{ "version": "2026-11-05.4", "asOf": "2026-11-05", "baseYear": 1992, "sourcePayloadSha256": "2764b723d3915993368f0c385429b8ff377b149f29677579e667e758b04b0c1a", "metadata": { "as_of": "2026-11-05", "base_year": 1992, "inflation_descriptions": { "cpi_series": { "name": "CPI-U all items, U.S. city average, not seasonally adjusted", "series_id": "CUUR0000SA0", "historical_method": "Use official BLS M13 published annual averages, never a current-year YTD average.", "forecast_method": "Extend the final BLS 2025 annual average by CBO February 2026 calendar-year CPI-U growth, 2.924% then 2.547%. No CBO index levels or Q4/Q4 growth imported.", "forecast_display_label": "CBO February 2026 forecast extension", "cbo_original_index_levels": { "2025": 322.378, "2026": 331.807, "2027": 340.26 }, "cbo_anchor_note": "CBO estimated 2025 CPI-U at 322.378. The extension instead anchors to BLS published 321.943, so model levels intentionally differ from the CBO original index levels." }, "mei_series": { "name": "CMS published MEI update chain, including productivity", "method": "Set 1992=1, then multiply by (1+published annual update) from 1993 onward. All annual rates are published policy updates/forecasts, not a fixed-vintage realized price-index history.", "caution": "Neither CMS current unadjusted market-basket index levels nor the legacy AMA-calibrated DB series may be silently substituted.", "multiplier_1992_to_2027": 2.044550774792661, "site_rate_discrepancies": [] } }, "cf_audit": { "schema_version": 1, "as_of": "2026-11-05", "scope": { "years": [ 2000, 2027 ], "code_family": "office/outpatient E/M 99202–99205 and99212–99215", "anesthesia_excluded": true, "prices": "national conversion factor per total geographic-adjusted RVU, allowed amount before sequestration, MIPS and collection adjustments" }, "intervals": [ { "year": 2000, "category": "Unified", "cf": 36.6137, "cf_decimal": "36.6137", "effective_start": "2000-01-01", "effective_end": "2000-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2000" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 366, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2000.csv" ] }, { "year": 2000, "category": "Unified", "cf": 36.6137, "cf_decimal": "36.6137", "effective_start": "2000-01-01", "effective_end": "2000-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2000" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 366, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2000.csv" ] }, { "year": 2001, "category": "Unified", "cf": 38.2581, "cf_decimal": "38.2581", "effective_start": "2001-01-01", "effective_end": "2001-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2001" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2001.csv" ] }, { "year": 2001, "category": "Unified", "cf": 38.2581, "cf_decimal": "38.2581", "effective_start": "2001-01-01", "effective_end": "2001-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2001" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2001.csv" ] }, { "year": 2002, "category": "Unified", "cf": 36.1992, "cf_decimal": "36.1992", "effective_start": "2002-01-01", "effective_end": "2002-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2002" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2002.csv" ] }, { "year": 2002, "category": "Unified", "cf": 36.1992, "cf_decimal": "36.1992", "effective_start": "2002-01-01", "effective_end": "2002-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2002" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2002.csv" ] }, { "year": 2003, "category": "Unified", "cf": 36.1992, "cf_decimal": "36.1992", "effective_start": "2003-01-01", "effective_end": "2003-02-28", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2002", "2003-date-correction" ], "legal_basis": "Consolidated Appropriations Resolution 2003; revised PFS effective March1,2003. CMS B-03-011 requires January/February services paid at2002rates, including massadjustment of claims processed later.", "date_and_retroactivity_notes": "January/February are real 2002-rate intervals, unlike unadopted SGR reductions.", "days": 59, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2002.csv", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/b03011.pdf" ] }, { "year": 2003, "category": "Unified", "cf": 36.7856, "cf_decimal": "36.7856", "effective_start": "2003-03-01", "effective_end": "2003-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2003", "2003-date-correction" ], "legal_basis": "Consolidated Appropriations Resolution 2003; revised PFS effective March1,2003. CMS B-03-011 requires January/February services paid at2002rates, including massadjustment of claims processed later.", "date_and_retroactivity_notes": "January/February are real 2002-rate intervals, unlike unadopted SGR reductions.", "days": 306, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2003.csv", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/b03011.pdf" ] }, { "year": 2003, "category": "Unified", "cf": 