Record Layout for PEN Fee Schedule

70.1 - Record Layout for PEN Fee Schedule (Rev. 3350, Issued: 09-11-15, Effective: 01-01-16, Implementation: 01-04-16) Field Name Pic Position Comment Year X(4) 1 - 4 Applicable Update Year HCPCS Code X(5) 5 - 9 All current year active and deleted codes 1st Modifier XX 10 - 11 2nd Modifier XX 12 - 13 Jurisdiction X 14 D = DME MAC Jurisdiction Category XX 15 - 16 PE = Parenteral and Enteral Nutrition. HCPCS Action X 17 Indicates active/delete status in HCPCS file A = Active Code D = Deleted Code, price provided for grace period processing only Filler XX 18 - 19 Value = 00 State XX 20 - 21 Original Base Fee 9(5)V99 22 - 28 This amount is not used for pricing claims. It is on file for informational purposes. Beginning January 1, 2016, this field will include the Competitive Bidding Rural Fee Amount for specific HCPCS codes. A new indicator field (RURAL FEE INDICATOR) shall be populated with a value of “R” when the Rural Fee is present in this field. Filler 9(5)V99 29 - 35 This field is zero filled. Field Name Pic Position Comment Filler 9(5)V99 36 - 42 This field is zero filled. Updated Fee Schedule Amount 9(5)V99 43 - 49 Amount used for pricing. Gap-Fill Indicator X 50 0 = No Gap-filling required. 1 = A/B MAC (B) Needs to Gap-fill Original Base Year Amount. Pricing Change Indicator X 51 0 = No change to the updated fee schedule amount since previous release. 1 = A change has occurred to the updated fee schedule amount since the previous release. Rural Fee Indicator X(01) 52 R = Rural Fee is present in the Original Base Fee field Filler X(8) 53 - 60