Search Frequenty Asked Questions

Highlights

• Instructions on using the HPSA/PSA Specialty page

• View the related Medlearn Matters Article:   Physician Education for the Revisions to the Health Professional Shortage Area (HPSA) Bonus Payment Processes and Implementation of the Physician Scarcity Area (PSA) Bonus Payments

Stay Informed - Go to CMS Mailing Lists to join a provider specific listserv (or electronic mailing list service) to receive news from CMS.

Medicare Prescription Drug, Improvement and Modernization Act of 2003

Overview of Section 413 (a) and (b) of Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA)

• Medicare Modernization Act
• Medicare Modernization Update

FAQs for Providers

Frequently Used Terms (Coming Soon)

Health Professional Shortage Area Designations

Listings of zip codes eligible for automated payment of the HPSA bonus

2005 Primary Care HPSA (zip 70Kb)

• Physicians providing services in a primary medical care HPSA. Eligible physicians include: general practitioners, family practice practitioners, general internists, obstetricians/gynecologists, and psychiatrists.

2005 Mental Health, HPSA (zip 88Kb

• Psychiatrists providing services in a mental health HPSA that does not overlap a primary care HPSA.

Do I need to use the "QU/QB" Modifier?
Areas eligible for payment via the QU/QB modifier must be verified using your local Carrier Web Sites (pdf 33Kb).

Physician Scarcity Area Designations

Listings of zip codes eligible for automated payment of the PSA bonus

• PSA bonuses payable for primary care physicians. Eligible physicians include: general practice, family practice, internal medicine, and obstetrics/gynecology.

• PSA bonuses payable for specialty physicians. Eligible physicians include all physicians other than general practice, family practice, internal medicine, and obstetrics/gynecology.

Do I need to use the "AR" Modifier?
Check the automated pay zip code lists under under Primary Care or Speciality links first. If your zip code is on either list, you do not have to use the "AR" modifier.

*Note -- The following listings contain all Primary Care and Speciality PSA designated counties. If the zip code where you rendered services is not included on the PSA automated pay zip code file, but is in a county on the following list you may use the modifier to claim the PSA bonus payment.

Primary Care PSA Counties (zip 22Kb)

Speciality PSA Counties (zip 28Kb)

Critical Access Hospitals

Critical Access Hospitals

Medlearn Matters Article SE0453: MMA-Proposed Implementation of the Physician Scarcity Bonus and Revision to the Health Professional Shortage Area (HPSA)

HPSA/PSA Regulatory Issues/Regulation

Quarterly Provider Update

• Physician Regulations Published This Quarter
• CMS-1429-P (pdf 56Kb): Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005

CMS Manuals and Transmittals

Medicare Claims Processing Manual: Physician/NonPhysician Practioners Chapter 12 - Section 90.4 - 90.5.7(Coming Soon)

Determine your Census Tract

www.ffiec.gov/geocode/default.htm

www.Census.gov