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Social Security Act (Title XVIII)

The section of federal law that established and governs the Medicare program, which provides health insurance for people aged 65 or older, some younger people with disabilities, and people with End-Stage Renal Disease.

National Relative Value Units (RVUs)

A standardized measure used by Medicare to assign value to physician services based on the resources typically required to perform them (e.g., physician work, practice expenses, malpractice insurance). These units are then multiplied by a conversion factor to determine payment amounts.

Physician Fee Schedule

The list of services and their associated payment rates, based on National Relative Value Units, used by Medicare to pay doctors and other healthcare providers for their services.

HCPCS Code (Healthcare Common Procedure Coding System)

A set of standardized codes used by healthcare providers to describe the medical supplies, procedures, and services they provide to patients. Level I codes are CPT codes for medical procedures, and Level II codes cover non-physician services like ambulance rides and durable medical equipment.

Qualifying Pediatric Technology

A medical device that is covered by Medicare, approved by the FDA, has a temporary billing code for new technologies, and is either primarily used for children or specifically designed for safe and effective use in children.