Medicare program; limitations on reimbursement of nonphysician medical services--HCFA. Final rule

We are amending the regulations that govern the determination of reasonable charges for certain nonphysician medical services under the Medicare Supplementary Medical Insurance Program (Part B). An additional charge factor is added to those currently taken into consideration by carriers in determining reasonable charges for nonphysician services, supplies and equipment that are reimbursed on a reasonable charge basis. This new factor, the "inflation-indexed charge," represents the lowest of the fee screens from the preceding fee screen year as updated by an inflation adjustment factor. For fee screen years beginning on or after October 1, 1986, the inflation adjustment factor to be used in determining the inflation-indexed charge is the annual change in the level of the consumer price index for urban consumers for the 12-month period ending on March 31 of each year. For services, supplies, and equipment furnished during Federal fiscal year (FY) 1986 only, the inflation adjustment factor is zero, which results in the lowest of the FY 1986 fee screens for nonphysician medical services and items being effectively capped at FY 1985 levels.