CHAPTER IV--CENTERS FOR MEDICARE
& MEDICAID SERVICES,
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
PART 414--PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES
414.1
Basis and scope.
414.2
Definitions.
414.4
Fee schedule areas.
414.20
Formula for computing fee schedule amounts.
414.21
Medicare payment basis.
414.22
Relative value units (RVUs).
414.24
Review, revision, and addition of RVUs for physician services.
414.26
Determining the GAF.
414.28
Conversion factors.
414.30
Conversion factor update.
414.32
Determining payments for certain physicians' services furnished in facility settings.
414.34
Payment for services and supplies incident to a physician's service.
414.36
Payment for drugs incident to a physician's service.
414.38
Special rules for payment of low osmolar contrast media.
414.39
Special rules for payment of care plan oversight.
414.40
Coding and ancillary policies.
414.42
Adjustment for first 4 years of practice.
414.44
Transition rules.
414.46
Additional rules for payment of anesthesia services.
414.48
Limits on actual charges of nonparticipating suppliers.
414.50
Physician billing for purchased diagnostic tests.
414.52
Payment for physician assistants' services.
414.54
Payment for certified nurse-midwives' services.
414.56
Payment for nurse practitioners' and clinical nurse specialists' services.
414.58
Payment of charges for physician services to patients in providers.
414.60
Payment for the services of CRNAs.
414.62
Fee schedule for clinical psychologist services.
414.63
Payment for outpatient diabetes self-management training.
414.64
Payment for medical nutrition therapy.
414.65
Payment for office or other outpatient visits, consultation, individual psychotherapy, and pharmacologic management via interactive telecommunications systems.
414.100
Purpose.
414.102
General payment rules.
414.104
PEN Items and Services.
414.200
Purpose.
414.202
Definitions.
414.210
General payment rules.
414.220
Inexpensive or routinely purchased items.
414.222
Items requiring frequent and substantial servicing.
414.224
Customized items.
414.226
Oxygen and oxygen equipment.
414.228
Prosthetic and orthotic devices.
414.229
Other durable medical equipment--capped rental items.
414.230
Determining a period of continuous use.
414.232
Special payment rules for transcutaneous electrical nerve stimulators (TENS).
414.300
Scope of subpart.
414.310
Determination of reasonable charges for physician services furnished to renal dialysis patients.
414.313
Initial method of payment.
414.314
Monthly capitation payment method.
414.316
Payment for physician services to patients in training for self-dialysis and home dialysis.
414.320
Determination of reasonable charges for physician renal transplantation services.
414.330
Payment for home dialysis equipment, supplies, and support services.
414.335
Payment for EPO furnished to a home dialysis patient for use in the home.