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107 STAT. 582 PUBLIC LAW 103-66—AUG. 10, 1993 services that are not described in clause (iv) and for which— "(I) there are work relative value units, and ''(II) the number of practice expense relative value units (determined for 1994) exceeds 128 per- cent of the number of work relative value units (determined for such year), "(iv) EXCLUDED SERVICES.—^For purposes of clause (iii), the services described in this clause are services which the Secretary determines at least 75 percent of which are provided under this title in an ofiEice setting.". SEC. 13514. SEPARATE PAYMENT FOR INTERPRETATION OF ELECTRO- CARDIOGRAMS. (a) IN GENERAL.—Paragraph (3) of section 1848(b) (42 U.S.C. 1395w-4(b)) is amended to read as follows: "(3) TREATMENT OF INTERPRETATION OF ELECTROCARDIO- GRAMS.—The Secretary- "(A) shall make separate payment under this section for the interpretation of electrocardiograms performed or ordered to be performed as part of or in coi\junction with a visit to or a consultation with a physician, and "(B) shall adjust the relative values established for visits and consultations imder subsection (c) so as not to include relative value units for interpretations of electro- cardiograms in the relative value for visits and consulta- tions.". (b) ASSURING BUDGET NEUTRALITY.—Section 1848(cX2) (42 U.S.C. 1395w-4(cX2)), as amended by section 13513, is further amended by adding at the end the following new subparagraph: "(F) BUDGET NEUTRALITY ADJUSTMENTS.—The Secretary— "(i) shall reduce the relative values for all services (other than anesthesia services) established under this paragraph (and, in the case of anesthesia services, the conversion factor established by the Secretary for such services) by such percentage as the Secretary determines to be necessary so that, beginning in 1996, the amendment made by section 13514(a) of the Omni- bus Budget Reconciliation Act of 1993 would not result in expenditures under this section that exceed the amoimt of such expenditures that would have been made if such amendment had not been made, and "(ii) shall reduce the amounts determined under subsection (aX2XBXiiXI) by such percentage as the Secretary determines to be required to assure that, t£iking into account the reductions made under clavise (i), the amendment made by section 13514(a) of the Omnibus Budget Reconciliation Act of 1993 would not result in expenditures under this section in 1994 that exceed the amount of such expenditures that would have been made if such amendment had not been made.". (c) CONFORMING AMENDMENTS.—Section 1848 (42 U.S.C. 1395w-4) is amended—