2007-04 ID Insert

April 2007Medicare Bulletin - Idaho Insert

Posted April 6, 2007

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Changes Included in Change Request (CR) 5528 for the April Update to the 2007 Medicare Physician Fee Schedule Database
Corrections to 2007 Idaho Fees for HCPCS Codes Newly Classified as Carrier Priced
Idaho Health Professional Shortage Areas (HPSAs)
Idaho Mental Health Professional Shortage Areas

Changes Included in Change Request (CR) 5528 for the April Update to the 2007 Medicare Physician Fee Schedule Database

Based on changes to the Transitional Non-Facility and/or Transitional Facility Practice Expense Relative Value Units, the fees for the following list of CPT codes will be updated. In addition, the Multiple Procedure Indicator for CPT codes 17311 and 17313 will be changed from “Standard payment adjustment rules for multiple procedures apply” to “No payment adjustment rules for multiple procedures apply.” These changes will be implemented April 2, 2007 for dates of service on or after January 1, 2007.

April 2007 MPFSDB Updated Fees – Idaho

CPT Code	PAR	NON-PAR	Limiting Charge
36478	1,608.87	1,528.43	1,757.69
37210	3,002.12	2,852.01	3,279.81
93225	38.91	36.96	42.50
93226	65.96	62.66	72.06
93231	45.36	43.09	49.55
93232	67.10	63.75	73.31
# 95991	32.78	31.14	35.81

# These amounts apply when service is performed in a facility setting.
Limiting charge applies to unassigned claims by non-participating providers.
© All Current Procedural Terminology (CPT) codes and descriptors are copyrighted by the American Medical Association

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Corrections to 2007 Idaho Fees for HCPCS Codes Newly Classified as Carrier Priced

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Mental Health Professional Shortage Areas

Designated Geographic Areas

Effective July 1, 2004

Idaho

County	Area Name/Parts	Rural/Urban
Ada	Mental Hlth Region IV Ada	Rural
Adams	Catchment Area # 3 Adams	Rural
Bannock	Mental Hlth Region VI Bannock	Rural
Bear Lake	Mental Hlth Region VI Bear Lake	Rural
Benewah	Mental Hlth Region I Benewah	Urban
Bingham	Mental Hlth Region VI Bingham	Rural
Blaine	Mental Hlth Region V Blaine	Rural
Boise	Mental Hlth Region IV Boise	Rural
Bonner	Mental Hlth Region I Bonner	Urban
Bonneville	Mental Hlth Region VII Bonneville	Rural
Boundary	Mental Hlth Region I Boundary	Urban
Butte	Mental Hlth Region VII Butte	Rural
Camas	Mental Hlth Region V Camas	Rural
Canyon	Catchment Area # 3 Canyon	Rural
Caribou	Mental Hlth Region VI Caribou	Rural
Cassia	Mental Hlth Region V Cassia	Rural
Clark	Mental Hlth Region VII Clark	Rural
Clearwater	Mental Hlth Region II Clearwater	Rural
Custer	Mental Hlth Region VII Custer	Rural
Elmore	Mental Hlth Region IV Elmore	Rural
Franklin	Mental Hlth Region VI Franklin	Rural
Fremont	Mental Hlth Region VII Fremont	Rural
Gem	Catchment Area # 3 Gem	Rural
Gooding	Mental Hlth Region V Gooding	Rural
Idaho	Mental Hlth Region II Idaho	Rural
Jefferson	Mental Hlth Region VII Jefferson	Rural
Jerome	Mental Hlth Region V Jerome	Rural
Kootenai	Mental Hlth Region I Kootenai	Urban
Latah	Mental Hlth Region II Latah	Rural
Lemhi	Mental Hlth Region VII Lemhi	Rural
Lewis	Mental Hlth Region II Lewis	Rural
Lincoln	Mental Hlth Region V Lincoln	Rural
Madison	Mental Hlth Region VII Madison	Rural
Minidoka	Mental Hlth Region V Minidoka	Rural
Nez Perce	Mental Hlth Region II Nez Perce	Rural
Oneida	Mental Hlth REgion VI Oneida	Rural
Owyhee	Catchment Area #3 Owyhee	Rural
Payette	Catchment Area # 3 Payette	Rural
Power	Mental Hlth Region VI Power	Rural
Shoshone	Mental Hlth Region I Shoshone	Urban
Teton	Mental Hlth Region VII Teton	Rural
Twin Falls	Mental Hlth Region V Twin Falls	Rural
Valley	Mental Hlth Region IV Valley	Rural
Washington	Catchment Area # 3 Washington	Rural

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Idaho Health Professional Shortage Areas (HPSAs)

Designated Geographic Areas

COUNTY	AREA NAME/PARTS
Adams	All
Bannock	South Bannock Division South Bannock Division
Bear Lake	Caribou/Georgetown Georgetown Division
Blaine	Carey Carey (CCD)
Boise	All
Bonner²	Priest River Blanchard-Glengary (CCD) Priest River (CCD)
Bonneville	Swan Valley Division SA Swan Valley Division
Boundary	All
Camas	All
Caribou¹	Caribou/Georgetown SA Caribou

Clark	All
Clearwater	Clearwater SA C.T. 9701.00 Elk River Elk River Division
Custer⁵	All
Elmore	All
Franklin	All
Fremont	All
Idaho	Riggins SA Riggins Division Elk City SA Elk City Division
Jefferson¹	C.T. 9601.00
Jerome	All

Lemhi³	All
Lewis⁴	Winchester /Nez Perce/Craigmont Lewis CT 9502.00 CT 9503.00
Lincoln	All
Owyhee	All
Payette	All
Teton	All
Washington⁶	All

¹ Classified as HPSA, effective 5/1/04
² No longer classified as a HPSA, effective April 12, 2005
³ No longer classified as a HPSA, effective January 7, 2004
⁴ Classified as a HPSA, effective September 8, 2005
⁵ Classified as a HPSA, effective November 18, 2005
⁶ No longer classified as a HPSA, effective July 5, 2006

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