Fee Schedule Localities
|Missouri Locality 01||01||Saint Louis City, Saint Louis, Jefferson, Saint Charles|
|Missouri Locality 02||02||Clay, Jackson, Platte|
|Missouri Locality 99||99||Those counties not listed under Locality 01 or 02|
Q: What is a Medicare Fee Locality?
A: A Medicare fee locality is a specific geographical area designated by CMS to receive the same fee schedule amount. Fee localities are typically divided along county lines, and may consist of a single county, several counties or may be a statewide designation.
There are two main types of fee localities: Medicare Physicians Fee Schedule (MPFS) Localities and Reasonable Charge Localities. MPFS Localities are used to determine payments for codes that are carried on the Medicare Physician's Fee Schedule. Reasonable Charge localities are used to determine pricing for the following types of procedures: Blood Products; Transfusion Medicine services; and Reproductive Medicine lab procedures.
Q: When choosing a fee schedule to download, what is the difference between localities?
A: Currently only providers in Missouri have different fee localities in the Jurisdiction 5 (J5) states. Please see the chart above the Q&As for the different localities.
Q: Where do I find the fee localities on the Centers for Medicare & Medicaid Services (CMS) website?
A: The localities are located under the downloads section on the CMS Fee Schedules - General Information web page.