U.S. Department of Health and Human Services Health Care Financing Administration Medicare Program; Physician Fee Schedule for Calendar Year 1995; Payment Policies and Relative Value Unit Adjustments; Final Rule and Medicare Program; Physician Fee Schedule Update for Calendar Year 1995; Physician Volume Performance Standard Rates of Increase for Federal Fiscal Year 1995; Notice These files contain the source data for the two documents which appear in the FEDERAL REGISTER, Volume 59, Number 235, (December 8, 1994), beginning at page 63410. The file formats are ASCII and Lotus 123 (.wk1 format). Every effort has been made to ensure that these files accurately reflect the final notices as published in the FEDERAL REGISTER; however, in the event of a discrepancy, the printed notice is the official version. The availability of the printed version will also allow anyone using these files to see how the complete documents are assembled. A complete set of files for these notices includes the following: 1README - basic documentation on files (this file) HCFA1.TXT - ascii format text of RVU document HCFA2.TXT - ascii format text of Performance Standard Rates document ADDENDAB.TX1 - ascii format of Addendum B database, records 1-4999 ADDENDAB.TX2 - ascii format of Addendum B database, records 5000-end ADDENDAC.TXT - ascii format of Addendum C database, complete ADB_NOTE.TXT - ascii format text of Addendum B header material ADC_NOTE.TXT - ascii format text of Addendum C header material ADD-D.WK1 - Lotus 1-2-3 format file of Addendum D ADD-D.FMT - Format file for ADD-D.WK1 ADD-E.WK1 - Lotus 1-2-3 format file of Addendum E ADD-E.FMT - Format file for ADD-E.WK1 ADD-F.WK1 - Lotus 1-2-3 format file of Addendum F ADD-F.FMT - Format file for ADD-F.WK1 ADD-G.WK1 - Lotus 1-2-3 format file of Addendum G ADD-G.FMT - Format file for ADD-G.WK1 TABLE1.WK1 - Lotus 1-2-3 format file of Table 1 TABLE1.FMT - Format file for TABLE1.WK1 TABLE2.WK1 - Lotus 1-2-3 format file of Table 2 TABLE2.FMT - Format file for TABLE2.WK1 TABLE3.WK1 - Lotus 1-2-3 format file of Table 3 TABLE3.FMT - Format file for TABLE3.WK1 TABLE4.WK1 - Lotus 1-2-3 format file of Table 4 TABLE4.FMT - Format file for TABLE4.WK1 TABLE5.WK1 - Lotus 1-2-3 format file of Table 5 TABLE5.FMT - Format file for TABLE5.WK1 TABLE6.WK1 - Lotus 1-2-3 format file of Table 6 TABLE6.FMT - Format file for TABLE6.WK1 The README file and the files with the extension .TXT, .TX1, and .TX2 are ASCII files. The files with the extension .WK1 are Lotus 123 worksheets and those with the extension .FMT are the format files for printing the Lotus worksheets. The text from both documents is contained in the ASCII files HCFA1.TXT and HCFA2.TXT. The text of the first document is contained in HCFA1.TXT and the second document is contained in HCFA2.TXT. HCFA1.TXT also contains the text for "Addenda A - Explanation and Use of Addenda B through G." ADDENDAB.TX1 and ADDENDAB.TX2 and ADDENDAC.TXT contain the files for Addenda B and C. The ADD*.WK1 and TABLE*.WK1 contains the files for Addenda D through G and for all 6 Tables. There are six tables contained in "Medicare Program; Physician Fee Schedule for Calendar Year 1995; Payment Policies and Relative Value Unit Adjustments; Final Rule:" Table 1 - Refinement of Proposed RVUs Table 2 - Work RVU Refinements of Interim and Related RVUs Table 3 - Prolonged Services Table 4 - AMA RUC Recommendations and HCFA's Decisions Table 5 - Preventive Medicine Table 6 - Anesthesia Codes and Imputed RVUs Imported into Lotus 1-2-3, TABLE1.WK1 with TABLE1.FMT creates a table entitled "Refinement of Proposed RVUs," which may be inserted in the text where TABLE 1 - REFINEMENT OF PROPOSED RVUs appears. Tables 2 through 6 may be reconstructed and inserted similarly. There are seven addenda to "Medicare Program; Physician Fee Schedule for Calendar Year 1995; Payment Policies and Relative Value Unit Adjustments; Final Rule " lettered A through G: Addendum A--Explanation and Use of Addenda B