36.1992, "cf_decimal": "36.1992", "effective_start": "2003-01-01", "effective_end": "2003-02-28", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2002", "2003-date-correction" ], "legal_basis": "Consolidated Appropriations Resolution 2003; revised PFS effective March1,2003. CMS B-03-011 requires January/February services paid at2002rates, including massadjustment of claims processed later.", "date_and_retroactivity_notes": "January/February are real 2002-rate intervals, unlike unadopted SGR reductions.", "days": 59, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2002.csv", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/b03011.pdf" ] }, { "year": 2003, "category": "Unified", "cf": 36.7856, "cf_decimal": "36.7856", "effective_start": "2003-03-01", "effective_end": "2003-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2003", "2003-date-correction" ], "legal_basis": "Consolidated Appropriations Resolution 2003; revised PFS effective March1,2003. CMS B-03-011 requires January/February services paid at2002rates, including massadjustment of claims processed later.", "date_and_retroactivity_notes": "January/February are real 2002-rate intervals, unlike unadopted SGR reductions.", "days": 306, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2003.csv", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/b03011.pdf" ] }, { "year": 2004, "category": "Unified", "cf": 37.3374, "cf_decimal": "37.3374", "effective_start": "2004-01-01", "effective_end": "2004-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2004" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 366, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2004.csv" ] }, { "year": 2004, "category": "Unified", "cf": 37.3374, "cf_decimal": "37.3374", "effective_start": "2004-01-01", "effective_end": "2004-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2004" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 366, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2004.csv" ] }, { "year": 2005, "category": "Unified", "cf": 37.8975, "cf_decimal": "37.8975", "effective_start": "2005-01-01", "effective_end": "2005-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2005" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2005.csv" ] }, { "year": 2005, "category": "Unified", "cf": 37.8975, "cf_decimal": "37.8975", "effective_start": "2005-01-01", "effective_end": "2005-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2005" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2005.csv" ] }, { "year": 2006, "category": "Unified", "cf": 37.8975, "cf_decimal": "37.8975", "effective_start": "2006-01-01", "effective_end": "2006-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2006", "2006-retroactive-CR4313" ], "legal_basis": "Deficit Reduction Act2005 §5104, enacted February8,2006, maintained2005CF for2006.", "date_and_retroactivity_notes": "Rates and reprocessing retroactive to January1,2006; do not retain an early-year lower-CF interval.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2006.csv", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r207otn.pdf" ] }, { "year": 2006, "category": "Unified", "cf": 37.8975, "cf_decimal": "37.8975", "effective_start": "2006-01-01", "effective_end": "2006-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2006", "2006-retroactive-CR4313" ], "legal_basis": "Deficit Reduction Act2005 §5104, enacted February8,2006, maintained2005CF for2006.", "date_and_retroactivity_notes": "Rates and reprocessing retroactive to January1,2006; do not retain an early-year lower-CF interval.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2006.csv", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r207otn.pdf" ] }, { "year": 2007, "category": "Unified", "cf": 37.8975, "cf_decimal": "37.8975", "effective_start": "2007-01-01", "effective_end": "2007-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2007" ], "legal_basis": "Tax Relief and Health Care Act2006 preserved the2006conversion factor for2007. SeparateworkBN.8994 remains a pricingcomponent.", "date_and_retroactivity_notes": "Unadopted preliminary CF35.9848 must not enter realized-price history.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2007.csv" ] }, { "year": 2007, "category": "Unified", "cf": 37.8975, "cf_decimal": "37.8975", "effective_start": "2007-01-01", "effective_end": "2007-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2007" ], "legal_basis": "Tax Relief and Health Care Act2006 preserved the2006conversion factor for2007. SeparateworkBN.8994 remains a pricingcomponent.", "date_and_retroactivity_notes": "Unadopted preliminary CF35.9848 must not enter realized-price history.