Summary of Adjustments to Fee Schedule Computations (Rev.1931, Issued:03-12-10)

by 
August 19th, 2015

For services prior to January 1, 1994, B/MACs computed the fee schedule amount for every service. Through 1995, the fee schedule amount is the transition fee schedule amount. For services after 1995, CMS computes and provides the fee schedule amount for every service discussed below. Certain adjustments are made in order to arrive at the final fee schedule amount.
 
Those adjustments are:
  • Participating versus non-participating differential;
  • Reduction for re-operations;
  • Site of service payment adjustment;
  • Multiple surgeries;
  • Bilateral surgery;
  • Anti-Markup Payment Limitation;
  • Provider providing less than global fee/package;
  • Assistant at surgery;
  • Two surgeons/surgical team; and
  • Supplies

Summary of Adjustments to Fee Schedule Computations (Rev.1931, Issued:03-12-10). (2015, August 19). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/summary-of-adjustments-to-fee-schedule-computations-rev-1931-issued-03-12-10-27277.html

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