through G Addendum B--1995 Relative Value Units (RVUs) and Related Information Used in Determining Medicare Payments for 1995 Addendum C--Codes with Interim RVUs Addendum D--1995 Geographic Practice Cost Indices by Medicare Carrier and Locality Addendum E--1996 Geographic Practice Cost Indices by Medicare Carrier and Locality Addendum F--Procedure Codes Subject to the Site-of-Service Differential Addendum G--Reference Set with 1995 Work RVUs. Addendum A is an ASCII text file and is totally contained in the narrative text. Addendum B is entitled 1995 RELATIVE VALUE UNITS RVUs AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 1995. The tabular data for Addendum B is contained in two comma-delimited ASCII files. There are 10,314 records in the files, each with ten fields. The field descriptions are: Field Name Field Type Width ---------------------- ---------- ---------------------- HCPCS* Character 5 Modifier Character 2 Status Character 1 Description Character 80 Work RVUs Numeric 6 (2 decimal places) Practice Expense RVUs Numeric 6 (2 decimal places) Malpractice RVUs Numeric 6 (2 decimal places) Total RVUs Numeric 6 (2 decimal places) Global Period Character 3 Update Character 1 TOTAL 116 Characters *All numeric CPT HCPCS copyright 1994 American Medical Association The fields in these files are separated by commas. Data from all fields are enclosed in quotation marks and may contain commas. Unused spaces at the end of character fields are dropped. The first row of the file consists of the field names as provided above. A sample record in the comma delimited ASCII format appears below: "10040","","A","ACNE SURGERY","1.35","0.32","0.03","1.70"," 010"," S" In tabular form this record translates as follows: Field Name Field Type Content ---------------------- ---------- ------------ HCPCS* Character 10040 Modifier Character [blank] Status Character A Description Character ACNE SURGERY Work RVUs Numeric 1.35 Practice Expense RVUs Numeric 0.32 Malpractice RVUs Numeric 0.03 Total RVUs Numeric 1.70 Global Period Character 010 Update Character S *All numeric CPT HCPCS copyright 1994 American Medical Association The two comma delimited files for Addendum B are ADDENDAB.TX1 and ADDENDAB.TX2. The first file contains HCPCS from 10040 to 4999 and the second contains HCPCS 5010 to V5364. Both files are located on Disk 2. The file ADB_NOTE.TXT contains the header material, including the field names, for Addendum B. Addendum C, entitled CODES WITH INTERIM RVUs, is an ascii format file. Its structure is the same as Addendum B. That is; it is comma-delimited database of ten fields with the same field names, in the same order. The first row of the file consists of the field names as given above for Addendum B. The file ADC_NOTE.TXT contains the header material, including the field names, for Addendum C. Addenda D, E, F, and G are Lotus 1-2-3 format files. This information is being distributed on The Federal Bulletin Board to facilitate its use by the public. Both the Health Care Financing Administration and the Government Printing Office are interested in receiving comments on the utility of the material in its present machine readable form and suggestions for improvements if other FEDERAL REGISTER material is disseminated on electronic format in the future. Your comments can be addressed to: Office of Electronic Information Dissemination Services (EIDS) Mail Stop SDE U.S. Government Printing Office Washington, DC 20401 Telephone: (202) 512-1530 FAX: (202) 512-1262 help@eids05.eids.gpo.gov These files are also available as a set of three 3.5" HD diskettes for $20. To order, call (202) 512-1530 or fax (202) 512-1262 or write: Superintendent of Documents, Attn: Electronic Products Coordinator, PO Box 37082, Washington, DC 20013-7082. To order the printed version for $8, call (202) 512-1800 or fax (202) 512-2250 or write: Superintendent of Documents, PO Box 371954, Pittsburgh, PA 15250-7954. (Paper edition: GPO Stock Number 069-001-00081-5)