For these services, the physician typically bears the cost of resources, such as labor, medical supplies and medical equipment associated with the physician's service. The higher non-facility practice expense RVUs are generally used to calculate payments for services performed in a physician's office and for services furnished to a patient in the patient's home facility or institution other than a hospital, skilled nursing facility (SNF), or ambulatory surgical center (ASC). Other services, such as most major surgical services with a 90-day global period, are performed entirely or almost entirely in the hospital, and those services generally are provided with a practice expense RVU only for the out-of-office or facility setting. Many of these are evaluation and management codes with code descriptions specific as to the location of the service. Some services, by the nature of their codes, are performed only in certain settings and will have only one level of practice expense RVU per code. Facility Setting Payment DifferentialĪs part of the resource-based practice expense initiative, CMS has replaced the previous policy that systematically reduced the practice expense relative value units (RVUs) by 50%for certain procedures performed in facilities with a policy that would generally identify two different levels (facility and non-facility) of practice expense RVUs for each procedure code depending on the location of the service. All services provided to Medicare beneficiaries are subject to audit and documentation requirements.

Limiting charge applies to unassigned claims by non-participating providers. The non-participating fee schedule amounts and limiting charges do not apply to services or supplies unless they are paid under the physician fee schedule. If you have elected to be a participant during 2019, the limiting charges indicated on the report will not pertain to your practice. The CY 2019 MPFS fees posted are valid from Januthrough December 31, 2019.

2019 MPFS Indicator List and Descriptors.

If you have elected to be a participant during 2020, the limiting charges indicated on the report will not pertain to your practice. Washington - Locality 99** (Rest of Washington) The fees are valid Januthrough December 31, 2020

The CY 2020 MPFS fees have been updated by the Further Consolidated Appropriations Act of 2020.

2020 MPFS Indicator List and Descriptors.

Oregon 2019 schedule or asc