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CMS Pub. 100-04, ch. 12, § 90.5

Billing and Payment in a Physician Scarcity Area (PSA)

activein force · 2026-08-25 – presentas-observed

Section 413a of the MMA requires that a 5 percent bonus payment be established for

physicians in designated physician scarcity areas for dates of service January 1, 2005,

through December 31, 2007. The Medicare, Medicaid, and State Children’s Health

Insurance Program (SCHIP) Extension Act of 2007 amended §1833(u)(1) of the Social

Security Act and has extended payment of that bonus through June 30, 2008. Physician

scarcity designations will be based on the lowest primary care and specialty care ratios of

Medicare beneficiaries to active physicians in every county. In addition, based on rural

census tracts of metropolitan statistical areas identified through the latest modification of

the Goldsmith Modification (i.e., Rural-Urban Commuting Area Codes), additional

physician scarcity areas will be identified based on the lowest primary care and specialty

care ratios of Medicare beneficiaries to active physicians in each identified rural census

area.

History

(Rev. 1434; Issued: 02-05-08; Effective: 01-01-08; Implementation: 01-07-08)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
1b9088aa10feb5d704c11fe3b8371ddc4654b92c9612baef1416bfbd38fbb748
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