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    the medical reviewer of the day   
503-934-6049   

Prior resources for calculating the
Fee Schedule
For health care providers
 

Questions? Ask MRT
Reviewer of the day:
503-947-7816
E-mail MRT
2007 resources effective 7/1/07
2006 resources effective 6/30/07
 
How to calculate the Fee Schedule Amount
Examples of calculating the Fee Schedule

 
2007 Resources effective 7/1/07
For OAR 436-009 rules
The Federal Register
ASA Relative Value Guide
Current Procedural Terminology (CPT®) codes/CPT® Assistant
ICD-9-CM Code Book
Ambulatory Surgical Center (ASC) Codes
NUBC-04
HCPCS Coding System
 
 
The Federal Register
Addendum B provides the relative value unit (RVUs) and related information used in determining medical services payments for health care providers. Addendum C lists codes with Interim RVUs.

Download Vol. 71. No. 231, December 1, 2006, go to the Centers for Medicare and Medicare Services, click on PDF format and scroll down to page 167
This file is very large and may take time to download.

Order a hardcopy online,
or call the Government Printing Office Bookstore at 1-866-512-1800
(Stock Number 069-001-00185-4; ISBN 0-16-077399-7).
Ask for the Federal Register, Vol. 71, No. 231, December 1, 2006.

View figures in spreadsheet format, go to www.cms.hhs.gov/physicianfeesched/PFSRVF. Select calendar year 2007 and click the link associated with 'rvu07a2'. This file is large and may take time to download. After the zipped file is downloaded, extract the contents. Files named 'PPRRVU07' contain the figures in a viewable format.
The American Society of Anesthesiology Relative Value Guide (ASA)
Provides RVUs and related information used in determining medical services payments for anesthesia providers. Ask for the 2007 Relative Value Guide.

To order the ASA Relative Value Guide, contact:
American Society of Anesthesiologists
520 N. Northwest Highway
Park Ridge, IL 60068-2573
Phone (847) 825-5586
Current Procedural Terminology (CPT®)/CPT® Assistant
Provides codes, descriptions, and guidelines for medical service providers to use in billing for their services. Ask for CPT® 2007.

To order the CPT® 2007 or the CPT Assistant, contact:
American Medical Association
515 North State Street
Chicago, IL 60610
Phone (800) 621-8335
 
ICD-9-CM Code Book
Provides codes and description to use for diagnosis and categorizing disease and injuries. Check out the free on-line ICD-9 search.
 
Ambulatory Surgical Center (ASC) Medicare ASC groups
These files contain the procedure codes which may be performed in an ASC under the Medicare program as well as the ASC payment group assigned to each of the procedure codes.

Note: These files contain material copyrighted by the American Medical Association. The downloadable zipped files are very long, use caution when printing. This information is located at: http://www.cms.hhs.gov/ASCpayment/

If you have questions about the information contained in this document, please contact the medical reviewer of the day, (503)-947-7816.
 
NUBC-04
For hospital billing, this replaces the UB-92.

To order the NUBC UB-04 Data Specifications Manual, contact:
National Uniform Billing Committee
American Hospital Association
29th Floor
One North Franklin
Chicago, IL 60606
Phone (312) 422-3390
Ask to: Become a subscriber of the NUBC UB-04 Specifications Manual
 
Healthcare Common Procedure Coding System
To order the Healthcare Common Procedure Coding System, 12/21/2006, contact:
National Technical Information Service
Springfield, VA 22161
Phone (800) 621- 8335
Online link
 

 
 
Prior Resources effective 6/30/07
For OAR 436-009 rules
The Federal Register
ASA Relative Value Guide
Current Procedural Terminology (CPT®) codes
ICD-9-CM Code Book
Ambulatory Surgical Center (ASC) Codes
 
 

The Federal Register

Addendum B provides the relative value unit (RVUs) and related information used in determining medical services payments for health care providers. Addendum C lists codes with Interim RVUs.

Download Vol. 70. No. 223, November 21, 2005, scroll down to page 223.
This file is very large and may take time to download.

Ask for: Federal Register, Vol. 70. No. 223, November 21, 2005

To order a hardcopy contact: United States Government Bookstore

 

The American Society of Anesthesiology Relative Value Guide (ASA)

Provides RVUs and related information used in determining medical services payments for anesthesia providers. Ask for: 2006 Relative Value Guide

To order contact:
American Society of Anesthesiologists
520 N. Northwest Highway
Park Ridge, IL 60068-2573
(847) 825-5586

 

Current Procedural Terminology (CPT®)

Provides codes, descriptions and guidelines for medical service providers to use in billing for their services. Ask for: CPT® 2006

To order contact:
American Medical Association
515 North State Street
Chicago, IL 60610
(800) 621-8335

 

ICD-9-CM Code Book

Provides codes and descriptions to use for diagnosis and categorizing diseases and injuries. A free on-line ICD-9 search service is provided at e-MDs.

 
Ambulatory Surgical Center (ASC) Medicare ASC groups
These files contain the procedure codes which may be performed in an ASC under the Medicare program as well as the ASC payment group assigned to each of the procedure codes.


Note: These files contain material copyrighted by the American Medical Association. The downloadable zipped files are very long, use caution when printing.

 

If you have questions about the information contained in this document, please contact the medical reviewer of the day, 503-934-6049.

 

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