Medicare Physician Fee Schedule Data Base

December 23rd, 2009 - Betsy Nicoletti
Categories:   Medicare Physician Fee Schedule (MPFSDB)  
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The Medicare Physician Fee Schedule Data Base is published annually by Medicare, and posted on their web site.  It is the source of Relative Value Units, but provides much more important billing information, aw well.  It can be difficult to use in its Excel format.  Many commercial vendors incorporate the fee schedule information and indicators into their coding programs.

You can download it at:

http://www.cms.hhs.gov/PhysicianFeeSched/

Defines payment criteria through a series of indicators:

Should you report it bilaterally or is it already defined as bilateral?

Is the code an active, payable code?

Is an assistant at surgeon paid for the procedure?

Can the procedure be performed by co-surgeons?

What modifiers can be used on the code?

Does the diagnostic service have both a technical and professional component?

What level of physician supervision is required for diagnostic tests?

You can get this information by downloading the fee schedule and the accompanying word file that explains the indicators.  

 

Many on line and disk based coding programs have this information built in, in a much easier to use fashion.

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