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

 PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2171 "(2) TREATMENT OF RADIOLOGY SERVICES AND ANESTHESIA SERV- ICES.— "(A) RADIOLOGY SERVICES. —With respect to radiology services (including radiologist services, as defined in section 1834(b)(6)), the Secretary shall base the relative values on the relative value scale developed under section 18340i)XlXA), with appropriate modifications of the relative values to assure that the relative values established for radiology services which are similar or related to other physicians' services are consistent with the relative values established for those similar or related services. "(B) ANESTHESIA SERVICES. —In establishing the fee sched- ule for anesthesia services for which a relative value guide has been established under section 4048(b) of the Omnibus Budget Reconciliation Act of 1987, the Secretary shall use, to the extent practicable, such relative value guide, with appropriate adjustment of the conversion factor, in a manner to assure that the fee schedule amounts for anesthesia services are consistent with the fee schedule amounts for other services determined by the Secretary to be of comparable value. In applying the previous sentence, the Secretary shall adjust the conversion factor by geo- graphic adjustment factors in the same manner as such adjustment is made under paragraph (I)(C). (C) CONSULTATION.—The Secretary shall consult with the Physician Payment Review Commission and organiza- tions representing physicians or suppliers who furnish radi- ology services and anesthesia services in applying subpara- graphs (A) and (B). "(c) DETERMINATION OF RELATIVE VALUES FOR PHYSICIANS* SERV- ICES.— "(1) DIVISION OF PHYSICIANS' SERVICES INTO COMPONENTS.—In this section, with respect to a physicians' service: "(A) WORK COMPONENT DEFINED. —The term 'work compo- nent' means the portion of the resources used in fumishing the service that reflects ph3rsician time and intensity in furnishing the service. Such portion shall— "(i) include activities before and after direct patient contact, and "(ii) be defined, with respect to surgical procedures, to reflect a global definition including pre-operative and postoperative physicians' services. "(B) Irenes EXPENSE COMPONENT DEFINED. —The term 'practice expense component' means the portion of the resources used in furnishing the service that reflects the general cat^ories of expenses (such as office rent and wages of personnel, but excluding malpractice expenses) comprising practice expenses. In this subparagraph, the term 'practice expenses includes all expenses for furnish- ing physicians' services, excluding malpractice expenses, physician compensation, and other physician fringe bene- fits. "(C) MALPRACTICE COMPONENT DEFINED.— The term 'mal- practice component' means the portion of the resources used in furnishing the service that reflects malpractice expenses in furnishing the service. "(2) DETERMINATION OF RELATIVE VALUES. —

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