42 U.S.C. 1395w-4: Payment for physicians' services

2024

• Pub. L. 118–158 substituted "April 1, 2025" for "January 1, 2025". (American Relief Act, 2025) Law text · (e)
• Pub. L. 118–42, §303, substituted "January 1, 2025" for "March 9, 2024". (Consolidated Appropriations Act, 2024) Law text · (e)
• Pub. L. 118–35 substituted "March 9, 2024" for "January 20, 2024". (Further Additional Continuing Appropriations and Other Extensions Act, 2024) Law text · (e)
• Pub. L. 118–42, §304(b)(1), substituted "2026" for "2025" in introductory provisions. (Consolidated Appropriations Act, 2024) Law text · (q)
• Pub. L. 118–42, §304(b)(2), substituted "2027" for "2026" in introductory provisions. (Consolidated Appropriations Act, 2024) Law text · (q)
• Pub. L. 118–42, §305(2)(A), substituted "March 9, 2024" for "January 1, 2025". (Consolidated Appropriations Act, 2024) Law text · (t)
• Pub. L. 118–42, §305(1), (2)(B), (3), added subpar. (E). (Consolidated Appropriations Act, 2024) Law text · (t)

2023

• Pub. L. 118–22 substituted "January 20, 2024" for "January 1, 2024". (Further Continuing Appropriations and Other Extensions Act, 2024) Law text · (e)

2022

• Pub. L. 117–328, §4123(a)(1), added par. (12). (Consolidated Appropriations Act, 2023) Law text · (b)
• Pub. L. 117–328, §4112(1), substituted "2021, 2022, 2023, or 2024" for "2021 or 2022". (Consolidated Appropriations Act, 2023) Law text · (c)
• Pub. L. 117–328, §4123(a)(2), added subcl. (VI). (Consolidated Appropriations Act, 2023) Law text · (c)
• Pub. L. 117–328, §4111(b)(1), substituted "2025" for "2024" in introductory provisions. (Consolidated Appropriations Act, 2023) Law text · (q)
• Pub. L. 117–328, §4111(b)(2), substituted "2026" for "2025" in introductory provisions. (Consolidated Appropriations Act, 2023) Law text · (q)
• Pub. L. 117–328, §4112(2)(A), substituted "2021 through 2024" for "2021 and 2022" in heading. (Consolidated Appropriations Act, 2023) Law text · (t)
• Pub. L. 117–328, §4112(2)(B)(i), substituted "during 2021, 2022, 2023, and 2024" for "during 2021 and 2022" in introductory provisions. (Consolidated Appropriations Act, 2023) Law text · (t)
• Pub. L. 117–328, §4112(2)(B)(ii)–(iv), added subpars. (C) and (D). (Consolidated Appropriations Act, 2023) Law text · (t), (D)
• Pub. L. 117–328, §4112(2)(C), substituted "2021 through 2024" for "2021 and 2022" in heading and "for services furnished in 2021, 2022, 2023, or 2024" for "for services furnished in 2021 or 2022" and ", 2022, 2023, or 2024, respectively" for "or 2022, respectively" in text. (Consolidated Appropriations Act, 2023) Law text · (t)

2021

• Pub. L. 117–71, §3(a)(1), substituted "2021 or 2022" for "2021". (Protecting Medicare and American Farmers from Sequester Cuts Act) Law text · (c)
• Pub. L. 117–71, §3(a)(2)(A), substituted "2021 and 2022" for "2021" in heading. (Protecting Medicare and American Farmers from Sequester Cuts Act) Law text · (t)
• Pub. L. 117–71, §3(a)(2)(B), substituted "during 2021 and 2022" for "during 2021" and "payment amounts for—" and subpars. (A) and (B) for "payment amounts for such services furnished on or after January 1, 2021, and before January 1, 2022, by 3.75 percent." (Protecting Medicare and American Farmers from Sequester Cuts Act) Law text · (t)
• Pub. L. 117–71, §3(a)(2)(C), substituted "2021 and 2022" for "2021" in heading and, in text, inserted "for services furnished in 2021 or 2022" after "under this subsection" and "or 2022, respectively" before period at end. (Protecting Medicare and American Farmers from Sequester Cuts Act) Law text · (t)

2020

• Pub. L. 116–260, §101(b), added subcl. (V). (Consolidated Appropriations Act, 2021) Law text · (c)
• Pub. L. 116–260 substituted "January 1, 2024" for "December 19, 2020". (Consolidated Appropriations Act, 2021) Law text · (e)
• Pub. L. 116–215 substituted "December 19, 2020" for "December 12, 2020". (Further Continuing Appropriations Act, 2021, and Other Extensions Act) Law text · (e)
• Pub. L. 116–159 substituted "December 12, 2020" for "December 1, 2020". (Continuing Appropriations Act, 2021 and Other Extensions Act) Law text · (e)
• Pub. L. 116–136 substituted "December 1, 2020" for "May 23, 2020". (Coronavirus Aid, Relief, and Economic Security Act" or the "CARES Act) Law text · (e)
• Pub. L. 116–260, §114(b)(1), substituted "each of 2021 through 2024" for "2021 and 2022" in introductory provisions. (Consolidated Appropriations Act, 2021) Law text · (q)
• Pub. L. 116–260, §114(b)(2), substituted "2025" for "2023" in introductory provisions. (Consolidated Appropriations Act, 2021) Law text · (q)
• Pub. L. 116–260, §119(c), inserted at end "This subcategory shall include as an activity, for performance periods beginning on or after January 1, 2022, use of a real-time benefit tool as described in section 1395w–104(o) of this title. The Secretary may establish this a… (Consolidated Appropriations Act, 2021) Law text · (q)
• Pub. L. 116–260, §101(a), added subsec. (t). (Consolidated Appropriations Act, 2021) Law text · (t)

2019

• Pub. L. 116–94 substituted "May 23, 2020" for "January 1, 2020". (Further Consolidated Appropriations Act, 2020) Law text · (e)

2018

• Pub. L. 115–123, §51009(1), substituted "2017, 2018, and 2019" for "2017 and 2018". (Bipartisan Budget Act of 2018) Law text · (b)
• Pub. L. 115–123, §51009(2), substituted "2017, 2018, and 2019" for "2017 and 2018". (Bipartisan Budget Act of 2018) Law text · (c)
• Pub. L. 115–123, §53106, substituted "paragraph (1)(C)—" for "paragraph (1)(C) for the period beginning on July 1, 2015, and ending on December 31, 2015, shall be 0.5 percent." and added subpars. (A) and (B). (Bipartisan Budget Act of 2018) Law text · (d)
• Pub. L. 115–123, §50201, substituted "January 1, 2020" for "January 1, 2018". (Bipartisan Budget Act of 2018) Law text · (e)
• Pub. L. 115–123, §50413, struck out "by requiring more stringent measures of meaningful use selected under this paragraph" after "health care quality over time" in concluding provisions. (Bipartisan Budget Act of 2018) Law text · (o)
• Pub. L. 115–123, §51003(a)(1)(A)(i), substituted "covered professional services (as defined in subsection (k)(3)(A))" for "items and services". (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(A)(ii)(I), amended subcl. (I) generally. Prior to amendment, subcl. (I) read as follows: "The minimum number (as determined by the Secretary) of individuals enrolled under this part who are treated by the eligible professional for the performa… (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(A)(ii)(II), substituted "covered professional services (as defined in subsection (k)(3)(A))" for "items and services". (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(A)(ii)(III), amended subcl. (III) generally. Prior to amendment, subcl. (III) read as follows: "The minimum amount (as determined by the Secretary) of allowed charges billed by such professional under this part for such performance period." (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(B)(i), inserted "subject to clause (iii)," after "clauses (i) and (ii) of paragraph (2)(A),". (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(B)(ii), added cl. (iii). (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(C)(i), substituted "First 5 years" for "First 2 years" in heading and "each of the first through fifth years" for "the first and second years" in text. (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(C)(ii), substituted "5 years" for "2 years" in heading and "For each of the second, third, fourth, and fifth years for which the MIPS applies to payments, not less than 10 percent and not more than 30 percent of such score shall be based o… (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(D)(i), substituted "Subject to clauses (iii) and (iv), such performance threshold" for "Such performance threshold". (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(D)(ii), in introductory provisions, inserted "(beginning with 2019 and ending with 2024)" after "for each year of the MIPS" and "subject to clause (iii)," after "For each such year,". (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(D)(iii), substituted "5" for "2" in heading and "five years" for "two years" in introductory provisions. (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(D)(iv), added cl. (iv). (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(E), in introductory provisions, substituted "In the case of covered professional services (as defined in subsection (k)(3)(A))" for "In the case of items and services" and "under this part with respect to such covered professional services" for "unde… (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(1)(F), substituted "covered professional services (as defined in subsection (k)(3)(A))" for "items and services". (Bipartisan Budget Act of 2018) Law text · (q)
• Pub. L. 115–123, §51003(a)(2), added subpar. (I). (Bipartisan Budget Act of 2018) Law text · (r)
• Pub. L. 115–123, §51003(a)(3), which directed amendment of subpar. (B) by substituting "section 1395l(z)(3)(D)" for "section 1395l(z)(2)(C)", was executed by making the substitution for "Section 1395l(z)(2)(C)" to reflect the probable intent of Congress. (Bipartisan Budget Act of 2018) Law text · (s)

