Overview of the Medicare Physician Fee Schedule Search

Overview This website is designed to provide information on services covered by the Medicare Physician Fee Schedule (MPFS). It provides more than 10000 ... OverviewoftheMedicarePhysicianFeeScheduleSearch Overview ThiswebsiteisdesignedtoprovideinformationonservicescoveredbytheMedicarePhysicianFeeSchedule(MPFS).Itprovidesmorethan10,000physicianservices,theassociatedrelativevalueunits,afeeschedulestatusindicatorandvariouspaymentpolicyindicatorsneededforpaymentadjustment(i.e.,paymentofassistantatsurgery,teamsurgery,bilateralsurgery,etc.).TheMedicarephysicianfeeschedulepricingamountsareadjustedtoreflectthevariationinpracticecostsfromareatoarea.Ageographicpracticecostindex(GPCI)hasbeenestablishedforeveryMedicarepaymentlocalityforeachofthethreecomponentsofaprocedure'srelativevalueunit(i.e.,theRVUsforwork,practiceexpense,andmalpractice).TheGPCIsareappliedinthecalculationofafeeschedulepaymentamountbymultiplyingtheRVUforeachcomponenttimestheGPCIforthatcomponent. ThePhysicianFeeSchedulelook-upwebsiteisdesignedtotakeyouthroughtheselectionstepspriortothedisplayoftheinformation.Thesiteallowsyouto: Searchpricingamounts,variouspaymentpolicyindicators,RVUs,andGPCIsbyasingleprocedurecode,arangeandalistofprocedurecodes. Searchforthenationalpaymentamount,aspecificMedicareAdministrativeContractor(MAC)oraspecificMAClocality.EachpagehasassociatedHelp/Hintavailabletocompleteyourselections. NOTE:IntheCY2010PFSfinalrulewithcommentperiod(74FR61751)weprovidedfora4-yeartransitiontothenewPERVUsresultedfromusingtheupdatedPPISPE/HRdata.ThisnewPPISdatacausedpaymentreductionsforsomespecialties.Inordertoeasethisimpact,wefinalizedagradual4yeartransitionfromthepreviousPERVUstothePERVUsdevelopedusingthenewPPISdata(75percentold/25percentnewforCY2010,50percentold/50percentnewforCY2011,25percentold/75percentnewforCY2012,and100percentnewforCY2013).CY2013isthefinalyearofthetransitiontothenewfullPEvalues,resultingintheeliminationoftheTransitionalPERVUs. Disclaimer:Pleasenotethatthisdisplaytooliscreatedandmaintainedasahelpfulaidforphysiciansandnonpractitionerslookingforaquicklook-upandreferencetothePhysicianFeeSchedule(PFS)paymentrates.UsersofthisdisplaytoolshouldnotethattheCentersforMedicare&MedicaidServices(CMS)makenowarranties,expressedorimplied,regardingerrorsoromissionsandassumenolegalliabilityorresponsibilityforlossordamageresultingfromtheuseofinformationcontainedwithin.FortheofficialanddefinitiveCMSPFSpaymentfiles,pleasecontactthelocalMedicareAdministrativeContractor(MAC)inyourpaymentjurisdiction. BeginSearch Downloads PhysicianFeeScheduleGuide(PDF) Feedback Sendemailto: [email protected] DataUpdated:07/01/2022 HelpwithFileFormats andPlug-Ins