hospital
3 Gates Circle
Buffalo, NY 14209
Medicare Provider 330005
Lakeview Regional Medical Center
95 E. Fairway Drive
Covington, LA 70433
Medicare Provider 190177
Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114
Medicare Provider 220071
Methodist Medical Center of Oak Ridge
990 Oak Ridge Turnpike
Oak Ridge, TN 37830
Medicare Provider 440034
North Oakland Medical Centers
461 W. Huron Street
Pontiac, MI 48341-1651
Medicare Provider 230013
Norton Healthcare
P.O. Box 35070
Louisville, KY 40232-5070
Medicare Provider 180088
Our Lady of Lourdes Regional Medical Center
611 St. Landry Street
Lafayette, LA 70506
[[Page 55880]]
Medicare Provider 190102
St. John West Shore Hospital
29000 Center Ridge Road
Westlake, OH 44145
Medicare Provider 360123
Swedish American Hospital
1401 East State Street
Rockford, IL 61104
Medicare Provider 140228
UPMC Presbyterian Shadyside
200 Lothrop Street
Pittsburgh, PA 15213
Medicare Provider 390164
May 5, 2005
Advocate Lutheran General Hospital
1775 Dempster Street
Park Ridge, IL 60068
Medicare Provider 140223
Avera Heart Hospital of South Dakota
4500 West 69th Street
Sioux Falls, SD 57108
Medicare Provider 430095
Baptist Medical Center
1225 North State Street
Jackson, MS 39202
Medicare Provider 250102
Baptist Memorial Hospital-DeSoto
7601 Southcrest Parkway
Southaven, MS 38671
Medicare Provider 250141
Barnes-Jewish Hospital
One Barnes-Jewish Hospital Plaza
St. Louis, MO 63110
Medicare Provider 260032
Bethesda Hospital
10500 Montgomery Road
Cincinnati, OH 45242-9508
Medicare Provider 360179
Eliza Coffee Memorial Hospital
P.O. Box 818
Florence, AL 35631
Medicare Provider 010006
Geisinger Medical Center
100 North Academy Avenue
Danville, PA 17822
Medicare Provider 390006
Geisinger Wyoming Valley Medical Center
1000 East Mountain Boulevard
Wilkes-Barre, PA 18711
Medicare Provider 390270
Grandview Hospital and Medical Center
405 Grand Avenue
Dayton, OH 45405
Medicare Provider 360133
Hamot Medical Center
201 State Street
Erie, PA 16550
Medicare Provider 390063
Hialeah Hospital
651 East 25th Street
Hialeah, FL 33013
Medicare Provider 100053
Huntington Hospital
100 W. California Boulevard
P.O. Box 7013
Pasadena, CA 91109-7013
Medicare Provider 050438
Kettering Medical Center
3535 Southern Blvd
Kettering, OH 45429
Medicare Provider 360079
Loyola University Medical Center
2160 South First Avenue
Maywood, IL 60153
Medicare Provider 140276
Mercy Hospital
500 E. Market Street
Iowa City, IA 52245
Medicare Provider 160029
Mercy Hospital and Medical Center
2525 South Michigan Avenue
Chicago, IL 60616
Medicare Provider 140158
New York Presbyterian Hospital
161 Ft. Washington Avenue
HIP1412
New York, NY 10032
Medicare Provider 330101
Ohio State University
University Medical Center
452 West 10th Avenue
Columbus, OH 43210
Medicare Provider 360085
Our Lady of Lourdes Medical Center
1600 Haddon Avenue
Camden, NJ 08103
Medicare Provider 310029
Parkwest Medical Center
9352 Park West Boulevard
Knoxville, TN 37923
Medicare Provider 440173
Parma Community General Hospital
7007 Powers Boulevard
Parma, OH 44129-5495
Medicare Provider 360041
Rogue Valley Medical Center
2825 East Barnett Road
Medford, OR 97504
Medicare Provider 380018
Sacred Heart Health System
5151 N. Ninth Avenue
P.O. Box 2700
Pensacola, FL 32513
Medicare Provider 100025
Saint Raphael Healthcare System
1450 Chapel Street
New Haven, CT 06511
Medicare Provider 070001
Seton Medical Center
1900 Sullivan Avenue
Daly City, CA 94015
Medicare Provider 050289
Southern Baptist Hospital of Florida, Inc.