2016

• Pub. L. 114–255, §4002(b)(1)(A), inserted after first sentence "The Secretary shall exempt an eligible professional from the application of the payment adjustment under subparagraph (A) with respect to a year, subject to annual renewal, if the Secretary determines that compliance… (21st Century Cures Act) Law text · (a)
• Pub. L. 114–255, §16003, substituted "hospital-based and ambulatory surgical center-based eligible professionals" for "hospital-based eligible professionals" in heading, designated existing provisions as cl. (i), inserted cl. (i) heading, and added cls. (ii) to (iv). (21st Century Cures Act) Law text · (a)
• Pub. L. 114–255, §4002(b)(1)(B), inserted at end "The provisions of subparagraphs (B) and (D) of subsection (a)(7), shall apply to assessments of MIPS eligible professionals under subsection (q) with respect to the performance category described in subsection (q)(2)(A)(iv) in an … (21st Century Cures Act) Law text · (o)

2015

• Pub. L. 114–10, §101(b)(1)(A)(i), substituted "each of 2015 through 2018" for "2015 or any subsequent payment year". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (a)
• Pub. L. 114–10, §101(b)(1)(A)(ii), substituted "2018" for "each subsequent year". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (a)
• Pub. L. 114–10, §101(b)(1)(A)(iii), struck out "and subsequent years" after "for 2018" in heading and "and each subsequent year" after "For 2018" and ", but in no case shall the applicable percent be less than 95 percent" after "in the preceding year" in text. (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (a)
• Pub. L. 114–115, §4(a), inserted "(and, with respect to the payment adjustment under subparagraph (A) for 2017, for categories of eligible professionals, as established by the Secretary and posted on the Internet website of the Centers for Medicare & Medicaid Services prior to De… (Patient Access and Medicare Protection Act) Law text · (a)
• Pub. L. 114–10, §101(b)(2)(A)(i), substituted "each of 2015 through 2018" for "2015 or any subsequent year". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (a)
• Pub. L. 114–10, §101(b)(2)(A)(ii), substituted ", 2017, and 2018" for "and each subsequent year". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (a)
• Pub. L. 114–10, §523(b), added par. (9). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (a)
• Pub. L. 114–10, §103(a), added par. (8). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (b)
• Pub. L. 114–113, §502(a)(1)(A), added par. (9). (Consolidated Appropriations Act, 2016) Law text · (b)
• Pub. L. 114–113, §502(a)(2)(A), added par. (10). (Consolidated Appropriations Act, 2016) Law text · (b)
• Pub. L. 114–115, §3(a)(1), added par. (11). (Patient Access and Medicare Protection Act) Law text · (b)
• Pub. L. 114–113, §502(a)(1)(B), added subcl. (X). (Consolidated Appropriations Act, 2016) Law text · (c)
• Pub. L. 114–113, §502(a)(2)(B), added subcl. (XI). (Consolidated Appropriations Act, 2016) Law text · (c)
• Pub. L. 114–115, §3(a)(2), added cl. (iv). (Patient Access and Medicare Protection Act) Law text · (c)
• Pub. L. 114–10, §523(a), added par. (8). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (c)
• Pub. L. 114–10, §101(a)(1)(A)(i), (2)(A), inserted "and ending with 2025" after "beginning with 2001", "or a subsequent paragraph" after "paragraph (4)", and "There shall be two separate conversion factors for each year beginning with 2026, one for items and services furnished by… (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (d)
• Pub. L. 114–10, §101(a)(2)(B), inserted "(or, beginning with 2026, applicable conversion factor)" after "single conversion factor". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (d)
• Pub. L. 114–10, §101(a)(1)(A)(ii)(I), inserted "and ending with 2014" after "years beginning with 2001" in heading. (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (d)
• Pub. L. 114–10, §101(a)(1)(A)(ii)(II), inserted "and ending with 2014" after "a year beginning with 2001" in introductory provisions. (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (d)
• Pub. L. 114–10, §101(a)(2)(C), added pars. (16) to (20) and struck out former par. (16) which related to update for January through March of 2015. (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (d)
• Pub. L. 114–10, §201, substituted "January 1, 2018" for "April 1, 2015". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (e)
• Pub. L. 114–10, §101(a)(1)(B)(i), inserted "through 2014" after "of each succeeding year". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (f)
• Pub. L. 114–10, §101(a)(1)(B)(ii), inserted "and ending with 2014" after "beginning with 2000" in introductory provisions. (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (f)
• Pub. L. 114–10, §101(b)(2)(B)(i), added par. (9). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (k)
• Pub. L. 114–10, §101(d)(1)(A), inserted "and, for 2016 and subsequent years, may provide" after "shall provide". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (m)
• Pub. L. 114–10, §101(d)(1)(B), inserted "and, for 2016 and subsequent years, subparagraph (A) or (C)" after "subparagraph (A)". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (m)
• Pub. L. 114–10, §101(d)(2), substituted "through reporting periods occurring in 2015" for "and subsequent years" and inserted "and, for reporting periods occurring in 2016 and subsequent years, the Secretary may establish" after "shall establish". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (m)
• Pub. L. 114–10, §101(b)(2)(B)(ii), redesignated par. (7) relating to additional incentive payment as (8) and added par. (9). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (m)
• Pub. L. 114–10, §101(d)(3), added par. (11). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (n)
• Pub. L. 114–10, §101(b)(1)(B)(i), in introductory provisions, substituted "An" for "For purposes of paragraph (1), an" and inserted ", or pursuant to subparagraph (D) for purposes of subsection (q), for a performance period under such subsection for a year" after "under such subs… (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (o)
• Pub. L. 114–10, §106(b)(2)(A), inserted ", and the professional demonstrates (through a process specified by the Secretary, such as the use of an attestation) that the professional has not knowingly and willfully taken action (such as to disable functionality) to limit or res… (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (o)
• Pub. L. 114–10, §101(d)(4), inserted "and subsection (q)(5)(B)(ii)(II)" after "Subject to subparagraph (B)(ii)". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (o)
• Pub. L. 114–10, §101(b)(1)(B)(ii), added subpar. (D). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (o)
• Pub. L. 114–10, §101(b)(3)(B)(i), added subpar. (C). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (p)
• Pub. L. 114–10, §101(b)(3)(B)(ii), inserted at end "With respect to 2019 and each subsequent year, the Secretary shall, in accordance with subsection (q)(1)(F), carry out this paragraph for purposes of subsection (q)." (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (p)
• Pub. L. 114–10, §101(b)(3)(A), amended cl. (iii) generally. Prior to amendment, text read as follows: "The Secretary shall apply the payment modifier established under this subsection for items and services furnished— (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (p)
• Pub. L. 114–10, §101(c)(1), added subsec. (q). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (q)
• Pub. L. 114–10, §101(f), added subsec. (r). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (r)
• Pub. L. 114–10, §102, added subsec. (s). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (s)

2014

• Pub. L. 113–93, §220(e)(2)(A), substituted "subclause (II) and paragraph (7)" for "subclause (II)". (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–295, §202(1)(A), substituted "2016" for "2017" in subcl. (VIII) relating to reductions for misvalued services if target not met. Law text · (c)
• Pub. L. 113–93, §220(d)(2), added subcl. (VIII) relating to reductions for misvalued services if target not met. (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–93, §218(a)(2)(B), added subcl. (VIII) relating to reduced expenditures attributable to application of quality incentives for computed tomography. (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–295, §202(1)(B), redesignated subcl. (VIII) relating to reductions for misvalued services if target not met as (IX). Law text · (c)
• Pub. L. 113–93, §220(f)(1), substituted "the service or group of services" for "the service" in two places. (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–93, §220(f)(2), inserted "or group of services" after "furnishing the service" the first time appearing in concluding provisions. (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–93, §220(f)(1), substituted "the service or group of services" for "the service" wherever appearing. (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–93, §220(c), amended cl. (ii) generally. Prior to amendment, text read as follows: "For purposes of identifying potentially misvalued services pursuant to clause (i)(I), the Secretary shall examine (as the Secretary determines to be appropriate) codes (and familie… (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–93, §220(e)(2)(B), substituted "provisions of subparagraph (B)(ii)(II) and paragraph (7)" for "provisions of subparagraph (B)(ii)(II)" and "under subparagraph (B)(ii)(I)" for "under subparagraph (B)(ii)(II)". (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–93, §220(a)(1), added subpar. (M). (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–93, §220(b), added subpar. (N). (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–295, §202(2)(A), substituted "2016 through 2018" for "2017 through 2020" in introductory provisions. Law text · (c)
• Pub. L. 113–93, §220(d)(1), added subpar. (O). (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–295, §202(2)(B), substituted "2016" for "2017". Law text · (c)
• Pub. L. 113–295, §202(2)(C), inserted "(or, for 2016, 1.0 percent)" after "0.5 percent". Law text · (c)
• Pub. L. 113–295, §202(3), substituted "2016" for "2017". Law text · (c)
• Pub. L. 113–93, §220(e)(1), added par. (7). (Protecting Access to Medicare Act of 2014) Law text · (c)
• Pub. L. 113–93, §101(1)(A), struck out "January through March of" before "2014" in heading. (Protecting Access to Medicare Act of 2014) Law text · (d)
• Pub. L. 113–93, §101(1)(B), struck out "for the period beginning on January 1, 2014, and ending on March 31, 2014" after "2014". (Protecting Access to Medicare Act of 2014) Law text · (d)
• Pub. L. 113–93, §101(1)(C), struck out "remaining portion of 2014 and" before "subsequent years" in heading and "the period beginning on April 1, 2014, and ending on December 31, 2014, and for" before "2015" in text. (Protecting Access to Medicare Act of 2014) Law text · (d)
• Pub. L. 113–93, §101(2), added par. (16). (Protecting Access to Medicare Act of 2014) Law text · (d)
• Pub. L. 113–93, §102, substituted "April 1, 2015" for "April 1, 2014". (Protecting Access to Medicare Act of 2014) Law text · (e)
• Pub. L. 113–93, §220(h)(1), added par. (6). (Protecting Access to Medicare Act of 2014) Law text · (e)
• Pub. L. 113–93, §220(a)(2), added subpar. (F). (Protecting Access to Medicare Act of 2014) Law text · (i)
• Pub. L. 113–93, §220(h)(2), substituted "Except as provided in subsection (e)(6)(D), the term" for "The term". (Protecting Access to Medicare Act of 2014) Law text · (j)

