Payment Policies
- 3D Rendering of Tomographic Modalities (PDF)
Last updated 10/14/2021 - Add On Codes (PDF)
Last updated 07/14/2022 - Administration of Injections and Infusions in Facility Settings (PDF)
Last updated 09/15/2022 - After Hours and Weekend Care (PDF)
Last updated 03/17/2022 - Ambulance Services (PDF)
Last updated 07/14/2022 - Anesthesia Services (PDF)
Last updated 08/12/2021 - B-Status Codes (PDF)
Last updated 11/11/2021 - Bilateral Procedures - Professional & Institutional Billing (PDF)
Last updated 10/14/2021 - Care Coordination Payment Policy (PDF)
Last updated 03/17/2022 - Co-Surgeons (Two Surgeons) (PDF)
Last updated 09/15/2022 - Consultation Services (PDF)
Last updated 05/12/2022 - Discontinued Procedure-53 Modifier (PDF)
Last updated 04/14/2022 - Evaluation and Management for Office and Other Outpatient Services (PDF)
Last updated 01/13/2022 - E&M Services by Physicians of the Same Group Practice (PDF)
Last updated 06/16/2022 - Global Surgery Package (PDF)
Last updated 12/09/2021 - Hospital Related Services (PDF)
Last updated 08/11/2022 - Increased Procedural Services (Modifier-22) (PDF)
Last updated 06/16/2022 - Initial Hospital Evaluation and Management (PDF)
Last updated 07/14/2022 - Institutional Payment Programs and Charged Based Reimbursement (PDF)
New policy - effective 09/16/2021 - Institutional Supply (PDF)
Lat updated 02/10/2022 - Laboratory Panels and Components (PDF)
Last updated 05/12/2022 - Maximum Units of Service (PDF)
Last updated 11/11/2021 - Moderate Sedation (PDF)
Last updated 03/17/2022 - Modifier Reference (PDF)
Last updated 09/15/2022 - Multiple Diagnostic Cardiovascular Procedure Reduction (PDF)
Last updated 08/11/2022 - Multiple Diagnostic Ophthalmology Procedure Reduction (PDF)
Last updated 08/11/2022 - Multiple Imaging Reduction (PDF)
Last updated 08/11/2022 - Multiple Procedure Reduction - Home Infusion Therapy Per-Diem (PDF)
Last updated 08/11/2022 - Multiple Surgical Procedure Reduction (Including Multiple Endoscopic Procedure Reduction) (PDF)
Last updated 08/11/2022 - Multiple Therapy Reduction (PDF)
Last updated 08/11/2022 - Multiple Visit Reduction (PDF)
Last updated 08/11/2022 - National Correct Coding Initiative (PDF)
Last updated 07/14/2022 - Never Event – Hospital Acquired Condition (HAC) in Inpatient Setting
Last updated 07/14/2022 - Never Events - Wrong Surgery (PDF)
Last updated 07/14/2022 - New Patient Visits (PDF)
Last updated 01/01/2023 - NonPhysician Healthcare Professionals Billing E-M Codes (PDF)
Last updated 01/12/2023 - Observation and Discharge Policy (PDF) NEW!
Last updated 09/16/2021 - Obstetric Services (PDF)
Last updated 02/10/2022 - Portable X-Ray and EKG Supplier Services (PDF)
Last updated 07/14/2022 - Professional Technical Component Payment Policy (PDF)
Last updated 09/16/2021 - Prolonged Services (PDF)
Last updated 04/14/2022 - Readmissions Review Quality Program for MA & Comm (PDF)
Last updated 12/01/2021 - Reduced Services-52 Modifier (PDF)
Last updated 04/14/2022 - Reporting Habilitative and Rehabilitative Services (PDF)
Last updated 09/15/2022 - Robotic Assisted Surgery (PDF)
Last updated 04/14/2022 - Robotic Assisted Surgery Facility (PDF)
Last updated 04/14/2022 - Split Surgical Package (PDF)
Last updated 11/11/2021 - Standby Services (PDF)
Last updated 04/14/22 - Supplies (PDF)
Last updated 10/14/2021 - Surgical Assistant (PDF)
Last updated 05/02/2022 - T-Status Codes (PDF)
Last updated 05/12/2022 - Telehealth Facility Procedure Q3014 (PDF)
Last updated 01/12/2023 - Unbundled, Incidental, and Mutually Exclusive Services (PDF)
Last updated 11/11/2021 - Unclassified Drugs (PDF)
Last updated 05/12/2022 - Unlisted Procedure Codes (PDF)
Last updated 05/12/2022 - Virtual Visits (PDF)
Last updated 01/12/2023
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