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2007.csv" ] }, { "year": 2008, "category": "Unified", "cf": 38.087, "cf_decimal": "38.0870", "effective_start": "2008-01-01", "effective_end": "2008-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2008A", "cms-indicators-2008B" ], "legal_basis": "MMSEA2007 first-half update and MIPPA2008 second-half replacement preserve38.0870 acrossboth halves. SeparateworkBN.8806 remains a pricingcomponent.", "date_and_retroactivity_notes": "Current official2008A/B datasets agree; no realized lower-CF July interval.", "days": 366, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators208a.csv", "https://pfs.data.cms.gov/sites/default/files/data/indicators208b.csv" ] }, { "year": 2008, "category": "Unified", "cf": 38.087, "cf_decimal": "38.0870", "effective_start": "2008-01-01", "effective_end": "2008-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2008A", "cms-indicators-2008B" ], "legal_basis": "MMSEA2007 first-half update and MIPPA2008 second-half replacement preserve38.0870 acrossboth halves. SeparateworkBN.8806 remains a pricingcomponent.", "date_and_retroactivity_notes": "Current official2008A/B datasets agree; no realized lower-CF July interval.", "days": 366, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators208a.csv", "https://pfs.data.cms.gov/sites/default/files/data/indicators208b.csv" ] }, { "year": 2009, "category": "Unified", "cf": 36.0666, "cf_decimal": "36.0666", "effective_start": "2009-01-01", "effective_end": "2009-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2009" ], "legal_basis": "MIPPA2008 moves separate work budget neutrality adjustment into CF beginning2009.", "date_and_retroactivity_notes": "Use workadjustor1.0 in2009; CF36.0666 must not receive a second.8806/.8994 adjustment.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2009.csv" ] }, { "year": 2009, "category": "Unified", "cf": 36.0666, "cf_decimal": "36.0666", "effective_start": "2009-01-01", "effective_end": "2009-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2009" ], "legal_basis": "MIPPA2008 moves separate work budget neutrality adjustment into CF beginning2009.", "date_and_retroactivity_notes": "Use workadjustor1.0 in2009; CF36.0666 must not receive a second.8806/.8994 adjustment.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2009.csv" ] }, { "year": 2010, "category": "Unified", "cf": 36.0791, "cf_decimal": "36.0791", "effective_start": "2010-01-01", "effective_end": "2010-05-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2010A", "2010-methodology", "2010-retroactive-CR6973", "2015-final-rule", "2010-to-2011-CR7264" ], "legal_basis": "Zero-percent update January–May, then2.2percent update effective June1, extended throughDecember31.", "date_and_retroactivity_notes": "June25enactment wasretroactive toJune1. ACA/RVUcorrections includingCF36.0791wereeffectiveJan1,implementedJune1. InitialCF36.0846isobsolete.", "days": 151, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators210a.csv", "https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/downloads/2010_GPRO_QRUR_Detailed_Methodology.pdf", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r700otn.pdf", "https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_Medicare_Physician_Fee_Schedule_Final_Rule.pdf", "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R833OTN.pdf" ] }, { "year": 2010, "category": "Unified", "cf": 36.8729, "cf_decimal": "36.8729", "effective_start": "2010-06-01", "effective_end": "2010-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2010B", "2010-methodology", "2010-retroactive-CR6973", "2015-final-rule", "2010-to-2011-CR7264" ], "legal_basis": "Zero-percent update January–May, then2.2percent update effective June1, extended throughDecember31.", "date_and_retroactivity_notes": "June25enactment wasretroactive toJune1. ACA/RVUcorrections includingCF36.0791wereeffectiveJan1,implementedJune1. InitialCF36.0846isobsolete.", "days": 214, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators210b.csv", "https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/downloads/2010_GPRO_QRUR_Detailed_Methodology.pdf", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r700otn.pdf", "https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_Medicare_Physician_Fee_Schedule_Final_Rule.pdf", "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R833OTN.pdf" ] }, { "year": 2010, "category": "Unified", "cf": 36.0791, "cf_decimal": "36.0791", "effective_start": "2010-01-01", "effective_end": "2010-05-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2010A", "2010-methodology", "2010-retroactive-CR6973", "2015-final-rule", "2010-to-2011-CR7264" ], "legal_basis": "Zero-percent update January–May, then2.2percent update effective June1, extended throughDecember31.", "date_and_retroactivity_notes": "June25enactment wasretroactive toJune1. ACA/RVUcorrections includingCF36.0791wereeffectiveJan1,implementedJune1. InitialCF36.0846isobsolete.", "days": 151, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators210a.csv", "https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/downloads/2010_GPRO_QRUR_Detailed_Methodology.pdf", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r700otn.pdf", "https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_Medicare_Physician_Fee_Schedule_Final_Rule.pdf", "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R833OTN.pdf" ] }, { "year": 2010, "category": "Unified", "cf": 