2013

• Pub. L. 112–240, §635(1), substituted ", 2012, and 2013" for "and subsequent years" and inserted at end "With respect to fee schedules established for 2014 and subsequent years, in such methodology, the Secretary shall use a 90 percent utilization rate." (American Taxpayer Relief Act of 2012) Law text · (b)
• Pub. L. 112–240, §633(a), substituted "2011, and before April 1, 2013," for "2011," and inserted at end "In the case of such services furnished on or after April 1, 2013, and for which payment is made under such fee schedules, instead of the 25 percent multiple procedure payment red… (American Taxpayer Relief Act of 2012) Law text · (b)
• Pub. L. 112–240, §635(2), substituted "changes in the utilization rate applicable to 2011 and 2014, as described in the first and second sentence, respectively, of" for "change in the utilization rate applicable to 2011, as described in". (American Taxpayer Relief Act of 2012) Law text · (c)
• Pub. L. 112–240, §601(a), added par. (14). (American Taxpayer Relief Act of 2012) Law text · (d)
• Pub. L. 113–67, §1101, added par. (15). Law text · (d)
• Pub. L. 113–67, §1102, substituted "April 1, 2014" for "January 1, 2014". Law text · (e)
• Pub. L. 112–240, §602, substituted "before January 1, 2014" for "before January 1, 2013". (American Taxpayer Relief Act of 2012) Law text · (e)
• Pub. L. 112–240, §601(b)(1), added subpars. (D) and (E) and redesignated former subpar. (D) as (F). (American Taxpayer Relief Act of 2012) Law text · (m)

2012

• Pub. L. 112–96, §3003(a)(1), substituted "2012" for "first two months of 2012" in heading. (Middle Class Tax Relief and Job Creation Act of 2012) Law text · (d)
• Pub. L. 112–96, §3003(a)(2), substituted "2012" for "the period beginning on January 1, 2012, and ending on February 29, 2012". (Middle Class Tax Relief and Job Creation Act of 2012) Law text · (d)
• Pub. L. 112–96, §3003(a)(3), (4), substituted "2013" for "remaining portion of 2012" in heading and "for 2013" for "for the period beginning on March 1, 2012, and ending on December 31, 2012, and for 2013" in text. (Middle Class Tax Relief and Job Creation Act of 2012) Law text · (d)
• Pub. L. 112–96, §3004(a), substituted "before January 1, 2013" for "before March 1, 2012". (Middle Class Tax Relief and Job Creation Act of 2012) Law text · (e)

2011

• Pub. L. 112–78, §309(1), substituted ", 2011, and the first 2 months of 2012" for "and 2011" wherever appearing. (Temporary Payroll Tax Cut Continuation Act of 2011) Law text · (b), (6)
• Pub. L. 112–78, §309(2), substituted ", 2011, or the first 2 months of 2012" for "or 2011". (Temporary Payroll Tax Cut Continuation Act of 2011) Law text · (c)
• Pub. L. 112–78, §301, added par. (13). (Temporary Payroll Tax Cut Continuation Act of 2011) Law text · (d)
• Pub. L. 112–78, §303, substituted "before March 1, 2012" for "before January 1, 2012". (Temporary Payroll Tax Cut Continuation Act of 2011) Law text · (e)

