Institutional Claim Record Layout for the Outpatient Rehabilitation and CORF

50.3 - Institutional Claim Record Layout for the Outpatient Rehabilitation and CORF Services Fee Schedule (Rev. 2643, Issued: 01-31-13, Effective: 07-01-13, Implementation: 07-01-13) This is a physician fee schedule abstract file for outpatient rehabilitation and CORF services payment. The CMS will provide the specific file names when the prices are released. The file name will contain the label ABSTR. Record Length - 60 Record Format - FB Block Size - 6000 Character Code - EBCDIC Sort Sequence - A/B MAC (B), Locality HCPCS Code, Modifier Data Element Name Picture Location Comment 1-HCPCS X(05) 1 - 5 2-Modifier X(02) 6 - 7 3-Non-Facility Fee 9(05)V99 8 - 14 4-PCTC Indicator X(01) 15 - 15 This field is only applicable when pricing Critical Access Hospitals (CAHs) that have elected the optional method (Method 2) of payment. 5-Facility Fee 9(05)V99 12 - 22 6-Effective Date X(08) 23 - 30 Update effective date 7- A/B MAC (B) Number X(05) 31 - 35 8-Locality X(02) 36 - 37 9-Filler X(03) 38 - 40 10-Fee Indicator X(1) 41 - 41 R = Rehab/Audiology function test/CORF services 11-Outpatient Hospital X(1) 42 - 42 0 = Fee applicable in hospital outpatient setting 1 = Fee not applicable in hospital outpatient setting 12-Status Code X(1) 43 - 43 Separate instructions will be used for the use of this field at a later date. This field indicates whether the code is in the physician fee schedule and whether it is separately payable if the service is covered. 13-Multiple Surgery X(01) 44 - 44 Indicator indicates which payment adjustment rule for multiple procedures apply to the service. 14-Non Facility PE 9(05)V99 45 - 51 Non-facility practice expense RVU 15-Filler X(01) 52 - 52 16- A/B MAC (A) or (HHH) Therapy Reduction 9(05)V99 53 - 59 Reduces payment amount for multiple surgery 17-Filler X(01) 60 - 60