============================================================================= Run Date: JUN 13, 2013 Designation: FB*3.5*145 Package : FB - FEE BASIS Priority: Mandatory Version : 3.5 SEQ #120 Status: Released Compliance Date: JUL 13, 2013 ============================================================================= Associated patches: (v)FB*3.5*118 <<= must be installed BEFORE `FB*3.5*145' (v)FB*3.5*120 <<= must be installed BEFORE `FB*3.5*145' Subject: UPDATE RBRVS FOR CY2013 AND MENTAL HEALTH PAYMENTS FOR CY2012 Category: - Routine - Other Description: ============ This patch addresses the following two issues: 1. Updates the Resource Based Relative Value Scale (RBRVS) Fee Schedule with changes for Calendar Year (CY) 2013. 2. Stops the payout of Mental Health Services at 105% after March 1st, 2012 as per the Middle Class Tax Relief and Job Creation Act of 2012. ASSOCIATED REMEDY TICKETS: ========================== 1. INC0000000779603 - Update RBRVS for CY2013 2. INC0000000616041 - Update Mental Health Payments for CY2012 ASSOCIATED NSR(S): ================== N/A PARTICIPATING TEST SITES: ========================= Martinsburg VAMC Upstate New York HCS San Juan VAMC REMEDY OVERVIEW: ================ 1. INC0000000779603 - Update RBRVS for CY2013 Problem: -------- The RBRVS Fee Schedule needs to be updated for the Calendar Year 2013. Resolution: ----------- This patch includes the data needed to calculate fee schedule amounts based on the RBRVS (also referred to as Medicare Physician Fee Schedule) for calendar year 2013. The RBRVS fee schedule for future calendar years will be issued by a patch as they become available. The RBRVS fee schedule data is contained in four existing files. These files are all stored in global "^FB". The four files are: FEE BASIS GEOGRAPHIC INDEX (#162.96) FILE FEE BASIS CPT RVU (#162.97) FILE FEE BASIS MODIFIER TABLE INDEX (#162.98) FILE FEE BASIS HCFA CONVERSION (#162.99) FILE The additional data added by this patch will increase the size of the FB global by approximately 5 MB. Installation of this patch will affect the menu options used to enter or edit payments for the Medical Fee program (Outpatient) and Ancillary Payments for the Civil Hospital program. The calendar year 2013 RBRVS fee schedule will be used for payments that have a date of service on or after January 1, 2013. The RBRVS fee schedules for calendar years beginning 1999 through 2012 will be retained in the VISTA database and will continue to be used for payments that have a date of service on or after September 1, 1999 and before January 1, 2013 . The 2002 RBRVS fee schedule will be used for any payments entered prior to the installation of this patch that had a date of service on or before March 1, 2003. Existing payments are NOT modified by this patch. The fee schedule amount is only calculated when payments are entered or edited. The PLACE OF SERVICE (POS) code is used to determine if the facility or non-facility practice expense Relative Value Unit (RVU) should be used during RBRVS fee schedule calculations. The list of codes considered facility and non-facility has not changed since 2011. Here are the valid POS codes that are in effect. Codes considered as facility setting - 05,06,07,08,21,22,23,24,26,31,34,41,42,51,52,53,56,61 Codes considered as non-facility setting - 01,03,04,09,11,12,13,14,15,16,17,20,25,32,33,49,50,54, 55,57,60,62,65,71,72,81,99 The following five options are used to enter or edit payments for the Medical Fee (outpatient) program: Enter Payment [FBAA ENTER PAYMENT] Multiple Payment Entry [FBAA MULTIPLE PAYMENT ENTRY] C&P/Multiple Patient Payment Entry [FBAA C&P ENTER PAYMENT] Reimbursement Payment Entry [FBAA MEDICAL REIMBURSEMENT] Edit Payment [FBAA EDIT PAYMENT] The following four options are used to enter or edit ancillary payments for the Civil Hospital program: Ancillary Contract Hosp/CNH Payment [FBCH ANCILLARY PAYMENT] Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] Patient Reimbursement for Ancillary [FBCH ANCILLARY REIMBURSEMENT] Services Edit Ancillary Payment [FBCH EDIT ANCILLARY PAYMENT] The following option is used to calculate a fee schedule amount without having to enter a payment: Calculate Payment Amount [FBAA FEE SCHEDULE RATE] 2. INC0000000616041 - Update Mental Health Payments for CY2012 Problem: -------- As of March 1st, 2012 under