2010

• Pub. L. 111–148, §3002(b), added par. (8). (Patient Protection and Affordable Care Act) Law text · (a)
• Pub. L. 111–148, §3007(1), inserted "subject to subsection (p)," after "1998," in introductory provisions. (Patient Protection and Affordable Care Act) Law text · (b)
• Pub. L. 111–152, §1107(1)(A), substituted "subparagraph (A)" for "this paragraph". (Health Care and Education Reconciliation Act of 2010) Law text · (b)
• Pub. L. 111–148, §3135(a)(1)(A), substituted "this paragraph" for "subparagraph (A)". (Patient Protection and Affordable Care Act) Law text · (b)
• Pub. L. 111–148, §3111(a)(1)(A)(i), inserted ", and for 2010 and 2011, dual-energy x-ray absorptiometry services (as described in paragraph (6))" before the period. (Patient Protection and Affordable Care Act) Law text · (b)
• Pub. L. 111–152, §1107(1)(B), amended subpar. (C) generally. Prior to amendment, text read as follows: "Consistent with the methodology for computing the number of practice expense relative value units under subsection (c)(2)(C)(ii) with respect to advanced diagnostic imaging ser… (Health Care and Education Reconciliation Act of 2010) Law text · (b)
• Pub. L. 111–148, §3135(a)(1)(B), added subpar. (C). (Patient Protection and Affordable Care Act) Law text · (b)
• Pub. L. 111–148, §3135(b)(1), added subpar. (D). (Patient Protection and Affordable Care Act) Law text · (b)
• Pub. L. 111–148, §3111(a)(1)(A)(ii), added par. (6). (Patient Protection and Affordable Care Act) Law text · (b)
• Pub. L. 111–286, §3(a), added par. (7). (The Physician Payment and Therapy Relief Act of 2010) Law text · (b)
• Pub. L. 111–148, §3111(a)(1)(B), added subcl. (IV). (Patient Protection and Affordable Care Act) Law text · (c)
• Pub. L. 111–152, §1107(2), added subcl. (III) and struck out former subcls. (III) to (V), which read as follows: (Health Care and Education Reconciliation Act of 2010) Law text · (c)
• Pub. L. 111–148, §3135(a)(2), added subcls. (III) to (V). (Patient Protection and Affordable Care Act) Law text · (c)
• Pub. L. 111–148, §3135(b)(2), added subcl. (VI). (Patient Protection and Affordable Care Act) Law text · (c)
• Pub. L. 111–286, §3(b), added subcl. (VII). (The Physician Payment and Therapy Relief Act of 2010) Law text · (c)
• Pub. L. 111–148, §5501(c), which directed the addition of cl. (vii), was repealed by Pub. L. 111–148, §10501(h). As enacted, text read as follows: "Fifty percent of the additional expenditures under this part attributable to subsections (x) and (y) of section 1395l of this t… (Patient Protection and Affordable Care Act) Law text · (c)
• Pub. L. 111–148, §3134(a), added subpars. (K) and (L). (Patient Protection and Affordable Care Act) Law text · (c), (L)
• Pub. L. 111–192, §101(a)(1), substituted "January through May" for "portion" in heading. (Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010) Law text · (d)
• Pub. L. 111–148, §3101, which directed the addition of par. (10) relating to update for 2010, was repealed by Pub. L. 111–148, §10310. As enacted, text read as follows: (Patient Protection and Affordable Care Act) Law text · (d)
• Pub. L. 111–157, §4(1), substituted "May 31, 2010" for "March 31, 2010". (Continuing Extension Act of 2010) Law text · (d)
• Pub. L. 111–144, §5(1), substituted "March 31, 2010" for "February 28, 2010". (Temporary Extension Act of 2010) Law text · (d)
• Pub. L. 111–157, §4(2), substituted "June 1, 2010" for "April 1, 2010". (Continuing Extension Act of 2010) Law text · (d)
• Pub. L. 111–144, §5(2), substituted "April 1, 2010" for "March 1, 2010". (Temporary Extension Act of 2010) Law text · (d)
• Pub. L. 111–286, §2(1), substituted "December" for "November" in heading. (The Physician Payment and Therapy Relief Act of 2010) Law text · (d)
• Pub. L. 111–192, §101(a)(2), added par. (11). (Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010) Law text · (d)
• Pub. L. 111–286, §2(2), substituted "December 31" for "November 30". (The Physician Payment and Therapy Relief Act of 2010) Law text · (d)
• Pub. L. 111–286, §2(3), substituted "2011" for "remaining portion of 2010" in heading and struck out "the period beginning on December 1, 2010, and ending on December 31, 2010, and for" before "2011 and subsequent years" in text. (The Physician Payment and Therapy Relief Act of 2010) Law text · (d)
• Pub. L. 111–309, §101, added par. (12). (Medicare and Medicaid Extenders Act of 2010) Law text · (d)
• Pub. L. 111–148, §10324(c)(1), substituted "(H), and (I)" for "and (H)" in introductory provisions. (Patient Protection and Affordable Care Act) Law text · (e)
• Pub. L. 111–148, §3102(b)(1), substituted "(G), and (H)" for "and (G)" in introductory provisions. (Patient Protection and Affordable Care Act) Law text · (e)
• Pub. L. 111–309, §103, substituted "before January 1, 2012" for "before January 1, 2011". (Medicare and Medicaid Extenders Act of 2010) Law text · (e)
• Pub. L. 111–148, §3102(a), substituted "before January 1, 2011" for "before January 1, 2010". (Patient Protection and Affordable Care Act) Law text · (e)
• Pub. L. 111–148, §3102(b)(2), added subpar. (H). (Patient Protection and Affordable Care Act) Law text · (e)
• Pub. L. 111–152, §1108, substituted "½" for "¾". (Health Care and Education Reconciliation Act of 2010) Law text · (e)
• Pub. L. 111–148, §10324(c)(2), added subpar. (I). (Patient Protection and Affordable Care Act) Law text · (e)
• Pub. L. 111–148, §4103(c)(2), inserted "(2)(FF) (including administration of the health risk assessment)," after "(2)(EE),". (Patient Protection and Affordable Care Act) Law text · (j)
• Pub. L. 111–148, §3002(c)(1), inserted "or through a Maintenance of Certification program operated by a specialty body of the American Board of Medical Specialties that meets the criteria for such a registry" after "Database)". (Patient Protection and Affordable Care Act) Law text · (k)
• Pub. L. 111–148, §3002(a)(1)(A), substituted "2014" for "2010" in introductory provisions. (Patient Protection and Affordable Care Act) Law text · (m)
• Pub. L. 111–148, §3002(a)(1)(B), added cls. (iii) and (iv). (Patient Protection and Affordable Care Act) Law text · (m), (iv)
• Pub. L. 111–148, §3002(a)(2)(A), inserted "(or, for purposes of subsection (a)(8), for the quality reporting period for the year)" after "reporting period" in introductory provisions. (Patient Protection and Affordable Care Act) Law text · (m)
• Pub. L. 111–148, §3002(a)(2)(B), inserted ", or, for purposes of subsection (a)(8), for a quality reporting period for the year" after "(a)(5), for a reporting period for a year". (Patient Protection and Affordable Care Act) Law text · (m)
• Pub. L. 111–148, §3002(f)(1), substituted "Except as provided in subparagraph (I), there shall" for "There shall" in introductory provisions. (Patient Protection and Affordable Care Act) Law text · (m)
• Pub. L. 111–148, §3002(a)(3), substituted "paragraphs (5)(A) and (8)(A) of subsection (a)" for "subsection (a)(5)(A)". (Patient Protection and Affordable Care Act) Law text · (m)
• Pub. L. 111–148, §3002(e), (f)(2), added subpars. (H) and (I). (Patient Protection and Affordable Care Act) Law text · (m), (I)
• Pub. L. 111–148, §3002(a)(4)(A), substituted "and subsequent years" for ", 2009, 2010, and 2011". (Patient Protection and Affordable Care Act) Law text · (m)
• Pub. L. 111–148, §3002(a)(4)(B), inserted "(a)(8)" after "(a)(5)" and substituted "under subsection (a)(5)(D)(iii) or the quality reporting period under subsection (a)(8)(D)(iii), respectively" for "under subparagraph (D)(iii) of such subsection". (Patient Protection and Affordable Care Act) Law text · (m)
• Pub. L. 111–148, §10327(a), added par. (7) relating to additional incentive payment. (Patient Protection and Affordable Care Act) Law text · (m)
• Pub. L. 111–148, §3002(d), added par. (7) relating to integration of physician quality reporting and EHR reporting. (Patient Protection and Affordable Care Act) Law text · (m)
• Pub. L. 111–148, §3003(a)(1)(A), designated existing provisions as cl. (i), inserted heading, substituted "the 'Program')." for "the 'Program') under which the Secretary shall use claims data under this subchapter (and may use other data) to provide confidential reports to physic… (Patient Protection and Affordable Care Act) Law text · (n)
• Pub. L. 111–148, §3003(a)(1)(B), substituted "subparagraph (A)(ii)" for "subparagraph (A)" in introductory provisions. (Patient Protection and Affordable Care Act) Law text · (n)
• Pub. L. 111–148, §3003(a)(2)(B), inserted "initial" after "focus the" in introductory provisions. (Patient Protection and Affordable Care Act) Law text · (n)
• Pub. L. 111–148, §3003(a)(2)(A), inserted "initial" after "focus" in heading. (Patient Protection and Affordable Care Act) Law text · (n)
• Pub. L. 111–148, §3003(a)(3), inserted at end "For adjustments for reports on utilization under paragraph (9), see subparagraph (D) of such paragraph." (Patient Protection and Affordable Care Act) Law text · (n)
• Pub. L. 111–148, §3003(a)(4), added pars. (9) and (10). (Patient Protection and Affordable Care Act) Law text · (n), (10)
• Pub. L. 111–157, §5(a)(1), substituted "inpatient or emergency room setting" for "setting (whether inpatient or outpatient)". (Continuing Extension Act of 2010) Law text · (o)
• Pub. L. 111–148, §3007(2), added subsec. (p). (Patient Protection and Affordable Care Act) Law text · (p)

2009

• Pub. L. 111–5, §4101(f)(1)(A), substituted ", 2013 or 2014" for "or any subsequent year". (American Recovery and Reinvestment Act of 2009) Law text · (a)
• Pub. L. 111–5, §4101(f)(1)(B), struck out "and each subsequent year" after "2014". (American Recovery and Reinvestment Act of 2009) Law text · (a)
• Pub. L. 111–5, §4101(b), added par. (7). (American Recovery and Reinvestment Act of 2009) Law text · (a)
• Pub. L. 111–118 added par. (10). (Department of Defense Appropriations Act, 2010) Law text · (d)
• Pub. L. 111–5, §4101(f)(2)(A), substituted "Subject to subparagraph (D), for 2009" for "For 2009". (American Recovery and Reinvestment Act of 2009) Law text · (m)
• Pub. L. 111–5, §4101(f)(2)(B), added subpar. (D). (American Recovery and Reinvestment Act of 2009) Law text · (m)
• Pub. L. 111–5, §4101(a), added subsec. (o). (American Recovery and Reinvestment Act of 2009) Law text · (o)

