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Try CasePilot| Short Descr | Comm bh clinic svc per diem | Coverage | Not payable by Medicare | Pricing Indicator(s) | 00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.) | MPI | 9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') | BETOS | Z2 – Undefined codes | TOS Code(s) | 9 – Other medical items or services | Added Date | 1/1/2017 | Status Code | Non-Covered Service | 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 | MUE | Not applicable/unspecified. | MUE | Not applicable/unspecified. | OTS Orthotic | No |
| HB | Adult program, non geriatric | Q2 | Demonstration procedure/service | U1 | Medicaid level of care 1, as defined by each state | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. | 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 | HO | Masters degree level | U3 | Medicaid level of care 3, as defined by each state | AH | Clinical psychologist | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | AJ | Clinical social worker | HA | Child/adolescent program | HQ | Group setting | SA | Nurse practitioner rendering service in collaboration with a physician | U2 | Medicaid level of care 2, as defined by each state | U6 | Medicaid level of care 6, as defined by each state |
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| 2017-01-01 | Added | Added |
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