Proposed physician fee schedule is out and on the table for comment - here are some issues that you need to be aware of:

"In the CY 2006 PFS proposed rule (70 FR 70116), we proposed to reinstate payment for all splints and cast supplies through the PE component of the PFS because we believed we may have unintentionally prohibited remuneration for these supplies when they are not used for reduction of a fracture or dislocation (covered under section 1861(s)(5) of the Act), but rather are provided (and covered) as "incident to" a physician service under section 1861(s)(2)(A) of the Act. This proposal was not finalized; however, in our final rule we asked the medical specialties and the PERC to determine the typical supplies for splints and casts
necessary for each of the fracture management codes and the cast/strapping application codes because we wanted to make certain that the supply inputs were correct before we
proceeded with rulemaking for the CY 2007 PFS. At its February 2006 meeting, the PERC reviewed and approved the supply inputs submitted by the AAOS for each CPT code for
fracture management and cast/strapping application and these were forwarded to us as PERC recommendations. During this interim period we also reassessed the options for payment of materials for splints and casts. We believe that the majority of the splint and cast
supplies that are currently paid through the Q-codes are furnished in relationship to cast/strapping procedures for the management of fractures and dislocations. However, we
did not intend for the medically necessary splint and cast supplies used for other reasons (for example, serial casting, wound care, or protection) not to be paid. Because it may be difficult for the contractors to identify the purpose for the cast/strapping application procedure on a
claim form, we believe that contractors may have been paying for the splint and cast supply Q-codes when the service is performed for other purposes than treatment of fractures and
dislocations.
Since these splint and cast supplies can be covered under both sections 1861(s)(5) and 1861(s)(2)(A) of the Act, we are proposing to include payment for both statutory
benefits using the separate HCPCS Q-codes. This would allow for payment for these medically necessary supplies whether based on sections 1861(s)(5) or 1861(s)(2)(A) of the Act, while ensuring that no duplicate payments are made.
Physicians would continue to bill the HCPCS Q-codes, in addition to the cast/strapping application procedure codes, to be paid for these materials.
The following supplies would continue to be paid separately using the HCPCS Q-codes and would not be included in the PE database upon adoption of this proposal:
. Fiberglass roll.
. Cast padding.
. Cast shoe.
. Stockingnet/stockinette.
. Plaster bandage.
. Denver splint.
. Dome paste bandage.
. Cast sole.
. Elastoplast roll.
. Fiberglass splint.
. Ace wrap.
. Kerlix.
. Webril.
. Malleable arch bars and elastics.
The splint and cast supplies would not be included in the PEs for the following CPT codes:
. 24500 through 24685
. 25500 through 25695
. 26600 through 26785
. 27500 through 27566
. 27750 through 27848
. 28400 through 28675
. 29000 through 29750.
We are requesting input, specifically from medical specialties and contractors on this proposal."