CMS Pub. 100-04, ch. 12, § 90.5.3

January 1, 2005 for the coding, testing, and implementation phases for the MCS

Maintainer and A/B MACs (B)

January 1, 2005 for all phases for the VIPS Maintainers and A/B MACs (B))

Medicare will automatically pay the physician scarcity bonus on a quarterly basis for

services provided in ZIP code areas that fully fall within a county designated as a PSA,

partially fall within a county designated as a PSA area and are considered to be dominant

for that county based on a determination by the United States Postal Service (USPS), or

fall within a rural census tract of a metropolitan statistical area identified through the

latest modification of the Goldsmith Modification that is determined to be a PSA.

In some cases, a service may be provided in a county that is considered to be a PSA, but

the ZIP code is not considered to be dominant for that area. The bonus payment cannot

automatically be made. In order to receive the bonus for those areas, physicians must

include the following modifier on the claim:

AR - Physician providing service in a Physician Scarcity Area.

In order to be considered for the bonus payment, the name, address, and ZIP code of

where the service was rendered must be included on all electronic and paper claims

submissions.