; and (ii) in the case of services furnished by such a center located in a rural area, 95 percent of the amount of payment that would otherwise apply under this subsection, including application of the geographic adjustment under paragraph (2)(D) and the OPD fee schedule increase factor under paragraph (3)(C)(iv). (G) Use of claims modifier A hospital-owned off-campus emergency department shall be required to add a claims modifier to claims for payment under this part in order to enable tracking of items and services furnished by those departments under this part. . (d) Medicaid coverage Section 1905(a)(2)(A) of the Social Security Act ( 42 U.S.C. 1396d(a)(2)(A) ) is amended by inserting the following after outpatient hospital services : , which shall include the services of freestanding emergency centers, as defined in section 1861(jjj), and provided that hospital-owned off-campus emergency departments shall be required to add a claims modifier to enable tracking of off campus emergency services furnished by these departments . (e) Rule of construction Nothing in the provisions of, or amendments made by, this Act shall be construed as reducing or otherwise affecting the amount of payment for any physicians' professional services under the physician fee schedule under section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ). (f) Effective date The amendments made by this Act shall apply to items and services furnished on or after January 1, 2019.