2008

• Pub. L. 110–275, §139(a)(1), inserted "except as provided in paragraph (5)," after "anesthesia cases,". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (a)
• Pub. L. 110–275, §132(b), added par. (5). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (a)
• Pub. L. 110–275, §139(a)(2), added par. (6). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (a)
• Pub. L. 110–275, §144(a)(2)(B), added par. (5). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (b)
• Pub. L. 110–275, §133(b), added cl. (vi). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (c)
• Pub. L. 110–275, §131(a)(1)(A)(i), struck out "a portion of" before "2008" in heading. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (d)
• Pub. L. 110–275, §131(a)(1)(A)(ii), struck out "for the period beginning on January 1, 2008, and ending on June 30, 2008," after "for 2008,". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (d)
• Pub. L. 110–275, §131(a)(1)(A)(iii), struck out "the remaining portion of 2008 and" before "2009" in heading and "for the period beginning on July 1, 2008, and ending on December 31, 2008, and" before "for 2009" in text. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (d)
• Pub. L. 110–275, §131(a)(1)(B), added par. (9). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (d)
• Pub. L. 110–275, §134(c), amended Pub. L. 108–173, §602(1). See 2003 Amendment note below. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (e)
• Pub. L. 110–275, §134(a), substituted "before January 1, 2010" for "before July 1, 2008". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (e)
• Pub. L. 110–275, §134(b), inserted at end "For purposes of payment for services furnished in the State described in the preceding sentence on or after January 1, 2009, after calculating the work geographic index in subparagraph (A)(iii), the Secretary shall increase the work geog… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (e)
• Pub. L. 110–275, §152(b)(1)(C), inserted "(2)(EE)," after "(2)(DD),". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (j)
• Pub. L. 110–275, §144(a)(2)(A), inserted "(2)(DD)," after "(2)(AA),". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (j)
• Pub. L. 110–275, §131(b)(1), added subpars. (C) and (D). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (k), (D)
• Pub. L. 110–275, §131(b)(4)(A), added cl. (iv). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (k)
• Pub. L. 110–275, §131(a)(3)(C)(i)(I), struck out subcl. (III) which read as follows: "For expenditures during 2013, an amount equal to $4,670,000,000." (Medicare Improvements for Patients and Providers Act of 2008) Law text · (l)
• Pub. L. 110–252, §7002(c)(1)(A), substituted "$4,670,000,000" for "$4,960,000,000". (Supplemental Appropriations Act, 2008) Law text · (l)
• Pub. L. 110–275, §131(a)(3)(C)(i)(I), struck out subcl. (IV) which read as follows: "For expenditures during 2014, an amount equal to $290,000,000." (Medicare Improvements for Patients and Providers Act of 2008) Law text · (l)
• Pub. L. 110–252, §7002(c)(1)(B), added subcl. (IV). (Supplemental Appropriations Act, 2008) Law text · (l)
• Pub. L. 110–275, §131(a)(3)(C)(i)(II), struck out subcl. (III). Text read as follows: "The amount available for expenditures during 2013 shall only be available for an adjustment to the update of the conversion factor under subsection (d) for that year." (Medicare Improvements for Patients and Providers Act of 2008) Law text · (l)
• Pub. L. 110–275, §131(a)(3)(C)(i)(II), struck out subcl. (IV). Text read as follows: "The amount available for expenditures during 2014 shall only be available for an adjustment to the update of the conversion factor under subsection (d) for that year." (Medicare Improvements for Patients and Providers Act of 2008) Law text · (l)
• Pub. L. 110–252, §7002(c)(2), added subcl. (IV). (Supplemental Appropriations Act, 2008) Law text · (l)
• Pub. L. 110–275, §131(a)(3)(C)(ii), inserted "and" at end of cl. (i), substituted period for semicolon at end of cl. (ii), and struck out cls. (iii) and (iv) which read as follows: (Medicare Improvements for Patients and Providers Act of 2008) Law text · (l)
• Pub. L. 110–252, §7002(c)(3), added cl. (iv). (Supplemental Appropriations Act, 2008) Law text · (l)
• Pub. L. 110–275, §131(b)(2), (3)(A), transferred subsec. (c) of section 101 of title I of div. B of Pub. L. 109–432 to subsec. (m) of this section and amended heading generally. Prior to amendment, heading read "Transitional Bonus Incentive Payments for Quality Reporting in 2007 and 20… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(B), added par. (1) and struck out former par. (1) which provided for an additional payment for certain covered professional services furnished by an eligible professional. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §132(a)(1), added par. (2). Former par. (2) redesignated (3). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §132(a)(2)(A), inserted "and successful electronic prescriber" after "reporting" in heading. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(D)(i), (ii), designated existing provisions as subpar. (A) and inserted heading, redesignated former subpars. (A) and (B) as cls. (i) and (ii), respectively, of subpar. (A), and realigned margins. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(C), redesignated par. (2) as (3) and struck out former par. (3) which provided for payment limitation. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(D)(iii), inserted concluding provisions. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §132(a)(2)(B), added subpar. (B). Former subpar. (B) redesignated cl. (i) of subpar. (A). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(D)(iv), added subpars. (C) and (D). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m), (D)
• Pub. L. 110–275, §131(b)(5)(A)(i), substituted "subsection (k)" for "section 1848(k) of the Social Security Act, as added by subsection (b)," and "such subsection" for "such section". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(5)(A)(ii), struck out "of the Social Security Act (42 U.S.C. 1395l)" before "and any payment". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(E)(i), inserted "for 2007, 2008, and 2009," after "provision of law,". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(E)(ii)(I), which directed amendment of cl. (i) by inserting "for 2007 and 2008" after "under this subsection" and then substituting "this subsection" for "paragraph (2)", was executed by substituting "under this subsection for 2007 and 2008" for "un… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(E)(ii)(II), substituted "may establish procedures to" for "shall". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(E)(ii)(III), inserted "(or, in the case of a group practice under paragraph (3)(C), the group practice)" after "an eligible professional", substituted "incentive payment under this subsection" for "bonus incentive payment", and inserted at end "If… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(5)(A)(iii), substituted "1395ff of this title, section 1395oo of this title, or otherwise" for "1869 or 1878 of the Social Security Act or otherwise". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(E)(iii)(I)–(III), struck out cl. (i) designation and heading before "There shall be", redesignated subcls. (I) to (IV) as cls. (i) to (iv), respectively, and struck out former cl. (ii). Prior to amendment, text of cl. (ii) read as follows: "A determination under this sub… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(E)(iii)(IV), substituted "this subsection" for "paragraph (2)". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §132(a)(3), added cl. (iii) and struck out former cl. (iii) which read as follows: "the determination of the payment limitation under paragraph (3); and". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(E)(iii)(V), substituted "any" for "the bonus" and inserted "and the payment adjustment under subsection (a)(5)(A)" before period at end. (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(E)(iv), (5)(A)(iv), substituted "subsequent years," for "2009, paragraph (3) shall not apply, and", "this subsection" for "paragraph (2)", "subsection (k)(2)(B)" for "paragraph (2)(B) of section 1848(k)" of the Social Security Act (42 U.S.C. 1395w–4(k)… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(E)(v), added subpar. (G). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(5)(B)(i), substituted "subsection (k)(3)" for "section 1848(k)(3) of the Social Security Act, as added by subsection (b)". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(5)(B)(ii), substituted "subsection (k)" for "section 1848(k) of the Social Security Act, as added by subsection (b)". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(3)(F), added subpar. (C) and struck out former subpar. (C). Prior to amendment, text read as follows: "The term 'reporting period' means— (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(b)(5)(C), struck out subpar. (D). Text read as follows: "The term 'Secretary' means the Secretary of Health and Human Services." (Medicare Improvements for Patients and Providers Act of 2008) Law text · (m)
• Pub. L. 110–275, §131(c)(1), added subsec. (n). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (n)

2007

• Pub. L. 110–173, §101(a)(1)(A), substituted "and the succeeding paragraphs of this subsection" for "and paragraphs (5) and (6)" in introductory provisions. (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (d)
• Pub. L. 110–173, §101(a)(1)(B), added par. (8). (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (d)
• Pub. L. 110–173, §103, substituted "before July 1, 2008" for "before January 1, 2008". (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (e)
• Pub. L. 110–173, §101(b)(1), in heading and cl. (i), inserted "and 2009" after "2008", and, in cls. (ii) and (iii), substituted "of each of 2007 and 2008" for ", 2007" and inserted "or 2009, as applicable" after "2008". (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (k)
• Pub. L. 110–173, §101(a)(2)(A)(i), added subpar. (A) and struck out former subpar. (A), which read as follows: "There shall be available to the Fund for expenditures an amount equal to $1,200,000,000, as reduced by section 524 and section 225(c)(1)(A) of the Departments of Labor,… (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (l)
• Pub. L. 110–161, §524, which directed amendment of subpar. (A) by reducing the dollar amount in the first sentence by $150,000,000, was executed by substituting "$1,200,000,000" for "$1,350,000,000" in first sentence. (Consolidated Appropriations Act, 2008) Law text · (l)
• Pub. L. 110–161, §225(c)(2), inserted, in first sentence, ", as reduced by section 524 and section 225(c)(1)(A) of the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2008 (division G of the Consolidated Appropriations Act, 2008)" after "$1,3… (Consolidated Appropriations Act, 2008) Law text · (l)
• Pub. L. 110–90, §6(1), inserted at end: "In addition, there shall be available to the Fund for expenditures during 2009 an amount equal to $325,000,000 and for expenditures during or after 2013 an amount equal to $60,000,000." (TMA, Abstinence Education, and QI Programs Extension Act of 2007) Law text · (l)
• Pub. L. 110–173, §101(a)(2)(A)(ii), substituted "entire amount available for expenditures, after application of subparagraph (A)(ii), during—" and cls. (i) to (iii) for "entire amount specified in the first sentence of subparagraph (A) for payment with respect to physicians' serv… (Medicare, Medicaid, and SCHIP Extension Act of 2007) Law text · (l)
• Pub. L. 110–90, §6(2), in heading, struck out "furnished during 2008" after "services" and, in text, substituted "specified in the first sentence of subparagraph (A)" for "specified in subparagraph (A)" and inserted "and for the obligation of the entire first amount specified in the second sentence… (TMA, Abstinence Education, and QI Programs Extension Act of 2007) Law text · (l)

