Federal (United States) · Agency guidance
Chapter 12
179 sections
179 sections
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 10General
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20Medicare Physicians Fee Schedule (MPFS)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.1Method for Computing Fee Schedule Amount
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.2Relative Value Units (RVUs)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.3Bundled Services/Supplies
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.4Summary of Adjustments to Fee Schedule Computations
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.4.1Participating Versus Nonparticipating Differential
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.4.2Site of Service Payment Differential
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.4.3Assistant-at Surgery-Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.4.4Supplies
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.4.5Allowable Adjustments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.4.6Payment Due to Unusual Circumstances (Modifiers “-22” and “-52”)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.4.7Technical Component Payment Reduction for X-Rays and Other
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.5No Adjustments in Fee Schedule Amounts
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.6Update Factor for Fee Schedule Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.7Comparability of Payment Provision of Delegation of Authority by
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 20.8Payment for Teleradiology Physician Services Purchased by the
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30Correct Coding Policy
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.1Digestive System (Codes 40000 - 49999)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.2Urinary and Male Genital Systems (Codes 50010 - 55899)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.3Audiology Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.4Cardiovascular System (Codes 92950-93799)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.5Payment for Codes for Chemotherapy Administration and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6Evaluation and Management Service Codes - General (Codes
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.1Selection of Level of Evaluation and Management Service
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.1.1Initial Preventive Physical Examination (IPPE) and Annual
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.2Billing for Medically Necessary Visit on Same Occasion as
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.3Payment for Immunosuppressive Therapy Management
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.4Evaluation and Management (E/M) Services Furnished Incident to
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.5Physicians in Group Practice
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.6Payment for Evaluation and Management Services Provided During
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.7Payment for Office or Other Outpatient Evaluation and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.8Payment for Hospital Observation Services and Observation or
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.9Payment for Inpatient Hospital Visits - General
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.9.1Payment for Initial Hospital Inpatient or Observation Care
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.9.2Subsequent Hospital Inpatient or Observation Care Visit and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.10Consultation Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.11Emergency Department Visits (Codes 99281 - 99288)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.12Critical Care Visits and Neonatal Intensive Care (Codes
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.12.1Definition
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.12.2Critical Care by a Single Physician or NPP
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.12.3Critical Care Visits Furnished Concurrently by Different
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.12.4Critical Care Furnished Concurrently by Practitioners in the
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.12.5Split (or Shared) Critical Care Visits
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.12.6Critical Care and Other Same-Day Evaluation and Management
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.12.7Critical Care Visits and Global Surgery
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.12.8Medical Record Documentation
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.13Nursing Facility Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.14Home or Residence Services (Codes 99341- 99350)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.14.1Home or Residence Services (Codes 99341 - 99350) When
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.15Prolonged Services, Standby Services, and Evaluation and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.15.1Prolonged Services – General Rules
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.15.2Prolonged Office/Outpatient E/M Visits
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.15.3Prolonged Other E/M Visits
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.15.4Power Mobility Devices (PMDs) (Code G0372)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.17Physician Management Associated with Superficial Radiation
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.18Split (or Shared) Visits
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 30.6.19Office/Outpatient Evaluation and Management (O/O E/M) Complexity
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 40Surgeons and Global Surgery
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 40.1Definition of a Global Surgical Package
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 40.2Billing Requirements for Global Surgeries
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 40.3Claims Review for Global Surgeries
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 40.4Adjudication of Claims for Global Surgeries
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 40.5Postpayment Issues
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 40.6Claims for Multiple Surgeries
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 40.7Claims for Bilateral Surgeries
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 40.9Procedures Billed With Two or More Surgical Modifiers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 50Payment for Anesthesiology Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 60Payment for Pathology Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 70Payment Conditions for Radiology Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 80Services of Physicians Furnished in Providers or to Patients of Providers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 80.1Coverage of Physicians’ Services Provided in Comprehensive
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 80.2Rural Health Clinic and Federally Qualified Health Center Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 80.3Unusual Travel (CPT Code 99082)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90Physicians Practicing in Special Settings
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.1Physicians in Federal Hospitals
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.2Physician Billing for End-Stage Renal Disease Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.2.1Inpatient Hospital Visits With Dialysis Patients
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.3Physicians’ Services Performed in Ambulatory Surgical Centers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4Billing and Payment in a Health Professional Shortage Area (HPSA)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.1Provider Education
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.1.1A/B MAC (B) Web Pages
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.2HPSA Designations
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.3Claims Coding Requirements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.4Payment
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.5Services Eligible for HPSA and Physician Scarcity Bonus Payments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.6Reserved for Future Use
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.7Post-payment Review
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.8Reporting
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.9HPSA Incentive Payments for Physician Services Rendered in a
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.10Administrative and Judicial Review
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.11Health Professional Shortage Areas (HPSA) Surgical Incentive Payment
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.11.1Overview of the HSIP
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.11.2HPSA Identification
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.11.3Coordination with Other Payments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.11.4General Surgeon and Surgical Procedure Identification for
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.4.11.5Claims Processing and Payment
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.5Billing and Payment in a Physician Scarcity Area (PSA)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.5.1Provider Education
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 12 § 90.5.2Identifying Physician Scarcity Area Locations