the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA), the 5% increase in Mental Health Payments ended, but VistA is still adding this increase. Resolution: ----------- For payments after March 1st, 2012, VistA will not add the 5% increase. Components: ----------- UP SEND DATA USER DATE SEC. COMES SITE RSLV OVER FILE # FILE NAME DD CODE W/FILE DATA PTRS RIDE ------------------------------------------------------------------------------- 162.96 FEE BASIS GEOGRAPHIC INDEX NO YES YES OVER NO NO 162.97 FEE BASIS CPT RVU NO YES YES OVER NO NO 162.98 FEE BASIS MODIFIER TABLE INDEX NO YES YES OVER NO NO 162.99 FEE BASIS HCFA CONVERSION NO YES YES OVER NO NO INSTALLATION INSTRUCTIONS: ========================== This patch may be installed during normal working hours with all users on the system. However, as it is necessary to disable some menu options when installing this patch it is recommended that the install be done during non-peak hours. Additionally, installing during peak hours may lead to an unusually long install time. ************************************************************************* * Install Time * * During testing, one site installed in less than 20 minutes while * * another site took over 2 hours. A production install of a previous * * RBRVS update took slightly over 10 hours. * * * * Installation time will vary. * ************************************************************************* Post-install routine, FBXIP145 can be deleted after the patch has been installed. 1. Retrieve the KIDS distribution host file. This patch will be distributed in a host file due to the amount of data contained in the patch. The name of the host file is: FEE3_5P145.KID Sites can retrieve VistA software from the following FTP addresses. The preferred method is to FTP the files from: download.vista.med.va.gov This will transmit the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The FEE3_5P145.KID host file is located in the anonymous.software directory. Use ASCII Mode when downloading the file. 2. Load the KIDS distribution that is contained in file FEE3_5P145.KID using the Load a Distribution option on the Installation menu. 3. Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... 4. From this menu, you may elect to use the following options (When prompted for the INSTALL NAME, enter FB*3.5*145): a. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as DD's or templates. b. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all components of this patch (routines, DD's, templates, etc.). c. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 5. Use the Install Package(s) option and select the package FB*3.5*145. a. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer NO. b. When prompted 'Want to DISABLE Scheduled Options and Menu Options and Protocols? YES//', answer YES. When prompted, 'Enter options you wish to mark as 'Out Of Order':', enter: Enter Payment [FBAA ENTER PAYMENT] Multiple Payment Entry [FBAA MULTIPLE PAYMENT ENTRY] C&P/Multiple Patient Payment Entry [FBAA C&P ENTER PAYMENT] Reimbursement Payment Entry [FBAA MEDICAL REIMBURSEMENT] Edit Payment [FBAA EDIT PAYMENT] Ancillary Contract Hosp/CNH Payment [FBCH ANCILLARY PAYMENT] Multiple Ancillary Payments [FBCH MULTIPLE PAYMENTS] Patient Reimbursement for Ancillary [FBCH ANCILLARY REIMBURSEMENT] Services Edit Ancillary Payment [FBCH EDIT ANCILLARY PAYMENT] Calculate Payment Amount [FBAA FEE SCHEDULE RATE] When prompted, 'Enter protocols you wish to mark as 'Out of Order':', enter: 6. Post-install routine FBXIP145 can be deleted after the patch is installed. Routine Information: ==================== The second line of each of these routines now looks like: ;;3.5;FEE BASIS;**[Patch List]**;JAN 30, 1995;Build 10 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: FBAAFSR Before: B45891635 After: B46637929 **4,53,71,84,92,93,99,102,105, 109,110,112,118,145** Routine Name: FBXIP145 Before: n/a After: B2032115 **145** Routine list of preceding patches: 118 ============================================================================= User Information: Entered By : POTTER,DAVID Date Entered : NOV 20, 2012 Completed By: PODLEY,CHRIS Date Completed: JUN 04, 2013 Released By : CARP,CHERYL Date Released : JUN 13, 2013 ============================================================================= Packman Mail Message: ===================== No routines included