; (ii) is trained and educated (including through on-the-job training) to assemble, program, adjust, service, and repair CRT items; and (iii) on an annual basis, completes at least 10 hours of education specific to the assembly, programming, service, adjusting, and repairing of CRT items. (C) Qualified ordering practitioner The term qualified ordering practitioner means a physician (as defined in section 1861(r)), a physician assistant, nurse practitioner, or a clinical nurse specialist (as those terms are defined in section 1861(aa)(5)). . 5. Conforming amendments (a) Exemption from competitive acquisition Section 1847(a)(7) of the Social Security Act ( 42 U.S.C. 1395w–3(a)(7) ) is amended by adding at the end the following new subparagraph: (C) CRT items For calendar year 2020 and subsequent years, complex rehabilitation technology items (as defined in section 1861(kkk)). . (b) Payment exclusions Section 1834(a) of the Social Security Act ( 42 U.S.C. 1395m(a) ) is amended— (1) in paragraph (4), by adding at the end the following sentence For calendar year 2020 and subsequent years, the items covered by this paragraph shall not include CRT items (as defined in section 1861(kkk)), which shall be paid pursuant to the fee schedule and methodology for CRT items described in section 1834(x) beginning on January 1, 2020, and in subsequent years. ; (2) in paragraph (7)(A), by adding at the end the following: For calendar year 2020 and subsequent years, this paragraph shall not apply to CRT items under section 1861(kkk).