2006

• Pub. L. 109–171, §5102(b)(1), added par. (4). (Deficit Reduction Act of 2005) Law text · (b)
• Pub. L. 109–171, §5102(a)(1), substituted "clauses (iv) and (v)" for "clause (iv)". (Deficit Reduction Act of 2005) Law text · (c)
• Pub. L. 109–171, §5102(a)(2), inserted "of certain additional expenditures" after "Exemption" in heading. (Deficit Reduction Act of 2005) Law text · (c)
• Pub. L. 109–171, §5102(a)(3), added cl. (v). (Deficit Reduction Act of 2005) Law text · (c)
• Pub. L. 109–171, §5102(b)(2), added subcl. (II). (Deficit Reduction Act of 2005) Law text · (c)
• Pub. L. 109–171, §5104(a)(1), substituted "paragraphs (5) and (6)" for "paragraph (5)" in introductory provisions. (Deficit Reduction Act of 2005) Law text · (d)
• Pub. L. 109–171, §5104(a)(2), added par. (6). (Deficit Reduction Act of 2005) Law text · (d)
• Pub. L. 109–432, §101(a), added par. (7). (Tax Relief and Health Care Act of 2006) Law text · (d)
• Pub. L. 109–432, §102, substituted "2008" for "2007". (Tax Relief and Health Care Act of 2006) Law text · (e)
• Pub. L. 109–171, §5112(c), inserted "(2)(AA)," after "(2)(W),". (Deficit Reduction Act of 2005) Law text · (j)
• Pub. L. 109–432, §101(b), added subsec. (k). (Tax Relief and Health Care Act of 2006) Law text · (k)
• Pub. L. 109–432, §101(d), added subsec. (l). (Tax Relief and Health Care Act of 2006) Law text · (l)

2003

• Pub. L. 108–173, §303(a)(1)(A)(i), substituted "Subject to clause (iv), the adjustments" for "The adjustments". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (c)
• Pub. L. 108–173, §303(a)(1)(A)(ii), added cl. (iv). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (c)
• Pub. L. 108–173, §303(a)(1)(B), added subpars. (H) to (J). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (c)
• Pub. L. 108–173, §601(a)(2), inserted "and paragraph (5)" after "subparagraph (D)" in introductory provisions. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (d)
• Pub. L. 108–173, §601(a)(1), added par. (5). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (d)
• Pub. L. 108–173, §602(1), as amended by Pub. L. 110–275, §134(c), substituted "subparagraphs (B), (C), (E), and (G)" for "subparagraphs (B), (C), and (E)". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
• Pub. L. 108–173, §412(1), substituted "subparagraphs (B), (C), and (E)" for "subparagraphs (B) and (C)". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
• Pub. L. 108–173, §412(2), added subpar. (E). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
• Pub. L. 108–173, §602(2), added subpar. (G). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
• Pub. L. 108–173, §601(b)(1), substituted "annual average" for "projected" and "during the 10-year period ending with the applicable period involved" for "from the previous applicable period to the applicable period involved". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (f)
• Pub. L. 108–173, §303(g)(2), substituted "subsections (c)(2)(F), (c)(2)(H), and (c)(2)(I)" for "subsection (c)(2)(F)". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (i)
• Pub. L. 108–7 amended subpar. (C) generally. Prior to amendment, subpar. (C) read as follows: "the determination of conversion factors under subsection (d) of this section,". (Consolidated Appropriations Resolution, 2003) Law text · (i)
• Pub. L. 108–173, §736(b)(10), substituted "comparable services" for "a comparable services". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (i)
• Pub. L. 108–173, §611(c), inserted "(2)(W)," after "(2)(S),". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (j)

2000

• Pub. L. 106–554 inserted "(13)," after "(4),". (Consolidated Appropriations Act, 2001) Law text · (j)

1999

• Pub. L. 106–113, §1000(a)(6) [title II, §211(a)(3)(A)(i)], inserted "(for years before 2001) and, for years beginning with 2001, multiplied by the update (established under paragraph (4)) for the year involved" before period at end. (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (d)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(a)(2)(A)], amended heading and text of subpar. (E) generally. Prior to amendment, text read as follows: "The Secretary shall cause to have published in the Federal Register, during the last 15 days of October of— (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (d)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(a)(1)(A)(i)], inserted "for 1999 and 2000" after "Update" in heading. (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (d)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(a)(1)(A)(ii)], substituted "1999 and 2000" for "a year beginning with 1999" in introductory provisions. (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (d)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(a)(1)(A)(iii)], inserted "and paragraph (4)" after "For purposes of this paragraph" in introductory provisions. (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (d)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(a)(1)(B)], added par. (4). (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (d)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(b)(1)], amended heading and text of par. (1) generally. Prior to amendment, text read as follows: "The Secretary shall cause to have published in the Federal Register the sustainable growth rate for each fiscal year beginning with fiscal … (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (f)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(b)(2)(A)], substituted "fiscal year 1998 and ending with fiscal year 2000) and a year beginning with 2000" for "fiscal year 1998)" in introductory provisions. (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (f)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(b)(2)(B)], substituted "applicable period" for "fiscal year". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (f)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(b)(2)(B)], substituted "applicable period" for "fiscal year" in two places. (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (f), (C)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(a)(3)(A)(ii), (b)(2)(B)], substituted "applicable period" for "fiscal year" in two places and "subsection (d)(3)(B) or (d)(4)(B), as the case may be" for "subsection (d)(3)(B)". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (f)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(b)(5)], added par. (3). Former par. (3) redesignated (4). (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (f)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(b)(3)], added subpar. (C). (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (f)
• Pub. L. 106–113, §1000(a)(6) [title II, §211(b)(4)], redesignated par. (3) as (4). (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (f)
• Pub. L. 106–113, §1000(a)(6) [title III, §321(k)(5)], substituted "section 1395x(oo)(2) of this title)" for "section 1395x(oo)(2) of this title,", "(B)," for "(B),", and ", and (15)" for "and (15)". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (j)

1997

• Pub. L. 105–33, §4644(d), substituted "Before November 1 of the preceding year, for each year beginning with 1998" for "Before January 1 of each year beginning with 1992" in introductory provisions. (Balanced Budget Act of 1997) Law text · (b)
• Pub. L. 105–33, §4022(b)(2)(C), substituted "Medicare Payment Advisory Commission" for "Physician Payment Review Commission". (Balanced Budget Act of 1997) Law text · (c)
• Pub. L. 105–33, §4505(b)(1)(A), which directed an amendment striking the comma at the end of cl. (ii) and inserting a period and the following: "For 1999, such number of units shall be determined based 75 percent on such product and based 25 percent on the relative practice e… (Balanced Budget Act of 1997) Law text · (c)
• Pub. L. 105–33, §4505(a)(1), substituted "1999" for "1998" in two places. (Balanced Budget Act of 1997) Law text · (c)
• Pub. L. 105–33, §4505(f)(1)(A), inserted "for the service for years before 2000" before "equal" in introductory provisions, substituted comma for period at end of subcl. (II), and inserted concluding provisions. (Balanced Budget Act of 1997) Law text · (c)
• Pub. L. 105–33, §4505(e), added subpar. (G). (Balanced Budget Act of 1997) Law text · (c)
• Pub. L. 105–33, §4505(b)(2), substituted "2002" for "1999" in introductory provisions. (Balanced Budget Act of 1997) Law text · (c)
• Pub. L. 105–33, §4505(a)(2), substituted "1999" for "1998" in introductory provisions. (Balanced Budget Act of 1997) Law text · (c)
• Pub. L. 105–33, §4505(f)(1)(B), substituted "For years before 1999, the malpractice" for "The malpractice" in introductory provisions. (Balanced Budget Act of 1997) Law text · (c)
• Pub. L. 105–33, §4501(b)(1), (2), struck out "(or factors)" after "conversion factor" in two places and struck out "or updates" after "update". (Balanced Budget Act of 1997) Law text · (d)
• Pub. L. 105–33, §4504(a)(1), substituted "Except as provided in subparagraph (D), the single conversion factor" for "The single conversion factor". (Balanced Budget Act of 1997) Law text · (d)
• Pub. L. 105–33, §4501(a)(2), added subpar. (C). Former subpar. (C) redesignated (D). (Balanced Budget Act of 1997) Law text · (d)
• Pub. L. 105–33, §4504(a)(3), added subpar. (D). Former subpar. (D) redesignated (E). (Balanced Budget Act of 1997) Law text · (d)
• Pub. L. 105–33, §4501(b)(1), (3), struck out "(or updates)" after "update" in two places and struck out "(or factors)" after "conversion factor" in cl. (ii). (Balanced Budget Act of 1997) Law text · (d)
• Pub. L. 105–33, §4501(a)(1), redesignated subpar. (C) as (D). (Balanced Budget Act of 1997) Law text · (d)
• Pub. L. 105–33, §4504(a)(2), redesignated subpar. (D) as (E). (Balanced Budget Act of 1997) Law text · (d)
• Pub. L. 105–33, §4502(b), struck out heading and text of par. (2) which related to recommendation of update. (Balanced Budget Act of 1997) Law text · (d)
• Pub. L. 105–33, §4022(b)(1)(B)(i), struck out heading and text of subpar. (F). Text read as follows: "The Physician Payment Review Commission shall review the report submitted under subparagraph (A) in a year and shall submit to the Congress, by not later than May 15 of the year,… (Balanced Budget Act of 1997) Law text · (d)
• Pub. L. 105–33, §4502(a)(1), amended heading and text generally. Prior to amendment, text related to updates of conversion factor based on index and made provision for adjustments in update. (Balanced Budget Act of 1997) Law text · (d)
• Pub. L. 105–33, §4503(b), amended subsec. heading and heading and text of par. (1) generally. Prior to amendment, par. (1) related to process for establishing medicare volume performance standard rates of increase. (Balanced Budget Act of 1997) Law text · (f)
• Pub. L. 105–33, §4022(b)(2)(B)(ii), struck out heading and text of subpar. (B). Text read as follows: "The Physician Payment Review Commission shall review the recommendation transmitted during a year under subparagraph (A) and shall make its recommendation to Congress, by not la… (Balanced Budget Act of 1997) Law text · (f)
• Pub. L. 105–33, §4503(a), added par. (2) and struck out heading and text of former par. (2) which related to specification of performance standard rates of increase for physician services for fiscal years beginning in 1991. (Balanced Budget Act of 1997) Law text · (f)
• Pub. L. 105–33, §4503(a), added par. (3) and struck out heading and text of former par. (3). Text read as follows: "The Secretary shall establish procedures for providing, on a quarterly basis to the the Congressional Budget Office, the Congressional Research Service, the Committees… (Balanced Budget Act of 1997) Law text · (f)
• Pub. L. 105–33, §4022(b)(2)(B)(iii), struck out "Physician Payment Review Commission," before "the Congressional Budget Office". (Balanced Budget Act of 1997) Law text · (f)
• Pub. L. 105–33, §4503(a), struck out heading and text of par. (4) which related to separate group-specific performance standard rates of increase and par. (5) which defined "physicians' services" and "HMO enrollee". (Balanced Budget Act of 1997) Law text · (f), (5)
• Pub. L. 105–33, §4714(b)(2), inserted before period at end "and the provisions of section 1396a(n)(3)(A) of this title apply to further limit permissible charges under this section". (Balanced Budget Act of 1997) Law text · (g)
• Pub. L. 105–33, §4022(b)(2)(C), substituted "Medicare Payment Advisory Commission" for "Physician Payment Review Commission". (Balanced Budget Act of 1997) Law text · (g), (7)
• Pub. L. 105–33, §4501(b)(4), substituted "For services furnished before January 1, 1998, the term" for "The term". (Balanced Budget Act of 1997) Law text · (j)
• Pub. L. 105–33, §4106(b), substituted "(4), (14)" for "(4) and (14)" and inserted "and (15)" after "1395x(nn)(2) of this title)". (Balanced Budget Act of 1997) Law text · (j)
• Pub. L. 105–33, §4105(a)(2), inserted "(2)(S)," before "(3)". (Balanced Budget Act of 1997) Law text · (j)
• Pub. L. 105–33, §4103(d), inserted "(2)(P) (with respect to services described in subparagraphs (A) and (C) of section 1395x(oo)(2) of this title," after "(2)(G)". (Balanced Budget Act of 1997) Law text · (j)
• Pub. L. 105–33, §§4102(d), 4104(d), inserted "(2)(R) (with respect to services described in subparagraphs (B) , (C), and (D) of section 1395x(pp)(1) of this title)," before "(3)" and substituted "(4) and (14) (with respect to services described in section 1395x(nn)(2) of this title)" for "and (4)". (Balanced Budget Act of 1997) Law text · (j)

