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How to Use the Searchable Medicare Physician Fee Schedule (MPFS) “The searchable Medicare Physician Fee Schedule is a great tool to help my practice understand my Medicare payment!” ICN 901344 January 2016
Contents INTRODUCTION 1 What is the Searchable Medicare Physician Fee Schedule (MPFS)? 1 Why Would a Health Care Professional, Supplier, or Provider Use the Searchable MPFS? 1 Background 2 How Up-to-Date is the Searchable Medicare Physician Fee Schedule? 2 How to Locate the Searchable Medicare Physician Fee Schedule 2 SEARCHING THE MPFS 3 Pricing Information Search 4 Pricing Search Using a List of Evaluation/Management Codes 6 Pricing Search Using a Code with an Applicable Professional/Technical Component 9 Payment Policy Indicators Search 10 Payment Policy Indicators Search Using a Code with an Applicable Professional/Technical Component 10 Payment Policy Indicators Search Using a Surgical Code 12 Relative Value Unit (RVU) and Geographic Practice Cost Index (GPCI) Search 14 RVU Search 15 GPCI Search 16 Conclusion 16 RESOURCES 17 APPENDIX 21 MEDICARE PHYSICIAN FEE SCHEDULE (MPFS) QUICK REFERENCE SEARCH GUIDE 29 Please note: The information in this publication applies only to the Medicare Fee-For-Service Program (also known as Original Medicare). To Learn More… If you find this How To booklet helpful, then you may wish to review the other booklets in this series. To locate these booklets, go to the MLN Publications page at and search for items containing the words “how to.” CPT Disclaimer-American Medical Association (AMA) Notice CPT codes, descriptions and other data only are copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply. CPT only copyright 2015 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS\DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
Page 1 HOW TO USE THE SEARCHABLE MEDICARE PHYSICIAN FEE SCHEDULE (MPFS) INTRODUCTION

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