1. Process by which tumor cells spread to distant parts of the body. 2. Tumor that develops away from the site of origin.

Alternative payment system for dialysis services. If a patient selects method I, the facility rendering the dialysis care assumes responsibility for giving home dialysis equipment, supplies, and home support services. The facility receives payment under the composite rate system. The patient pays the Medicare Part B deductible and coinsurance at the facility’s composite rate.

Alternative payment system for dialysis services. If the patient selects method II, the patient contacts the supplier of the home dialysis equipment and supplies and not a dialysis facility. The patient has only one supplier and pays the Medicare Part B deductible and coinsurance. The dialysis facility may not be paid for home dialysis equipment or supplies under this reimbursement system. The facility only receives method II payment for home dialysis support services.

Major urban population areas designated by the U.S. Department of Commerce that have aggregate populations in excess of 1 million individuals. MSA designations are used as a factor in the Medicare fee schedule calculations for physician office costs and in the prospective payment system (PPS) calculation of hospital labor costs.

Medical professional who renders medical care under the direct supervision of a state-licensed physician (e.g., nurse midwife, nurse practitioner, physical therapist, physician assistant). Commonly referred to as midlevel provider (MLP), nonphysician practitioner (NPP) , or physician extenders (PEs) .

Card issued to active duty service members that may be used to present to providers when seeking medical care under the TRICARE Prime Remote program (see Figure M-2 ). Also known as a sponsor identification card .Military identification card for an active duty individual in the armed forces. It is used as the identification card for the TRICARE Prime Remote Program and is considered a sponsor identification card.

Individual who is retired from a career in the armed forces; also known as service retiree .

Credits recognizing that military personnel receive other cash payments and wages in kind (such as food and shelter) in addition to their basic pay.