1994

• Pub. L. 103–432, §126(b)(6), struck out "that are subject to section 6105(b) of the Omnibus Budget Reconciliation Act of 1989" after "nuclear medicine services" and substituted "provided under section 6105(b) of the Omnibus Budget Reconciliation Act of 1989" for "provided un… · (a)
• Pub. L. 103–432, §121(b)(1), inserted "for the service for years before 1998" before "equal to" in introductory provisions, substituted comma for period at end of subcl. (II), and inserted "and for years beginning with 1998 based on the relative practice expense resources inv… · (c)
• Pub. L. 103–432, §121(b)(2), substituted "For years before 1998, the practice" for "The practice". · (c)
• Pub. L. 103–432, §126(g)(6), made technical amendment to directory language of Pub. L. 101–508, §4118(f)(1)(D). See 1990 Amendment note below. · (c)
• Pub. L. 103–432, §126(g)(5), inserted "date of the" before "last previous adjustment". · (e)
• Pub. L. 103–432, §122(a), substituted "shall, in consultation with appropriate representatives of physicians, review" for "shall review". · (e)
• Pub. L. 103–432, §122(b), added subpar. (D). · (e)
• Pub. L. 103–432, §126(g)(7), made technical amendment to directory language of Pub. L. 101–508, §4118(f)(1)(N)(ii). See 1990 Amendment note below. · (f)
• Pub. L. 103–432, §126(g)(2)(B), inserted heading. · (f)
• Pub. L. 103–432, §123(a)(1), amended heading and text of par. (1) generally. Prior to amendment, text read as follows: "If a nonparticipating physician or nonparticipating supplier or other person (as defined in section 1395u(i)(2) of this title) knowingly and willfully bills on a r… · (g)
• Pub. L. 103–432, §123(a)(2), inserted after first sentence "No person is liable for payment of any amounts billed for such a service in violation of the previous sentence." and in last sentence substituted "first sentence" for "previous sentence". · (g)
• Pub. L. 103–432, §123(d), inserted "information on the extent to which actual charges exceed limiting charges, the number and types of services involved, and the average amount of excess charges and information" after "report to the Congress". · (g)
• Pub. L. 103–432, §126(g)(10)(A), struck out space before the period at end. · (i)

1993

• Pub. L. 103–66, §13515(c)(1), inserted "and under section 13515(b) of the Omnibus Budget Reconciliation Act of 1993" after "subsection (c)(2)(F)(ii)". · (a)
• Pub. L. 103–66, §13514(c)(1), inserted "and as adjusted under subsection (c)(2)(F)(ii)" after "for 1994". · (a)
• Pub. L. 103–66, §13517(a)(1), in heading inserted "and suppliers" after "physicians" and in text inserted "or a nonparticipating supplier or other person" after "nonparticipating physician" and inserted at end "In the case of physicians' services (including services which the Secret… · (a)
• Pub. L. 103–66, §13516(a)(1), added par. (4). · (a)
• Pub. L. 103–66, §13515(a)(1), struck out heading and text of par. (4). Text read as follows: "In the case of physicians' services furnished by a physician before the end of the physician's first full calendar year of furnishing services for which payment may be made under this part, and during each… · (a)
• Pub. L. 103–66, §13514(a), amended heading and text of par. (3) generally. Prior to amendment, text read as follows: "If payment is made under this part for a visit to a physician or consultation with a physician and, as part of or in conjunction with the visit or consultation there… · (b)
• Pub. L. 103–66, §13515(c)(2), inserted before period at end "and section 13515(b) of the Omnibus Budget Reconciliation Act of 1993". · (c)
• Pub. L. 103–66, §13514(c)(2), inserted at end "Such relative values are subject to adjustment under subparagraph (F)(i)." · (c)
• Pub. L. 103–66, §13513, added subpar. (E). · (c)
• Pub. L. 103–66, §13514(b), added subpar. (F). · (c)
• Pub. L. 103–66, §13511(a)(1)(A), substituted "clauses (iii) through (v)" for "clause (iii)". · (d)
• Pub. L. 103–66, §13511(a)(1)(B), added cls. (iv) to (vi). · (d)
• Pub. L. 103–66, §13512(b), substituted "1994" for "1994 or 1995" in subcl. (II) and "5" for "3" in subcl. (III). · (d)
• Pub. L. 103–66, §13512(a), added cls. (iii) to (v) and struck out former cl. (iii) which read as follows: "for each succeeding year is 2 percentage points." · (f)
• Pub. L. 103–66, §13517(a)(2)(C), (D), inserted ", supplier, or other person" after "such physician" and inserted at end "In applying this subparagraph, any reference in such section to a physician is deemed also to include a reference to a supplier or other person under this subpara… · (g)
• Pub. L. 103–66, §13517(a)(2)(B), which directed insertion of "including services which the Secretary excludes pursuant to subsection (j)(3) of this section," after "physician's services (", was executed by making the insertion after "physicians' services (" to reflect the probable intent of Congres… · (g)
• Pub. L. 103–66, §13517(a)(2)(A), inserted "or nonparticipating supplier or other person (as defined in section 1395u(i)(2) of this title)" after "nonparticipating physician". · (g)
• Pub. L. 103–66, §13517(a)(3), inserted "or for nonparticipating suppliers or other persons" after "nonparticipating physicians". · (g)
• Pub. L. 103–66, §13517(a)(4), inserted "(or, if payment under this part is made on a basis other than the fee schedule under this section, 95 percent of the other payment basis)" after "subsection (a)". · (g)
• Pub. L. 103–66, §13517(a)(5), inserted "or nonparticipating supplier or other person furnishing physicians' services (as defined in subsection (j)(3))" after "each physician", inserted ", supplier, or other person" after "by the physician", and inserted ", suppliers, and other persons"… · (h)
• Pub. L. 103–66, §13515(c)(3), inserted "and section 13515(b) of the Omnibus Budget Reconciliation Act of 1993" after "subsection (c)(2)(F)". · (i)
• Pub. L. 103–66, §13514(c)(3), inserted at end "including adjustments under subsection (c)(2)(F),". · (i)
• Pub. L. 103–66, §13511(a)(2), substituted "Secretary and including anesthesia services), primary care services (as defined in section 1395u(i)(4) of this title)," for "Secretary)". · (j)
• Pub. L. 103–66, §13518(a), inserted "(2)(G)," after "(2)(D),". · (j)
• Pub. L. 103–66, §13517(a)(6), inserted ", except for purposes of subsections (a)(3), (g), and (h)" after "tests and". · (j)

