Links to Payor Resources

Medicare Physician Fee Schedule "Lookup" Tool

The Physician Fee Schedule lookup website is designed to take you through the selection steps prior to the display of the information. The site allows you to (1) search pricing amounts, various payment policy indicators, RVUs, and GPCIs by a single procedure code or a range of procedure codes; and (2) search for the national payment amount, a specific Medicare Administrative Contractor (MAC) or a specific MAC locality. Each page has associated help/hint available to complete your selections.

ICD-10-CM Resources

This website provides the latest news on ICD-10-CM codes, including any fiscal year changes or errata.

Medicare Revalidation (Renewing Your Enrollment)

Providers are required to revalidate—or renew—their enrollment record periodically to maintain Medicare billing privileges. In general, providers and suppliers revalidate every five years. Keep your information up to date, including your specialty designation.

Medicare Claims Processing Manual

The Medicare Claims Processing Manual–specifically Chapter 12–provides claims processing instructions and correct coding policy for physician and nonphysician practitioner services.

Medicare NCCI Procedure-to-Procedure Edits

National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits prevent inappropriate payment of services that should not be reported together. CMS posts changes to each of its NCCI PTP published edit files on a quarterly basis.