d/b/a Baptist Medical Center
800 Prudential Drive
Jacksonville, FL 32207
Medicare Provider 100088
St. Bernardine Medical Center
2101 N. Waterman Avenue
San Bernardino, CA 92404-4836
Medicare Provider 050129
St. David's Medical Center
919 East 32nd Street
P.O. Box 4039
Austin, TX 78765-4039
Medicare Provider 450431
Town and Country Hospital
6001 Webb Road
Tampa, FL 33615-3241
Medicare Provider 100255
University of Louisville Hospital
530 South Jackson Street
Louisville, KY 40202
Medicare Provider 180141
Vassar Brother Medical Center
45 Reade Place
Poughkeepsie, NY 12601
Medicare Provider 330023
Western Baptist Hospital
2501 Kentucky Avenue
Paduach, KY 42003-3200
Medicare Provider 180104
The Wisconsin Heart Hospital, LLC
10000 West Blue Mound Road
Wauwatosa, WI 53226
Medicare Provider 520199
May 10, 2005
Aiken Regional Medical Centers
302 University Parkway
P.O. Drawer 1117
Aiken, SC 29802-1117
Medicare Provider 420082
Aspirus Wausau Hospital, Inc.
333 Pine Ridge Boulevard
Wausau, WI 54401
Medicare Provider 520030
Deaconess Medical Center
P.O. Box 248
Spokane, WA 99210-0248
Medicare Provider 500044
El Camino Hospital
2500 Grant Road
P.O. Box 7025
Mountain View, Ca 94039-7025
Exempla St. Joseph Hospital
1835 Franklin Street
Denver, CO 80218-1191
Medicare Provider 060009
Hahnemann University Hospital/Tenet
230 N. Broad Street, Mailstop 119
Philadelphia, PA 19102-1192
Medicare Provider 390290
Irvine Regional Hospital & Medical Center
16200 Sand Canyon Avenue
Irvine, CA 92618
Medicare Provider 050693
John Muir Medical Center
1601 Ygnacio Valley Road
Walnut Creek, CA 94598-3194
Medicare Provider 050180
Mid Michigan Medical Center-Midland
4005 Orchard Drive
Midland, MI 48670
Medicare Provider 230222
Mount Diablo Medical Center
2540 East Street
P.O. Box 4110
Concord, CA 94524-4110
Medicare Provider 050496
Palomar Medical Center
555 East Valley Parkway
Escondido, CA 92025
Medicare Provider 050115
Pomerado Hospital
15615 Pomerado Road
Poway, CA 92064
Medicare Provider 050636
Presbyterian Hospital of Dallas
8200 Walnut Hill Lane
Dallas, TX 75231-4496
Medicare Provider 450462
St. John's Hospital
800 East Carpenter Street
Springfield, IL 62769
Medicare Provider 140053
St. Joseph Regional Medical Center
5000 West Chambers Street
[[Page 55881]]
