Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.5.4
Payment
90.5.4 - Payment
(Rev. 280, Issued 08-13-04, Effective/Implementation: October 1, 2004 for the
analysis and design phases for the MCS Maintainer and A/B MACs (B)
January 1, 2005 for the coding, testing, and implementation phases for the MCS
Maintainer and A/B MACs (B)
January 1, 2005 for all phases for the VIPS Maintainers and A/B MACs (B))
Section 413a of the MMA adds subsection (u)(6) to Section 1833 of the Social Security
Act. For the payment of the physician scarcity bonus, this section defines physicians as
doctors of medicine or osteopathy described per Section 1861(r)(1). Therefore, dentists,
chiropractors, podiatrists, and optometrists are not eligible for the physician scarcity
bonus as either primary care or specialty physicians
Only the provider specialty designations of General Practice - 01, Family Practice - 08,
Internal Medicine - 11, and Obstetrics/Gynecology - 16, will be paid the bonus for the zip
codes designated as primary care PSAs. All other physician provider specialties will be
eligible for the specialty physician scarcity bonus for the zip codes designated as
specialty PSAs.
The bonus is to be paid based on date of service. Accommodations must be made in
payment systems to maintain an active file for a current period as well as an active file
for a previous period so that the bonus can be paid based on date of service. Also, the
A/B MACs (B) and standard systems maintainers shall program systems to be able to
maintain files for the periods prior to the two active periods as an archive for reference
purposes.