Incentive payments for primary care services

In the case of primary care services furnished on or after January 1, 2011 , and before January 1, 2016 , by a primary care practitioner, in addition to the amount of payment that would otherwise be made for such services under this part, there also shall be paid (on a monthly or quarterly basis) an amount equal to 10 percent of the payment amount for the service under this part.

In this subsection:

(A) Primary care practitioner The term “primary care practitioner” means an individual— (i) who— (I) is a physician (as described in section 1395x(r)(1) of this title ) who has a primary specialty designation of family medicine, internal medicine, geriatric medicine, or pediatric medicine; or (II) is a nurse practitioner, clinical nurse specialist, or physician assistant (as those terms are defined in section 1395x(aa)(5) of this title ); and (ii) for whom primary care services accounted for at least 60 percent of the allowed charges under this part for such physician or practitioner in a prior period as determined appropriate by the Secretary.

(B) Primary care services The term “primary care services” means services identified, as of January 1, 2009 , by the following HCPCS codes (and as subsequently modified by the Secretary): (i) 99201 through 99215. (ii) 99304 through 99340. (iii) 99341 through 99350.

There shall be no administrative or judicial review under section 1395ff of this title , 1395 oo of this title, or otherwise, respecting the identification of primary care practitioners under this subsection.