Incentive payments for Medicare part B items and services furnished in Health Investment Zones

Section 1833 of the Social Security Act (42 U.S.C. 1395l) is amended by adding at the end the following new subsection: (ee) Incentive payments for items and services furnished in Health Investment Zones (1) In general In the case of items and services furnished under this part in an area that is designated as a Health Investment Zone under section 2(a)(1) of the Health Investment Zones Act of 2026, in addition to the amount of payment that would otherwise be made for such items and services under this part, there also shall be paid (on a monthly or quarterly basis)— (A) an amount equal to 10 percent of the payment amount for the item or service under this part; (B) for such an item or service furnished at a freestanding physician office or clinic (as defined in paragraph (2)) or a Federally qualified health center (as defined in section 1861(aa)(3)), in addition to any applicable additional payment amount under this paragraph, an amount equal to 5 percent of the payment amount for the item or service under this part; and (C) for an annual wellness visit (HCPCS codes G0438–G0439), diabetes self-management training (CPT codes 98960–98962), chronic care management (CPT codes 99487–99491), and a preventative screening such as a mammography or colorectal cancer screening, in addition to any applicable additional payment amount under this paragraph, an amount equal to 10 percent of the payment amount for such item or service under this part. (2) Definition of freestanding physician office or clinic In this subsection, the term freestanding physician office or clinic means a clinic that— (A) bills by place of service code 11 (office) or 22 (independent clinic) in the physician fee schedule under section 1848; and (B) is not directly or indirectly owned or controlled by a hospital system enrolled in the Medicare Provider Enrollment, Chain, and Ownership System (commonly referred to as PECOS). (3) Coordination with other payments The amount of the additional payment for an item or a service under this subsection and subsection (m) shall be determined without regard to any additional payment for the item or service under subsection (m) and this subsection, respectively. The amount of the additional payment for an item or a service under this subsection and subsection (z) shall be determined without regard to any additional payment for the item or service under subsection (z) and this subsection, respectively..