Page:United States Statutes at Large Volume 103 Part 3.djvu/102

 103 STAT. 2170 PUBLIC LAW 101-239—DEC. 19, 1989 "(I) 67 percent of the fee schedule amount deter- mined under clause (i), adjusted by the update established under subsection (d)(3) for 1994, and "(11) 33 percent of the fee schedule amount deter- mined under paragraph (1) for 1994 without regard to this paragraph; and "(iii) during 1995, there shall be substituted for the fee schedule amount an amount equal to the sum of— "(I) 50 percent of the fee schedule amount deter- mined under clause (ii) adjusted by the update established under subsection (d)(3) for 1995, and "(II) 50 percent of the fee schedule amount deter- mined under paragraph (1) for 1995 without regard to this paragraph. " (C) SPECIAL RULE FOR ANESTHESIA SERVICES. —With respect to physicians' services which are anesthesia serv- ices, the Secretary shall provide for a transition in the same manner as a transition is provided for other services under subparagraph (B). " (D) ADJUSTED HISTORICAL PAYMENT BASIS DEFINED. — "(i) IN GENERAL.— In this paragraph, the term 'ad- justed historical payment basis' means, with respect to a physicians' service furnished in a fee schedule area, the weighted average prevailing charge applied in the area for the service in 1991 (as determined by the Secretary without regard to physician specialty and as adjusted to reflect pa3mients for services with cus- tomary charges below the prevailing charge or other payment limitations imposed by law or regulation) ad- justed by the update established under subsection (d)(3) for 1992. "(ii) APPLICATION TO RADIOLOGY SERVICES.— In apply- ing clause (i) in the case of physicians' services which are radiology services (including radiologist services, as defined in section 1834(b)(6)), there shall be substituted for the weighted average prevailing charge the amount provided under the fee schedule established for the service for the fee schedule area under section 1834(b). "(3) INCENTIVES FOR PARTICIPATING PHYSICIANS. — In applying paragraph (I)(B) in the case of a nonparticipating physician, the fee schedule amount shall be 95 percent of such amount other- wise applied under this subsection (without regard to this para- graph). Regulations. "(b) ESTABLISHMENT OF FEE SCHEDULES.— "(1) IN GENERAL.— Before Jtinuary 1 of each year beginning with 1992, the Secretary shall establish, by regulation, fee schedules that establish payment amounts for all physicians' services furnished in all fee schedule areas (as defined in subsec- tion (j)(2)) for the year. Except as provided in paragraph (2), each such payment amount for a service shall be equal to the product of— "(A) the relative value for the service (as determined in subsection (c)(2)), "(B) the conversion factor (established under subsection (d)) for the year, and "(C) the geographic adjustment factor (established under subsection (e)(2)) for the service for the fee schedule area.

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