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107 STAT. 592 PUBLIC LAW 103-66—AUG. 10, 1993 42 u s e 1395x note. 42 u s e 1395x note. 42 u s e 1395Z note. 42 u s e 1395x note. 42 u s e 1395b-l note. that by the Secretary, unless the Secretary has determined that the use is not medically appropriate or the use is identified as not indicated in one or more such compendia, or ''(II) the C£urrier involved determines, based upon guidance provided by the Secretary to carriers for determining accepted uses of drugs, that such use is medically accepted based on supportive clinical evidence in peer reviewed medical literature appearing in publications which have been identified for pur- poses of mis subclause by the Secretcuy. The Secretary may revise the list of compendia in clause (iiXD as is appropriate for identifying medically accepted indications for drugs. . (c) EFFECTIVE DATE.—^The amendments made by subsections (a) and (b) shall apply to items fiimished on or after January 1,1994. SEC. 13554. CLARIFICATION OF COVERAGE OF CERTIFIED NURSE-MID- WIFE SERVICES PERFORMED OUTSIDE THE MATERNITY CYCLE. (a) IN GENERAL.—Section 1861(afX2) (42 U.S.C. 1395x(j is amended by striking ", and penorms services" and all follows and inserting a period. (b) EFFECTIVE DATE.—^The amendment made by subsection (a) shall apply to services fiimished on or after January 1, 1994. SEC. 13655. INCREASE IN ANNUAL CAP ON AMOUNT OF MEDICARE PAYMENT FOR OUTPATIENT PHYSICAL THERAPY AND OCCUPATIONAL THERAPY SERVICES. (a) INCREASE IN ANNUAL LIMITATION.—Section 1833(g) (42 U.S.C. 13951(g)) is amended by striking "$750" and inserting ^$900" each place it appears. (b) EFFECTIVE DATE.—^The amendment made by subsection (a) shall apply to services furnished on or afi^er January 1, 1994. SEC. 13556. RURAL HEALTH CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS. (a) IN GENERAL.—Paragraph (4) of section 1861(aa) (42 U.S.C. 1395x(aa)) is amended— (1) by striking "or" at the end of subparagraph (B); (2) by striking the period at the end of subpars^aph (C) and inserting "; or"; and (3) by adding at the end the following new subparagraph: "(D) is an outpatient health program or facility operated by a tribe or tribal organization under the Indian Self-Deter- mination Act or by an urban Indian organization receiving fimds under title V of the Indian Health Care Improvement Act.". (b) EFFECTIVE DATE.—^The amendments made by subsection (a) shall take efiTect as if included in the enactment of section 4161(aX2XC) of OBRA-1990. SEC. 13557. EXTENSION OF MUNICIPAL HEALTH SERVICE DEM- ONSTRATION PROJECTS. Section 9215 of the Consolidated Omnibus Budget Reconcili- ation Act of 1985, as amended by section 6135 of OBRA-1989, is amended— (1) by striking "December 31, 1993" and inserting "Decem- ber 31,1997", andT