36.8729, "cf_decimal": "36.8729", "effective_start": "2010-06-01", "effective_end": "2010-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2010B", "2010-methodology", "2010-retroactive-CR6973", "2015-final-rule", "2010-to-2011-CR7264" ], "legal_basis": "Zero-percent update January–May, then2.2percent update effective June1, extended throughDecember31.", "date_and_retroactivity_notes": "June25enactment wasretroactive toJune1. ACA/RVUcorrections includingCF36.0791wereeffectiveJan1,implementedJune1. InitialCF36.0846isobsolete.", "days": 214, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators210b.csv", "https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/downloads/2010_GPRO_QRUR_Detailed_Methodology.pdf", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r700otn.pdf", "https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_Medicare_Physician_Fee_Schedule_Final_Rule.pdf", "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R833OTN.pdf" ] }, { "year": 2011, "category": "Unified", "cf": 33.9764, "cf_decimal": "33.9764", "effective_start": "2011-01-01", "effective_end": "2011-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2011", "2010-to-2011-CR7264" ], "legal_basis": "Medicare and Medicaid Extenders Act2010 provides zero update January1–December31, with RVUbudget neutrality and MEIweightrescaling.", "date_and_retroactivity_notes": "CMSR833OTNeffectiveJan1establishesCF33.9764; initialscheduledSGRcutwasnotrealized.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2011.csv", "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R833OTN.pdf" ] }, { "year": 2011, "category": "Unified", "cf": 33.9764, "cf_decimal": "33.9764", "effective_start": "2011-01-01", "effective_end": "2011-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2011", "2010-to-2011-CR7264" ], "legal_basis": "Medicare and Medicaid Extenders Act2010 provides zero update January1–December31, with RVUbudget neutrality and MEIweightrescaling.", "date_and_retroactivity_notes": "CMSR833OTNeffectiveJan1establishesCF33.9764; initialscheduledSGRcutwasnotrealized.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2011.csv", "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R833OTN.pdf" ] }, { "year": 2012, "category": "Unified", "cf": 34.0376, "cf_decimal": "34.0376", "effective_start": "2012-01-01", "effective_end": "2012-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2012A", "cms-indicators-2012B", "2015-final-rule" ], "legal_basis": "TPTCCA firstJan1–Feb29, JobCreationActMarch1–Dec31: bothzero-update statutoryperiods useCF34.0376.", "date_and_retroactivity_notes": "No numerical CF change atMarch1; no gap.", "days": 366, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators212a.csv", "https://pfs.data.cms.gov/sites/default/files/data/indicators212b.csv", "https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_Medicare_Physician_Fee_Schedule_Final_Rule.pdf" ] }, { "year": 2012, "category": "Unified", "cf": 34.0376, "cf_decimal": "34.0376", "effective_start": "2012-01-01", "effective_end": "2012-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2012A", "cms-indicators-2012B", "2015-final-rule" ], "legal_basis": "TPTCCA firstJan1–Feb29, JobCreationActMarch1–Dec31: bothzero-update statutoryperiods useCF34.0376.", "date_and_retroactivity_notes": "No numerical CF change atMarch1; no gap.", "days": 366, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators212a.csv", "https://pfs.data.cms.gov/sites/default/files/data/indicators212b.csv", "https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_Medicare_Physician_Fee_Schedule_Final_Rule.pdf" ] }, { "year": 2013, "category": "Unified", "cf": 34.023, "cf_decimal": "34.0230", "effective_start": "2013-01-01", "effective_end": "2013-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2013", "2015-final-rule" ], "legal_basis": "American Taxpayer Relief Act2012 preserves zero update January1–December31,2013.", "date_and_retroactivity_notes": "ScheduledSGRcutnotrealized; usecurrentcorrectedCF34.0230.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2013.csv", "https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_Medicare_Physician_Fee_Schedule_Final_Rule.pdf" ] }, { "year": 2013, "category": "Unified", "cf": 34.023, "cf_decimal": "34.0230", "effective_start": "2013-01-01", "effective_end": "2013-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2013", "2015-final-rule" ], "legal_basis": "American Taxpayer Relief Act2012 preserves zero update January1–December31,2013.", "date_and_retroactivity_notes": "ScheduledSGRcutnotrealized; usecurrentcorrectedCF34.0230.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2013.csv", "https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_Medicare_Physician_Fee_Schedule_Final_Rule.pdf" ] }, { "year": 2014, "category": "Unified", "cf": 35.8228, "cf_decimal": "35.8228", "effective_start": "2014-01-01", "effective_end": "2014-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2014", "2015-final-rule" ], "legal_basis": "Pathway forSGRReformAct firstquarter. PAMA2014 enactedApril1 extends the0.5percent update throughDecember31.", "date_and_retroactivity_notes": "EntireyearCF35.8228; noMarch/AprilCFchange. OriginalfinalruleCF27.2006neverapplied.