Milwaukee, WI 53210-1688
Medicare Provider 520136
St. Luke's Hospital
1026 A Avenue NE.
P.O. Box 3026
Cedar Rapids, IA 52406-3026
Medicare Provider 160045
Wentworth-Douglass Hospital
789 Central Avenue
Dover, NH 03820
Medicare Provider 300018
William Beaumont Hospital
3601 W. 13 Mile Road
Royal Oak, MI 48073
Medicare Provider 230130
May 11, 2005
Allegheny General Hospital
320 East North Avenue
Pittsburg, PA 15212-4772
Medicare Provider 390050
Central Georgia Health Systems
d/b/a The Medical Center of Central Georgia
777 Hemlock Street
Macon, GA 31208
Medicare Provider 110107
Charlotte Regional Medical Center
809 East Marion Avenue
Punta Gorda, FL 33950
Medicare Provider 100047
Fort Sanders Regional Medical Center
1901 W. Clinch Avenue
Knoxville, TN 37916-2398
Medicare Provider 440125
Greater Baltimore Medical Center
6701 N. Charles Street
Baltimore, MD 21204
Medicare Provider 210044
Northeast Methodist Hospital
12412 Judson Road
Live Oak, TX 78233
Medicare Provider 450388
Parkview Hospital
2200 Randallia Drive
Fort Wayne, IN 46805
Medicare Provider 150021
Provena Saint Joseph Hospital
77 North Airlite Street
Elgin, IL 60123-4912
Medicare Provider 140217
St. Francis Hospital and Health Center
12935 S. Gregory Street
Blue Island, IL 60406
Medicare Provider 140118
May 16, 2005
Akron General Medical Center
400 Wabash Avenue
Akron, OH 44266
Medicare Provider 360027
Albany Medical Center Hospital
43 New Scotland Avenue
Albany, NY 12208
Medicare Provider 330013
Baystate Medical Center
759 Chestnut Street
Springfield, MA 01199
Medicare Provider 220077
Brigham and Women's Hospital
75 Francis Street
Boston, MA 02115
Medicare Provider 220110
Emory Crawford Long Hospital
550 Peachtree Street, N.E.
Atlanta, GA 30308-2225
Medicare Provider 110078
Galichia Heart Hospital
2610 N. Woodlawn
Wichita, KS 67220-2729
Medicare Provider 170192
Harris Methodist HEB
1600 Hospital Parkway
Bedford, TX 76022
Medicare Provider 450639
Hennepin County Medical Center
701 Park Avenue
Minneapolis, MN 55415-1829
Medicare Provider 240004
High Point Regional Health System
601 North Elm Street
P.O. Box HP-5
High Point, NC 27261
Medicare Provider 340004
Hillcrest Hospital
6780 Mayfield Road
Mayfield Heights, OH 44124
Medicare Provider 360230
Lenox Hill Hospital
100 East 77 Street
New York, NY 10021
Medicare Provider 330119
Los Robles Hospital and Medical Center
215 West Janss Road
Thousand Oaks, CA 91360
Medicare Provider 050549
Medical Center of Plano
3901 West 15th Street
Plano, TX 75075
Medicare Provider 450651
Memorial Medical Center
2700 Napoleon Avenue
New Orleans, LA 70115
Medicare Provider 190135
Morton Plant Hospital
300 Pinellas Street
Clearwater, FL 33756
Medicare Provider 100127
Phoenix Memorial Hospital
Cardiac Catheterization Laboratory/Interventional Radiology Suite
1201 South 7th Avenue
Phoenix, AZ 85007
Medicare Provider 030106
Providence Portland Medical Center
4805 Northeast Glisan Street
Portland, OR 97213-2967
Medicare Provider 380061
Providence St. Vincent Medical Center
9205 S.W. Barnes Road
Portland, OR 97225
Medicare Provider 380004
Saint Joseph Health Center
1000 Carondelet Drive
Kansas City, MO 64114
Medicare Provider 260085
Shawnee Mission Medical Center
9100 W. 74th Street
Shawnee Mission, KS 66204
Medicare Provider 170104
Sierra Medical Center
1625 Medical Center Drive
El Paso, TX 79902
Medicare Provider 450668
St. Joseph Mercy Hospital
5301 E. Huron River Drive
P.O. Box 995
Ann Arbor, MI 48106
Medicare Provider 230156
St. Mary's Medical Center
407 East Third Street
Duluth, MN 55805
Medicare Provider 240002
Swedish Medical Center
501 East Hampden Ave
Engelwood, CO 80113
Medicare Provider 060034
Tallahassee Memorial
1300 Miccosukee Road
Tallahassee, FL 32308
Medicare Provider 100135
United Regional Health Care System
Eleventh Street Campus
1600 Eleventh Street
Wichita Falls, TX 76301
Medicare Provider 450010
University of Kentucky Hospital
800 Rose Street
Lexington, KY 40536-0293
Medicare Provider 180067
Washington Hospital Center
110 Irving Street, NW.
Washington, DC 20010
Medicare Provider 090011
