Medicare Established Fees

What Are Medicare Established Fees?

A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis. CMS develops fee schedules for physicians, ambulance services, clinical laboratory services, and durable medical equipment, prosthetics, orthotics, and supplies.

Visit CMS.gov to search the American Medical Association (AMA) Medicare Physician Schedule (MPS). It provides more than 10,000 physician services, the associated relative value units, a fee schedule status indicator, and various payment policy indicators needed for payment adjustment (i.e., payment of assistant at surgery, team surgery, bilateral surgery, etc.). The Medicare physician fee schedule pricing amounts are adjusted to reflect the variation in practice costs from area to area. A geographic practice cost index (GPCI) has been established for every Medicare payment locality for each of the three components of a procedure's relative value unit (i.e., the RVUs for work, practice expense, and malpractice). The GPCIs are applied in the calculation of a fee schedule payment amount by multiplying the RVU for each component times the GPCI for that component.

Find-A-Code's Medicare Fee Information Includes

• Medicare Fee Amounts (Non-Facility and Facility)
• Relative Value Units (RVUs - Non-Facility and Facility)
• All LDCs (Local Coverage Determinations)
• All NCDs (National Coverage Determinations)
• All Contractor/Carrier Articles
• Contractor/Carrier Contact Information
• Medicare Policies & Guidelines
• NCCI Edits Manual & Guidelines
• and more...

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