The data sets are summarized at the carrier level by meaningful Healthcare Common Procedure Coding/Current Procedural Terminology, (HCPC/CPT), code ranges. For ease of reference, included is a listing of the Medicare carriers arrayed by State. Brief descriptions for the code ranges and modifiers are also provided in the Readme file (see Numeric and Alpha numeric Code Ranges and Descriptions). The data set name contains the year followed by a carrier number. Within each code range are, procedural, condition, or description subheadings. Each data set displays the allowed services, allowed charges, payment amounts by HCPCS/CPT codes and prominent modifiers. These reports will only illustrate the modifiers where duplicative claim submissions occur. This is to avoid duplicate counting of services. Utilization for modifiers not affected by duplicative counting are collapsed into the Other category on the reports. Therefore, not all CMS published modifiers are illustrated. The file is updated annually and usually available by September for the previous year. Media: CD ROM File Cost: $100.00 per year Available: CY 2005 through 2007
Page Last Modified: 12/31/2008 12:17:53 PM
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