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Last Modified: 6/2/2014 Location: FL, PR, USVI Business: Part A, Part B

Fee schedule policy indicators FAQ

Q. Where can I obtain fee schedule policy indicators? For example, how can I find the global surgery days for a service? What about relative value units (RVUs) for a particular code?
A. Policy indicators for procedure codes in the Medicare physician fee schedule database (MPFSDB) are available in First Coast Service Options’ fee lookup tool. Select Medicare Physician and Nonphysician Practitioner Fee Schedule (MPFS) from the drop-down list enter a date of service, location, and procedure code, and select submit. Then select the “more” links in the modifier field to view MPFS policy indicators.
These Indicators include: global surgery including pre-operative, intra-operative, and post-operative days, PCTC (professional/technical component), multiple surgery, bilateral surgery, assistant surgery, cosurgery, team surgery, physician supervision requirements, and base codes for multiple endoscopy procedures. For more information regarding these indicators, click here.
Also included are work, practice expense and malpractice expense geographic practice cost indices (GPCIs) and relative value units (RVUs). Note: the allowances Medicare contractors use in their claims payment system use these factors, in combination with an annual conversion factor, but allowances are not calculated at the local level. The allowances are furnished to contractors by CMS after all calculations have been completed.
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First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.