Wellmont Holston Valley Medical Center
Holston Valley Vascular Institute
130 W. Ravine Road
Kingsport, TN 37660
Medicare Provider 440017
Westchester Medical Center
95 Grasslands Road
Valhalla, NY 10595
Medicare Provider 330234
Winchester Medical Center
P.O. Box 3340
Winchester, VA 22604-2540
Medicare Provider 490005
May 17, 2005
Lee's Summit Hospital
530 N.W. Murray Road
Lee's Summit, MO 64081
Medicare Provider 260190
Mercy Hospital Fairfield
3000 Mack Road
Fairfield, OH 45014
Medicare Provider 360056
Saint Louis University Hospital
3635 Vista at Grand Boulevard
P.O. Box 15250
St. Louis, MO 63110
Medicare Provider 260105
Samaritan Hospital
310 South Limestone Street
Lexington, KY 40508
Medicare Provider 180007
St. Joseph Medical Center
Heart Institute
7601 Osler Drive
Towson, MD 21204-7582
Medicare Provider 210007
St. Joseph's Medical Center
1800 N. California Street
Stockton, CA 95204
Medicare Provider 050084
St. Mary's Medical Center
3700 Washington Avenue
Evansville, IN 47740-001
Medicare Provider 150100
[[Page 55882]]
Swedish Medical Center
First Hill Campus
747 Broadway
Seattle, WA 98122
Medicare Provider 500027
May 23, 2005
Bakersfield Memorial Hospital
420 34th Street
Bakersfield, CA 93301
Medicare Provider 050036
Banner Good Samaritan Medical Center
1111 E. McDowell Road
Phoenix, AZ 85006
Medicare Provider 030002
Bay Medical Center
615 North Bonita Avenue
Panama City, FL 32401
Medicare Provider 100026
Christiana Care Health Services
4755 Ogletown-Stanton Road
P.O. Box 6001
Newark, DE 19718-6001
Medicare Provider 080001
Clarian Health Partners, Inc.
I-65 at 21st Street
P.O. Box 1367
Indianapolis, IN 46206-1367
Medicare Provider 150056
Community Health Partners
3700 Kolbe Road
Lorain, OH 44052-1697
Medicare Provider 360172
EMH Regional Medical Center
630 East River Street
Elyria, OH 44035
Medicare Provider 360145
Erlanger Health System
975 East Third Street
Chattanooga, TN 37403
Medicare Provider 440104
Hartford Hospital
80 Seymour Street
P.O. Box 5037
Hartford, CT 06102-5037
Medicare Provider 070025
Hays Medical Center
2220 Canterbury Road
Hays, KS 67601
Medicare Provider 170013
Hospital of the University of Pennsylvania
3400 Spruce Street
Philadelphia, PA 19104
Medicare Provider 390111
Kansas Heart Hospital
3601 N. Webb Road
Wichita, KS 67226
Medicare Provider 170186
King's Daughters Medical Center
2201 Lexington Avenue
Ashland, KY 41101
Medicare Provider 180009
Los Alamitos Medical Center
3751 Katella Avenue
Los Alamitos, CA 90720
Medicare Provider 050551
Maricopa Integrated Health System
Maricopa Medical Center
Cardiac Catheterization Laboratory
2601 E. Roosevelt
Phoenix, AZ 85008
Medicare Provider 030022
Mayo Clinic Hospital
5777 East Mayo Boulevard
Phoenix, AZ 85054
Medicare Provider 030103
Missouri Baptist Medical Center
3015 N. Ballas Road
St. Louis, MO 63131
Medicare Provider 260108
Munroe Regional Medical Center
1500 S.W. 1st Avenue
Ocala, FL 34474
Medicare Provider 100062
Norman Regional Hospital
901 North Porter, Box 1308
Norman, OK 73070-1308
Medicare Provider 370008
Oklahoma Heart Hospital
4050 West Memorial Road
Oklahoma City, OK 73120
Medicare Provider 370215
Orlando Regional Healthcare System, Inc.
1414 Kuhl Avenue
Orlando, FL 32806
Medicare Provider 100006
Pinnacle Health Hospitals
111 South Front Street
Harrisburg, PA 17101
Medicare Provider 390067
Plaza Medical Center of Fort Worth
900 Eighth Avenue
Fort Worth, TX 76104
Medicare Provider 450672
Rapides Regional Medical Center
Box 30101
211 Fourth Street
Alexandria, LA 71301-8454
Medicare Provider 190026
Research Medical Center
2316 East Meyer Boulevard
Kansas City, MO 64132
Medicare Provider 260027
St. Luke's-Roosevelt Hospital Center
1000 Tenth Avenue
New York, NY 10019
Medicare Provider 330046
Swedish Medical Center
Providence Campus
747 Broadway
Seattle, WA 98122
Medicare Provider 500025
May 25, 2005
Bakersfield Heart Hospital
3001 Sillect Avenue
Bakersfield, CA 93308
Medicare Provider 050724
College Station Medical Center
1604 Rock Prairie Road
College Station, TX 77845
Medicare Provider