Billing Requirements for Physician Services Rendered in Method II Critical Access Hospitals (CAHs)
This transmittal: 1) Establishes a mechanism that will
prevent the overpayment of physician services rendered in a Method II CAH; 2) Corrects
the type of bill (TOB) for CAH outpatient to 85x (the TOB was stated as 72x in Change
Request 3262, Transmittal 262, dated July 30, 2004); 3) Clarifies the non-applicability of
the payment window provisions; 4) Includes the new file layout for the 2005, Physician
Fee Schedule Supplemental file; and 5) Establishes a mechanism for a CAH, using the
Method II payment methodology, with off-site outpatient departments/clinics to receive
HPSA/PSA bonus payments if applicable.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 22, 2005
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