2010 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments
MLN Matters® Number: MM6581
Related Change Request (CR) #: 6581
Related CR Release Date: August 7, 2009
Effective Date: January 1, 2010
Related CR Transmittal #: R1789CP
Implementation Date: January 4, 2010
Provider Types Affected
Physicians and other providers who bill Palmetto GBA for services provided to Medicare beneficiaries in HPSAs.
What You Need to Know
Change Request (CR) 6581, from which this article is taken, alerts providers that the 2010 file will be posted to the Centers for Medicare & Medicaid Services (CMS) Web site.
Background
The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) (Section 413(b)) mandated that the automated HPSA bonus payment files be updated annually. CMS will create a new automated HPSA bonus payment file
for claims with dates of service on or after January 1, 2010, through December 31, 2010, and post it to the Web site in early December of 2009.
You will find the annual HPSA bonus payment file and other important HPSA information at www.cms.hhs.gov/hpsapsaphysicianbonuses/. You should also review the CMS Web site to determine whether a
HPSA bonus will automatically be paid for services provided in your ZIP code area or whether a modifier must be submitted. You can determine if you are eligible for the automated payment by going to
www.cms.hhs.gov/HPSAPSAPhysicianBonuses/Downloads/instructions.pdf (PDF, 35 KB).
Additional Information
The official instruction (CR 6581) issued to Palmetto GBA may be found at www.cms.hhs.gov/Transmittals/downloads/R1789CP.pdf (PDF, 117 KB).
If you have questions, please contact our Provider Contact Center at our toll-free number (866) 332-7025 (Ohio and West Virginia) or (888) 828-2092 (South Carolina Part B).
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents. CPT only copyright 2008 American Medical Association.