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2012 Fee Schedules

2012 Medicare Physician Fee Schedules

Revised Zero Percent 2012 Medicare Physician Fee Schedules
(Effective for dates of service 01/01/2012 through 12/31/2012.)

Instructions for Downloading:

The fee schedules have been placed in two different file types. There is a PDF version for easy viewing/printing, while in the other column, the files have been placed in a .zip file. Within the zip file, the fees have been placed in an Excel and PDF format for use.

To access the Excel files, you need software that can open .zip files. If you do not currently have unzip software, please talk to your Systems department for recommendations.

Congress recently passed the Middle Class Tax Relief and Job Creation Act of 2012. With some exceptions, this bill extends the current zero percent (0%) update for the MPFS through the end of 2012. The extension does NOT continue the 5% physician fee schedule Mental Health Add-on payment or the 2011 payment rates for bone mass measurement. The following 2012 MPFS payment rates are now effective through December 31, 2012. To view the revised Mental Health and Bone Density MPFS fee schedules that are effective March 1, 2012 through December 31, 2012, please click on the link found under the Updates to the 2012 Medicare Physician Fee Schedule heading below.

Note: A revision was made on 03/08/2012 to the Physician's Fee Schedules below to correct the Anesthesia Conversion Factors. The revised rates are effective for Dates of Service 01/01/2012 through 12/31/2012. The corrected conversion factors will appear on claims for all 2012 dates of service that are processed or reprocessed on or after 03/02/2012.

Note 2: Errors were detected in the 2012 Indiana Physician Fee Schedule Files that were originally posted to our website. The files were replaced on 08/22/2012. If you downloaded or referenced these files prior to that date, you may have inadvertently obtained incorrect pricing information. Please re-check the Indiana Physicians Fee Schedule pricing files you are using to ensure you have the most current and accurate information. (This error did not impact the pricing of claims or physician payment. It is a website display issue that impacted only certain procedure codes.)

State/Locality Types of Files
Indiana (Revised 08/22/2012) Download
How to Download
PDF
Michigan Locality-01 (Revised 03/01/2012) Download
How to Download
PDF
Michigan Locality-99 (Revised 03/01/2012) Download
How to Download
PDF
All States (Revised 08/22/2012) Download
How to Download

Updates to the 2012 Medicare Physician Fee Schedule

2012 Michigan Medicare Physician Fee Schedule Carrier Priced Fees Established for Codes 0256T, 0257T, 0258T, & 0259T (Indiana pricing for these codes is included in the Medicare Physician Fee Schedule file.)
2012 Michigan Medicare Physician Fee Schedule Carrier Priced Fees Established for Codes 0295T, 0296T, 0297T, & 0298T (Indiana pricing for these codes is included in the Medicare Physician Fee Schedule file.)
2012 Michigan Medicare Physician Fee Schedule RVU and Fee Updates for Carrier Priced Codes 77520, 77522, 77523 & 77525 (Indiana pricing for these codes is included in the Medicare Physician Fee Schedule file.)
2012 MPFS amounts effective 03/01/2012 through 12/31/2012 for Mental Health and Bone Density services
April Update to the Calendar Year (CY) 2012 Medicare Physician Fee Schedule Database (MPFSDB)Adobe Portable Document Format (MM 7745)
July Update to the Calendar Year (CY) 2012 Medicare Physician Fee Schedule Database (MPFSDB)Adobe Portable Document Format (MM 7844)
October Update to the Calendar Year (CY) 2012 Medicare Physician Fee Schedule Database (MPFSDB)Adobe Portable Document Format
(Revised MM 8017)

Important Links

For additional information on procedures, including relative value units, a fee schedule status indicator, and various payment policy indicators needed for payment adjustment (i.e., payment of assistant at surgery, team surgery, bilateral surgery, etc.) you may wish to access the Medicare Physician Fee Schedule Database (MPFSDB)/ Relative Value File on the CMS website.

CMS offers the complete file in several different formats and also provides a single code look up.

Access the Medicare Physician Fee Schedule Database (MPFSDB)/Relative Value File(external link) on the CMS website.

Access the Medicare Physician Fee Schedule Database (MPFSDB)/Fee Schedule Look-Up(external link).



2012 Specialty Pricing

(Effective for dates of service 01/01/2012 and after.)

2012 Ambulance Fee Schedules

Ambulatory Surgical Center (ASC)

Anesthesia

Average Sales Price (ASP) Drug Pricing

Chiropractic

The chiropractic fees are available in the Medicare Physician Fee Schedule.

Clinical Psychologist & Clinical Social Worker Fees

Labs

Durable Medical Equipment, Prosthetics, and Orthotics (DMEPOS)

Medical Nutrition Therapy

The medical nutrition therapy fees are available in the Medicare Physician Fee Schedule. To determine the fee, multiply the fee amount by 85%. (Exception - The 85% calculation does not apply to Codes G0108 and G0109).

Nurse Practitioner / Physician Assistant / Clinical Nurse Specialist

The NP, PA and CNS fees are available in the Medicare Physician Fee Schedule. To determine the fee, multiply the fee amount by 85%. (Exception - The 85% calculation does not apply to codes with a TC modifier, Technical Component Only codes or CPT codes G0108 and G0109).

Splints and Casts

Vaccinations (Influenza (flu) and Pneumococcal)


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Page Last Updated: Wednesday, 17-Apr-2013 15:27:51 CDT