Furnishing Other Fee Schedule, Prevailing Charge, and Conversion Factor

30.3.3 - Furnishing Other Fee Schedule, Prevailing Charge, and Conversion Factor Data (Rev. 1, 10-01-03) B3-4620.3 A/B MACs (B) use the file format in §30.3.5 to furnish fee schedule (Excluding Physician Fee Schedule), prevailing charge, and conversion factor information to Palmetto GBA (S MAC for RRB), A/B MACs (A) or (HHH), State Agencies, Indian Health Services, and United Mine Workers. A/B MACs (B) furnish statewide (or A/B MAC (B)-wide for areas less than an entire State) pricing data for certified registered nurse anesthetist conversion factors. Furnish all fee schedules and conversion factors on tape unless the receiving entity agrees that a paper listing is acceptable. Clinical Lab pricing files subject to national limitation amounts and DMEPOS pricing files subject to national floor and ceiling limitation amounts will be furnished by CMS to all entities except the State Medicaid Agencies. The Center for Medicaid and State Operations will provide those pricing files to the State Medicaid Agencies. In addition to the above pricing files, A/B MACs (B) furnish Palmetto GBA (the S MAC for RRB) with a tape file of locality prevailing charges for ambulance services and inflation indexed prevailing charges for non-physician services subject to the IIC. Send pricing files for the RRB S MAC to: Medicare Systems RRB - AG-430 Palmetto GBA Building One 2300 Springdale Drive Camden, SC 29020 For Indian Health Services, send pricing files to: IHS Contract Health Services 12800 Indian School Road North East Albuquerque, NM 87112 For releasing nonphysician pricing files to State Agencies, contact the RO to obtain the name and mailing address of the individual to whom the file should be addressed. For the United Mine Workers, send the pricing files to: Government Programs Manager UMWA Health and Retirement Funds 2121 K Street, NW Washington, DC 20037, or MedPricing@umwafunds.org You may negotiate agreements with the receiving entity to use an alternate medium (e.g., paper, diskette) or a tape file format other than that specified in §30.3.5. However, such agreements must be in writing and signed by the affected entities (e.g., A/B MAC (A), (B), (HHH), or DME MAC, RRB S MAC, UMWA, etc.). Furnish your RO with a copy of written agreements for using mediums other than tape or tape file formats other than that in §30.3.5.