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Rhode Island Health Professional Shortage Area (HPSA) Listing
Please check the CMS Website at
http://www.cms.hhs.gov/HPSAPSAPhysicianBonuses/ to determine whether
the HPSA bonus payment will automatically be paid for services rendered
in your area.
The payment files for the automated payment of the HPSA bonus payment
will be developed and updated annually. Once the annual designations are
made, no interim changes will be made to the automated payment files to
account for HRSA updates to designations throughout the year. New
designations and withdrawals of HPSA designations during a calendar year
will be included in the next annual update.
For newly designated HPSA areas, physicians will be able to receive
the bonus by self-designating through the use of the AQ modifier
(Physician providing a service in a Health Professional Shortage Area (HPSA))
must be submitted. They will also need to submit the modifier for any
designated areas not included in the automated file due to the cut off
date of the data used. This will only be necessary if the zip code of
where they provide their service is not already on the list of zip codes
that will automatically receive the bonus payment. Physicians must not
continue to self-designate through the use of the modifiers for HPSA
designations that are withdrawn during the year, but are not part of the
automated files.
The following are the specific instances in which you will need to
enter a modifier:
- When you provide services in zip code areas that do not fall
entirely within a designated full county HPSA bonus area;
- When you provide services in a zip code area that falls
partially within a full county HPSA but is not considered to be in
that county based on the USPS dominance decision;
- When you provide services in a zip code area that falls
partially within a non-full county HPSA;
- When you provide services in a zip code area that was not
included in the automated file of HPSA areas based on the date of
the data run used to create the file.
Prior to the beginning of each calendar year, CMS will post on its
Web site zip codes that are eligible to automatically receive the bonus
payment as well as information on how to determine when the modifier is
needed to receive the bonus payment.
Please check the Health Resources and Services Administration
(HRSA) Website at
http://www.bhpr.hrsa.gov/shortage/ to verify your HPSA status.
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