1990

• Pub. L. 101–508, §4104(b)(2), struck out "or 1395m(f)" after "section 1395m(b)" in introductory provisions. · (a)
• Pub. L. 101–508, §4102(b), inserted "and radiology" after "Special rule for anesthesia" in heading and inserted at end "With respect to radiology services, '109 percent' and '9 percent' shall be substituted for '115 percent' and '15 percent', respectively, in subparagraph (A)(ii)… · (a)
• Pub. L. 101–508, §4102(g)(2)(A), inserted ", but excluding nuclear medicine services that are subject to section 6105(b) of the Omnibus Budget Reconciliation Act of 1989" after "section 1395m(b)(6) of this title)". · (a)
• Pub. L. 101–508, §4102(g)(2)(B), added cl. (iii). · (a)
• Pub. L. 101–508, §4106(b)(1), added par. (4). · (a)
• Pub. L. 101–508, §4109(a), added par. (3). · (b)
• Pub. L. 101–508, §4118(f)(1)(A), struck out at end "In this subparagraph, the term 'practice expenses' includes all expenses for furnishing physicians' services, excluding malpractice expenses, physician compensation, and other physician fringe benefits." · (c)
• Pub. L. 101–508, §4118(f)(1)(C), redesignated par. (3), relating to ancillary policies, as (4). · (c)
• Pub. L. 101–508, §4118(f)(1)(B), struck out "by" before "the proportion". · (c), (iii)
• Pub. L. 101–508, §4118(f)(1)(D), as amended by Pub. L. 103–432, §126(g)(6), substituted "section" for "subsection". · (c)
• Pub. L. 101–508, §4118(f)(1)(C), redesignated par. (3), relating to ancillary policies, as (4). Former par. (4) redesignated (5). · (c)
• Pub. L. 101–508, §4118(d), struck out "only for services furnished on or after January 1, 1993" after "visits and consultations". · (c)
• Pub. L. 101–508, §4118(f)(1)(C), redesignated pars. (4) and (5) as (5) and (6), respectively. · (c), (6)
• Pub. L. 101–508, §4118(f)(1)(E), (F)(i)(III), amended subpar. (A) identically, substituting "paragraph (3)" for "subparagraph (C)". · (d)
• Pub. L. 101–508, §4118(f)(1)(F)(i)(I), (II), substituted "conversion factor (or factors)" for "conversion factor" in two places and "update or updates" for "update". · (d)
• Pub. L. 101–508, §4118(f)(1)(F)(ii)(I), substituted "conversion factor" for "conversion factor (or factors)". · (d)
• Pub. L. 101–508, §4118(f)(1)(F)(ii)(II), inserted "the conversion factor (or factors) which will apply to physicians' services for the following year and" before "the update (or updates)" and substituted "such year" for "the following year". · (d)
• Pub. L. 101–508, §4118(f)(1)(G), (I), substituted "physicians' services (as defined in subsection (f)(5)(A) of this section)" for "physicians' services" in first sentence and "proportion of individuals who are enrolled under this part who are HMO enrollees" for "proportion of HMO… · (d)
• Pub. L. 101–508, §4118(f)(1)(H), substituted "and for the services involved" for "(as defined in subsection (f)(5)(A) of this section)" and "such services" for "all such physicians' services". · (d)
• Pub. L. 101–508, §4118(f)(1)(J), inserted "the" before "most recent". · (d)
• Pub. L. 101–508, §4118(f)(1)(K), substituted "payments for physicians' services" for "physicians' services". · (d)
• Pub. L. 101–508, §4105(a)(3)(A), inserted "except as provided in clause (iii)," after "subparagraph (B),". · (d)
• Pub. L. 101–508, §4105(a)(3)(B), added cl. (iii). · (d)
• Pub. L. 101–508, §4118(f)(1)(L)(i)(II), which directed amendment of cl. (i) by substituting "services in such category" for "physicians' services (as defined in subsection (f)(5)(A))", was executed by making the substitution for "physicians' services (as defined in section (f)… · (d)
• Pub. L. 101–508, §4118(f)(1)(L)(i)(I), substituted "update for a category of physicians' services for a year" for "update for a year". · (d)
• Pub. L. 101–508, §4118(f)(1)(L)(ii), inserted "more than" after "decrease of" in introductory provisions and struck out "more than" before "2 percentage points" in subcl. (I). · (d)
• Pub. L. 101–508, §4118(c)(1), substituted "subparagraphs (B) and (C)" for "subparagraph (B)" in introductory provisions. · (e)
• Pub. L. 101–508, §4118(c)(2), added subpar. (C). · (e)
• Pub. L. 101–508, §4105(c)(1), substituted "1991" for "1990" after "beginning with". · (f)
• Pub. L. 101–508, §4118(f)(1)(M), substituted "portions of calendar years" for "calendar years". · (f)
• Pub. L. 101–508, §4118(b)(1), (f)(1)(N)(i), in introductory provisions, substituted "the performance standard rate of increase, for all physicians' services and for each category of physicians' services," for "each performance standard rate of increase" and "product" for "sum". · (f)
• Pub. L. 101–508, §4118(b)(6), substituted "minus 1, multiplied by 100, and reduced" for "reduced" in concluding provisions. · (f)
• Pub. L. 101–508, §4118(f)(1)(N)(ii), as amended by Pub. L. 103–432, §126(g)(7), substituted "all physicians' services or for the category of physicians' services, respectively," for "physicians' services (as defined in subsection (f)(5)(A) of this section)". · (f)
• Pub. L. 101–508, §4118(f)(1)(M), substituted "portions of calendar years" for "calendar years". · (f)
• Pub. L. 101–508, §4118(b)(2), (3), substituted "1 plus the Secretary's" for "the Secretary's" and "percentage increase (divided by 100)" for "percentage increase". · (f)
• Pub. L. 101–508, §4118(b)(2), (4), substituted "1 plus the Secretary's" for "the Secretary's" and inserted "(divided by 100)" after "decrease". · (f)
• Pub. L. 101–508, §4118(f)(1)(N)(iii), substituted "all physicians' services or of the category of physicians' services, respectively," for "physicians' services". · (f)
• Pub. L. 101–508, §4118(b)(2), (5), substituted "1 plus the Secretary's" for "the Secretary's" and inserted "(divided by 100)" after "percentage growth". · (f)
• Pub. L. 101–508, §4118(e), (f)(1)(N)(iv), substituted "all physicians' services or of the category of physicians' services, respectively," for "physicians' services (as defined in subsection (f)(5)(A) of this section)" and inserted "including changes in law and regulations af… · (f)
• Pub. L. 101–508, §4118(b)(2), (4), substituted "1 plus the Secretary's" for "the Secretary's" and "decrease (divided by 100)" for "decrease". · (f)
• Pub. L. 101–508, §4105(c)(2), added subpar. (C). · (f)
• Pub. L. 101–508, §4118(f)(1)(O), substituted "subparagraph (B)" for "paragraph (B)". · (f)
• Pub. L. 101–508, §4118(f)(1)(P), substituted "specifically approved by law" for "Congress specifically approves the plan". · (f)
• Pub. L. 101–508, §4118(f)(1)(Q), inserted "other than radiologist services subject to section 1395m(b) of this title," after "during 1991," in introductory provisions. · (g)
• Pub. L. 101–508, §4116, inserted at end "In the case of evaluation and management services (as specified in section 1395u(b)(16)(B)(ii) of this title), the preceding sentence shall be applied by substituting '40 percent' for '25 percent'." · (g)
• Pub. L. 101–508, §4118(f)(1)(Q), inserted "other than radiologist services subject to section 1395m(b) of this title," after "during 1992," in introductory provisions. · (g)
• Pub. L. 101–508, §4118(f)(1)(R), substituted "adjusted historical payment basis (as defined in subsection (a)(2)(D)(i)" for "historical payment basis (as defined in subsection (a)(2)(C)(i)". · (i)
• Pub. L. 101–508, §4107(a)(1), added par. (2). · (i)
• Pub. L. 101–508, §4118(k), added par. (3). · (i)
• Pub. L. 101–508, §4118(f)(1)(S), which directed the amendment of par. (1) by substituting "(as defined by the Secretary) and all other physicians' services" for ", and such other" and all that follows through the period was executed by making the substitution for ", and such other c… · (j)