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42 C.F.R. § 414.24   Review, revision, and addition of RVUs for physician services.

Title 42 - Public Health

Title 42: Public Health
PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES
Subpart B—Physicians and Other Practitioners

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§ 414.24   Review, revision, and addition of RVUs for physician services.

(a) Interim values for new and revised HCPCS level 1 and level 2 codes. (1) CMS establishes interim RVUs for new services and for codes for which definitions have changed.

(2) CMS publishes a notice in the Federal Register to announce interim RVUs and seek public comment on them. The RVUs are effective prospectively for services furnished beginning on the effective date specified in the notice.

(3) After considering public comments, CMS revises, if necessary, the interim RVUs and announces those revisions in a final notice published in the Federal Register. Any revisions in the RVUs are effective prospectively for services furnished beginning on the effective date specified in the final notice.

(b) Revision of RVUs for established HCPCS level 1 and level 2 codes. (1) CMS publishes a proposed notice in the Federal Register to announce changes in RVUs for established codes and provides an opportunity for public comment no less often than every 5 years.

(2) After considering public comments, CMS publishes a final notice in the Federal Register to announce revisions to RVUs.

(3) The RVU revisions are effective prospectively for services furnished beginning on the effective date specified in the final notice.

(c) Values for local codes (HCPCS Level 3). (1) Carriers establish relative values for local codes for services not included in HCPCS levels 1 or 2.

(2) Carriers must obtain prior approval from CMS to establish local codes for services that meet the definition of “physician services” in §414.2.

[56 FR 59624, Nov. 25, 1991, as amended at 57 FR 42492, Sept. 15, 1992]

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