April 2007 Medicare Bulletin - Tennessee 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
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 - Tennessee
| CPT Code |
PAR |
NON-PAR |
Limiting Charge |
| 36478 |
1,630.21 |
1,548.70 |
1,781.01 |
| 37210 |
3,042.29 |
2,890.18 |
3,323.71 |
| 93225 |
39.94 |
37.94 |
43.63 |
| 93226 |
67.73 |
64.34 |
73.99 |
| 93231 |
46.66 |
44.33 |
50.98 |
| 93232 |
68.83 |
65.39 |
75.20 |
| #95991 |
33.24 |
31.58 |
36.32 |
# 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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Correction to 2007 Tennessee Fees for HCPCS Codes Newly Classified as Carrier Priced
Correction to 2007 Tennessee Fees for HCPCS Codes Newly Classified as Carrier Priced
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Tennessee Mental Health Professional Shortage Areas (HPSAs)
Designated Geographic Areas
| COUNTY |
AREA NAME/PARTS |
RURAL/URBAN |
| Bedford |
MHCA 19
|
Rural |
| Benton |
MHCA 21
|
Rural |
| Bledsoe |
MHCA 12
|
Rural |
| Bradley |
MHCA 10
|
Rural |
| Cannon |
MHCA 9
|
Rural |
| Carroll |
MHCA 21
|
Rural |
| Cheatham |
Catchment Area 14
|
Rural |
| Chester |
MHCA 24
|
Rural |
| Claiborne |
MHCA 5
|
Rural |
| Clay |
MHCA 9
|
Rural |
Cocke |
MHCA 5
|
Rural |
| Coffee |
MHCA 19
|
Rural |
| Crockett |
Catchment Area 22
|
Rural |
| Cumberland |
MHCA 9
|
Rural |
| Decatur |
MHCA 24
|
Rural |
| Dekalb |
MHCA 9
|
Rural |
| Dickson |
Catchment Area 14
|
Rural |
| Dyer |
Catchment Area 22
|
Rural |
| Fayette |
MHCA 25
|
Rural |
| Fentress |
MHCA 9
|
Rural |
| Franklin |
MHCA 19
|
Rural |
| Gibson |
MHCA 21
|
Rural |
| Giles |
MHCA 20
|
Rural |
| Grainger |
MHCA 5
|
Rural |
| Greene |
MHCA 4
|
Rural |
| Grundy |
MHCA 12
|
Rural |
| Hamblen |
MHCA 5
|
Rural |
| Hancock |
MHCA 4
|
Rural |
| Hardeman |
MHCA 24
|
Rural |
| Hardin |
MHCA 24
|
Rural |
| Hawkins |
MHCA 4
|
Rural |
| Haywood |
Catchment Area 23
|
Urban |
| Henderson |
Catchment Area 23
|
Urban |
| Henry |
MHCA 21
|
Rural |
| Hickman |
MHCA 20
|
Rural |
| Houston |
Catchment Area 14
|
Rural |
| Humphreys |
Catchment Area 14
|
Rural |
| Jackson |
MHCA 9
|
Rural |
| Jefferson |
MHCA 5
|
Rural |
| Lake |
Catchment Area 22
|
Rural |
| Lauderdale |
MHCA 25
|
Rural |
| Lawerence |
MHCA 20
|
Rural |
| Lewis |
MHCA 20
|
Rural |
| Lincoln |
MHCA 19
|
Rural |
| McMinn |
MHCA 10
|
Rural |
| McNairy |
MHCA 24
|
Rural |
| Macon |
MHCA 9
|
Rural |
| Madison |
Catchment Area 23
|
Urban |
| Marion |
MHCA 12
|
Rural |
| Marshall |
MHCA 20
|
Rural |
| Maury |
MHCA 20
|
Rural |
| Meigs |
MHCA 10
|
Rural |
| Montgomery |
Catchment Area 14
|
Rural |
| Moore |
MHCA 19
|
Rural |
| Obion |
Catchment Area 22
|
Rural |
| Overton |
MHCA 9
|
Rural |
| Perry |
MHCA 20
|
Rural |
| Pickett |
MHCA 9
|
Rural |
| Polk |
MHCA 10
|
Rural |
| Putman |
MHCA 9
|
Rural |
| Rhea |
MHCA 12
|
Rural |
| Robertson |
Catchment Area 14
|
Rural |
| Sequatchie |
MHCA#12
|
Rural |
| Smith |
MHCA 9
|
Rural |
| Stewart |
Catchment Area 14
|
Rural |
