decisionhealth Newsletters, Answer Books - 2006 Issue 10 (October)
Medicare_Claims_Processing_Manual / 475
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Article Overview
This CMS manual transmittal summarizes a revision to the 2005 Medicare Physician Fee Schedule database and associated payment files. It is relevant to Medicare billing and coding staff, payer operations teams, and system implementers who need to track database updates, file changes, and PET-related code set adjustments. The article also includes effective and implementation dates, references to CMS policy authority, and a detailed attachment listing revised file contents.
Why This Topic Matters
These kinds of transmittals drive Medicare claims processing updates and can affect how carrier and intermediary systems load and process fee schedule data. Understanding the scope of the update helps organizations align claim systems, payment files, and coding edits with CMS release timing.
Article Sections
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General Information
Overview of the transmittal background, policy basis, and the reason for the fee schedule database update.
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Business Requirements
Administrative requirements and implementation notes related to the update are referenced here.
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Provider Education
Provider-facing education material referenced by the transmittal.
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Supporting Information and Possible Design Considerations
Supplemental implementation and systems-planning considerations for the update.
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Schedule, Contacts, and Funding
Effective dates, implementation timing, and contact information for the transmittal.
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Changes included in the 1st Update to the 2005 Medicare Physician Fee Schedule Database
A structured list of revised fee schedule database entries and related file updates, including PET-related changes and other code-set maintenance.
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Filenames for Revised Payment Files
Names of the revised carrier and intermediary files associated with the database update.
What You Will Learn
- How CMS structured the 2005 physician fee schedule database update
- Which parts of the transmittal describe payment file revisions
- What categories of code-set changes are included in the update
- Which CMS timing dates are associated with the update
- How the revised files are organized for carriers and intermediaries
Who Should Read This
- Medical coders
- Billing and reimbursement staff
- Medicare claims processing teams
- Payer system analysts
- Healthcare compliance staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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