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Codes for which there is a significant difference in payment for the same service between different sites of service

Moreover, if this policy were to be finalized, CMS would no longer determine or enforce the standard of RHCs being primarily engaged in furnishing primary care services. [808] which has been enforced via the sub-regulatory guidance contained in the State Operations Manual Appendix GGuidance for Surveyors: Rural Health Clinics (RHCs)

(e) Alternative Policy Considered: 340B Claims Identifier As described in section 40.2.7 of the initial Medicare Part D Drug Inflation Rebate Guidance, CMS considered requiring that a 340B indicator be included on the PDE record at the time of dispense to identify drugs purchased under the 340B Program that were dispensed under Medicare Part D

The study goes on to state, as CT image quality has improved, there has been an increase in the frequency of detecting `incidental findings,' defined as findings that are unrelated to the clinical indication for the imaging examination performed

and (G) The difference between the total rebate amount due as specified on the Rebate Report set forth in paragraph (c) of this section and the reconciled rebate amount as set forth in this paragraph (d)(1)(i)