Physician_Fee_Schedule_Rules / 2005_Physician_Fee_Schedule

Why This Topic Matters

It helps readers understand which Medicare payment and coverage rules were updated for 2005 and which service categories were affected. It also supports review of the fee schedule addenda framework used to interpret code-level payment information.

Article Sections

1. Part 403 — Special Programs and Projects

   Regulatory changes for religious nonmedical health care institutions and home services are described, including coverage, oversight, and payment-related provisions.

2. Part 405 — Federal Health Insurance for the Aged and Disabled

   This section addresses Medicare payment provisions related to noncovered devices, drugs and biologicals, preventive benefits, screening services, therapy, telehealth, deductible changes, and incentive payments.

3. Part 411 — Exclusions From Medicare and Limitations on Medicare Payment

   Updates are provided to exclusions and beneficiary notice-related rules that affect whether certain services are treated as covered or noncovered.

4. Part 414 — Payment for Part B Medical and Other Health Services

   This section covers physician fee schedule payment rules, telehealth payment, geographic incentive programs, and new subparts addressing drugs, biologicals, and dispensing-related fees.

5. Part 418 — Hospice Care

   Hospice-related evaluation, counseling, and payment provisions are added, including documentation and billing requirements.

6. Part 424 — Conditions for Medicare Payment

   Revisions address supplier payment, reassignment limits, contractual arrangements, and related Medicare enrollment concepts.

7. Part 484 — Home Health Services

   A terminology correction is made within the home health regulations.

8. Part 486 — Conditions for Coverage of Specialized Services Furnished by Suppliers

   A reserved subpart is removed from the regulations.

9. Addendum A — Explanation and Use of Addenda B

   The article explains how to interpret the physician fee schedule addenda and the type of information presented for services included in the payment files.

10. Addendum B — 2005 Relative Value Units and Related Information Used in Determining Medicare Payments for 2005

    This section outlines the structure of fee schedule code listings, modifiers, status indicators, RVUs, and global period information used for 2005 payment references.