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Try CasePilot| Short Descr | Adm subq drug 1st home visit | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 11 – Physician Fee Schedule - Price established using national RVUs | MPI | A – Not applicable, as HCPCS priced under one methodology | Processing Note | THESE G CODES ARE ASSOCIATED WITH A NEW PART B BENEFIT CATEGORY ESTABLISHED BY THE FOLLOWING SECTIONS IN THE SOCIAL SECURITY ACT: 1861(s)(2)(GG), 1861(iii), 1834(u). | BETOS | M4A – Home visit | TOS Code(s) | 1 – Medical care | Added Date | 1/1/2021 | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | MUE | Not applicable/unspecified. | MUE | Not applicable/unspecified. | OTS Orthotic | No |
| GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit |
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| 2021-01-01 | Added | Code added. |
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