Q: CMS Fee Schedule Lookup Tool Step-by-Step Instructions
A: Let’s take a look at the first topic that I’ve got. This is all around that CMS Fee Schedule Lookup Tool and this is actually one that I started with the last webinar. Last month, there was a question about whether or not a certain modifier was allowed on the CPT code for Medicare. And the way that I found that, I kind of went through real quickly and said “Oh, here’s what I find on the Medicare website,” and somebody said, “Wait, wait, wait, can you back up and actually give us the step-by-step of how we get there?” It’s funny, you take for granted those things that you’re used to using day in and day out. So, I did, I put together kind of a step-by-step process here.
Step 1: Kind of tells you started the Physician Fee Schedule Lookup, and I’ve included the link directly to that. If, you, for some reason don’t have that link and you’re trying to get there, just go to the CMS.gov website and there’s a small search engine up in the corner, right there. You just can type in “Physician Fee Schedule 2016” and that will get you to the same screen that I’m on. So, that’s step one, I put a screenshot in there for you.
VIDEO: CMS Fee Schedule Lookup Tool Step-by-Step Instructions
Step 2: On that same screen, we are going to click the “Start Search” button which is orange and it’s in the middle of the screen. Down at the bottom…Laureen, can you go back to there? If you scroll up just a little bit? Right there next to the computer, that search button is what we will click here in just a second. But what I want to point out here is down at the bottom there is a Help PDF file. That PDF file is actually a little booklet that will walk you through how to use this tool, what the different pieces mean, all of that thing. that’s where I found a lot of the information that I included in this.
But if we’re to click “Start Search” here, then what it’s going to do is it’s going to pop up a screen that says, “Hey, you got to accept the CPT agreement,” because they’re using CPT codes. Then it’s going to ask you to put in your search criteria. Well, ideally, what we would do is in the search the selected year we would put in the current year, which would be 2016. However, if you click that dropdown you’re going to find out that we’re so early in the year. We haven’t had that adjustment to the Physician Fee Schedule yet, so instead of listing it as 2016, it’s listed as 2015B. That’s the most current version that we have right now.
You would click on that and then you’re going to select what type of information do you want to get? We want pricing information, do we want policy indicators, or relative value units, cost indices. What are you looking for? If you’re looking for anything around global days, or if you’re looking for anything around modifiers, you want that payment policy indicators because that’s what is going to give you that information. It’s things that’s going to affect potential payment for that procedure, so we would click that.
Then you can search by a single HCPCS code. Remember when we say HCPCS, HCPCS codes include CPT. CPT is considered level 1 HCPCS codes and our little HCPCS