| Sumner |
MHCA 31
|
Urban |
| Tipton |
MHCA 25
|
Rural |
| Trousdale |
MHCA 31
|
Urban |
| Union |
MHCA 5
|
Rural |
| Van Buren |
MHCA 9
|
Rural |
| Warren |
MHCA 9
|
Rural |
| Wayne |
MHCA 20
|
Rural |
| Weakley |
Catchment Area 22
|
Rural |
| White |
MHCA 9
|
Rural |
| Wilson |
MHCA 31
|
Urban |
|
Top
Tennessee Health Professional Shortage Areas (HPSAs)
Designated Geographic Areas
| COUNTY |
AREA NAME/PARTS |
RURAL/URBAN |
| Anderson |
Briceville - Lake City
- Lake City West City Division
- New River City Division
- Lake City East City Division
|
Urban |
| Bledsoe |
Dayton/Pikeville/Decataur/Bledsoe |
Rural |
| Cheatham |
All |
Rural |
| Chester3 |
All |
Rural |
| Claiborne1 |
All |
Rural |
| Crockett |
All |
Rural |
| Decatur |
All |
Rural |
| Dickson |
Vanleer/Shiloh
|
Urban |
| Fayette |
All |
Urban |
| Fentress7 |
All |
Rural |
| Giles4 |
All |
Rural |
Grainger2 |
All |
Urban |
| Greene |
Baileyton
- Baileyton CCD
- Jearoldstown Division
|
Rural |
| Grundy |
All |
Rural |
| Hamilton |
Middle Valley
- Soddy Daisy Division
- Middle Valley Division
- Sale Creek Division
|
Urban |
| Hancock |
All |
Rural |
| Hardeman |
All |
Rural |
| Hawkins |
All |
Urban |
| Haywood |
All |
Rural |
| Henderson10 |
All |
Rural |
| Hickman |
All |
Rural |
| Houston7 |
All |
Rural |
| Jackson |
All |
Rural |
| Johnson |
All |
Rural |
| Knox |
Mechanicsville -
- Census Tracts 1, 2, 3, 4, 5, 6, 7, 11, 12, 13, 14, 20, 28
|
Urban |
| Lake2 |
All |
Rural |
| Lauderdale |
All |
Rural |
| Lewis 6 |
All |
Rural |
| Lincoln3 |
Cash Point - Blanche
|
Rural |
| Macon5 |
All |
Rural |
| Madison |
East Jackson -
|
Rural |
| Marshall 10 |
All |
Rural |
| Maury |
Fairview/Boston/Santa Fe/Santa Fe Division |
Rural |
| Meigs |
Dayton/Pikeville/Decatur/Meigs
|
Rural |
| Montgomery |
Vanleer/Shiloh
|
Urban |
| Moore |
All |
Rural |
| Morgan |
All |
Rural |
| Obion |
Hornbeak/Samburg
- Hornbeak/Samburg CCD
- Dixie Division
- Elbridge-Cloverdale Division
|
Rural |
| Perry |
All |
Rural |
| Pickett |
All |
Rural |
| Polk1 |
Benton/Parkville
- Benton Division
- Parkville Division
|
Rural |
| Rhea |
Dayton/Pikeville/Decatur/Rhea |
Rural |
| Rutherford |
Eagleville
- Eagleville CCD
- Bethesda/Eagleville
|
Urban |
| Stewart 7 |
All |
Rural |
| Unicoi |
All |
Urban |
| Union |
All |
Urban |
| Van Buren |
All |
Rural |
| Williamson |
Bethesda/Eagleville
- Bethesda Division/Fairview/Boston/Santa Fe/Fairview Division /Boston Division
|
Rural |
|
1 Classified as a HPSA, effective March 1, 2002.
2 No longer classified as a HPSA, effective March 1, 2002.
3 Classified as a HPSA, effective June 1, 2002.
4 Classified as a HPSA, effective February 1, 2004.
5
No longer classified as a HPSA, effective February 1, 2005
6Classified as a HPSA, effective September 12, 2006
7Classified as a HPSA, Effective August 8, 2006
8 No longer classified as a HPSA. effective August 8, 2006
9No longer classified as a HPSA. effective October 2, 2006
10 Classified as a HPSA, effective October 2, 2006