PSA

Services are eligible to receive the PSA bonus for dates of service January 1, 2005 through June 30, 2008.  Medicare will automatically pay the PSA bonus on a quarterly basis without the need for a modifier on the claim for services provided in ZIP code areas that:

• Fall fully within a county designated as a PSA; or
• Fall partially within a county designated as a PSA and are considered to be dominant for that county, based on a determination of the United States Postal Service; or
• Fall within a rural area 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. In these cases, the bonus payment cannot be made automatically. To receive the bonus for such services, physicians will need to include the AR modifier.

Some key points to remember regarding the PSA bonus are the following:

• Medicare will pay a five percent PSA bonus on a quarterly basis, and the bonus will be based on what Medicare actually paid not on the Medicare-approved payment amount.
• The same service may be eligible for the PSA bonus and the HPSA bonus.  
• Payment will be based on where the service is performed, not on the address of the beneficiary.
• The PSA bonus will be paid on services rendered on or after January 1, 2005 through June 30, 2008.
• Only the provider designations of General Practice (01), Family Practice (08), Internal Medicine (11), and Obstetrics/Gynecology (16) will be paid the bonus for the ZIP code areas designated as primary care PSAs. All other physician provider specialties will be eligible for the specialty PSA area bonus for the ZIP codes areas designated as specialty PSAs.
• Dentists, chiropractors, podiatrists, and optometrists are not eligible for the PSA bonus.
• Services submitted with the AR modifier will be subject to validation by Medicare.