Allowables & Limiting Chg Data - Individual Geo Loocality

Description

This data file contains a complete listing of Medicare's participating and nonparticipating physician fee schedule allowables, as well as the nonparticipating limiting charges, for each fee schedule procedure (CPT^©), applicable professional and technical component codes and site-of-service differentials. Entire listing of fees allowed by Medicare is available by individual state, or by geographic region, or for all 94 payment areas (entire U.S.).

Record Layout - Fixed Format

Fields	Columns			Description
1	1	-	5	Carrier Number
2	6	-	7	Locality Number
3	8	-	9	State
4	10	-	14	CPT^©/HCPCS Code Number
5	15	-	16	Modifier
6	17	-	23	Fee Schedule Amount
7	24	-	30	Site-of-Service Fee Schedule Amount
8			31	Filler

Note: Carrier and Locality values are right-adjusted, zero filled.

The Modifier field can contain one of four different values: Blank, TC, 26 or 53. TC indicates the Technical Component, 26 indicates the Professional Component and 53 indicates a Discontinued Procedure.

Each locality in each state will have its own files in the format listed above.

Formats Available:

* ASCII Diskette: 3.5" (Fixed Field or Comma-Delimited)
* CD-ROM (Fixed Field or Comma-Delimited)

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