; and (ii) by inserting before the semicolon at the end the following and (EE) with respect to qualifying reconstructive breast surgery services (as defined in section 1861(kkk)), the amount paid shall be equal to the amount payable in accordance with section 1834(x) . (B) Payment determination Section 1834 of the Social Security Act ( 42 U.S.C. 1395m ) is amended by adding at the end the following new subsection: (x) Qualifying reconstructive breast surgery services (1) In general With respect to qualifying reconstructive breast surgery services described in section 1861(kkk)(4) for which payment is determined under this subsection, payment shall be made in an amount equal to 100 percent of the reasonable and customary amount for nipple areolar tattooing, determined according to the reimbursement rates for CPT codes 11920, 11921, and 11922 (or any successor to such codes). (2) Reasonable and necessary treatment Qualifying reconstructive breast surgery services described in section 1861(kkk)(4) shall be deemed to be reasonable and necessary for purposes of section 1862(a)(1)(A). (3) Physician extender For purposes of this subsection and section 1861(kkk)(4), the term physician extender means a health care practitioner who is not a physician and who is licensed or certified by the State in which the practitioner if furnishing services to furnish items or services typically furnished by a physician, such as a nurse practitioner or physician assistant. (4) State-licensed tattoo artist For purposes of this subsection and section 1861(kkk)(4), the term State-licensed tattoo artist means an individual (as specified by the law of the State in which the individual is licensed in performing permanent body art and in which they are so practicing such art) who maintains all public health, safety, and welfare standards and regulations set forth by the State, including all sterilization, sanitation, and safety regulations for tattoo parlors and salons, tattoo inks, tattoo instruments, and any other related paraphernalia, as