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Medicare Fee Schedule
Par-Allowables

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Description

This data file contains a complete listing of Medicare's participating physician fee schedule allowables for each fee schedule procedure (CPT©), applicable professional and technical component modified codes and site of service differentials. Data files are available by State, or by each of Medicare's 94 geographic localities, or the entire United States.

 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

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.

Formats Available:

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

CPT Copyright 2010, American Medical Association (AMA). All Rights Reserved. Click here for AMA disclaimer.
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