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2014.csv", "https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_Medicare_Physician_Fee_Schedule_Final_Rule.pdf" ] }, { "year": 2014, "category": "Unified", "cf": 35.8228, "cf_decimal": "35.8228", "effective_start": "2014-01-01", "effective_end": "2014-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2014", "2015-final-rule" ], "legal_basis": "Pathway forSGRReformAct firstquarter. PAMA2014 enactedApril1 extends the0.5percent update throughDecember31.", "date_and_retroactivity_notes": "EntireyearCF35.8228; noMarch/AprilCFchange. OriginalfinalruleCF27.2006neverapplied.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2014.csv", "https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_Medicare_Physician_Fee_Schedule_Final_Rule.pdf" ] }, { "year": 2015, "category": "Unified", "cf": 35.7547, "cf_decimal": "35.7547", "effective_start": "2015-01-01", "effective_end": "2015-06-30", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2015A", "2015-macra-CR9152", "2015-extension-CR9104", "2015-correction-notice" ], "legal_basis": "MACRA2015 extendszero update throughJune30, then0.5percent update July1–December31.", "date_and_retroactivity_notes": "CorrectionnoticepublishedMarch20,effectiveMarch19,hasapplicabilityJan1:CF35.7547supersedes35.8013. MACRAenactedApril16retroactivelyavoidsAprilSGRcut.", "days": 181, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators215a.csv", "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3259CP.pdf", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r3283cp.pdf", "https://www.govinfo.gov/content/pkg/FR-2015-03-20/pdf/2015-06427.pdf" ] }, { "year": 2015, "category": "Unified", "cf": 35.9335, "cf_decimal": "35.9335", "effective_start": "2015-07-01", "effective_end": "2015-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2015B", "2015-macra-CR9152", "2015-extension-CR9104", "2015-correction-notice" ], "legal_basis": "MACRA2015 extendszero update throughJune30, then0.5percent update July1–December31.", "date_and_retroactivity_notes": "CorrectionnoticepublishedMarch20,effectiveMarch19,hasapplicabilityJan1:CF35.7547supersedes35.8013. MACRAenactedApril16retroactivelyavoidsAprilSGRcut.", "days": 184, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators215b.csv", "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3259CP.pdf", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r3283cp.pdf", "https://www.govinfo.gov/content/pkg/FR-2015-03-20/pdf/2015-06427.pdf" ] }, { "year": 2015, "category": "Unified", "cf": 35.7547, "cf_decimal": "35.7547", "effective_start": "2015-01-01", "effective_end": "2015-06-30", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2015A", "2015-macra-CR9152", "2015-extension-CR9104", "2015-correction-notice" ], "legal_basis": "MACRA2015 extendszero update throughJune30, then0.5percent update July1–December31.", "date_and_retroactivity_notes": "CorrectionnoticepublishedMarch20,effectiveMarch19,hasapplicabilityJan1:CF35.7547supersedes35.8013. MACRAenactedApril16retroactivelyavoidsAprilSGRcut.", "days": 181, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators215a.csv", "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3259CP.pdf", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r3283cp.pdf", "https://www.govinfo.gov/content/pkg/FR-2015-03-20/pdf/2015-06427.pdf" ] }, { "year": 2015, "category": "Unified", "cf": 35.9335, "cf_decimal": "35.9335", "effective_start": "2015-07-01", "effective_end": "2015-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2015B", "2015-macra-CR9152", "2015-extension-CR9104", "2015-correction-notice" ], "legal_basis": "MACRA2015 extendszero update throughJune30, then0.5percent update July1–December31.", "date_and_retroactivity_notes": "CorrectionnoticepublishedMarch20,effectiveMarch19,hasapplicabilityJan1:CF35.7547supersedes35.8013. MACRAenactedApril16retroactivelyavoidsAprilSGRcut.", "days": 184, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators215b.csv", "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3259CP.pdf", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r3283cp.pdf", "https://www.govinfo.gov/content/pkg/FR-2015-03-20/pdf/2015-06427.pdf" ] }, { "year": 2016, "category": "Unified", "cf": 35.8043, "cf_decimal": "35.8043", "effective_start": "2016-01-01", "effective_end": "2016-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2016", "2016-emergency-CR9495" ], "legal_basis": "MACRAannualupdate with RVUbudgetneutrality and misvalued-codetargetadjustments.", "date_and_retroactivity_notes": "EmergencyCR9495effectiveJan1revisesfiles; usecorrected35.8043throughyear, notinitial35.8279.", "days": 366, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2016.csv", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r3438cp.pdf" ] }, { "year": 2016, "category": "Unified", "cf": 35.8043, "cf_decimal": "35.8043", "effective_start": "2016-01-01", "effective_end": "2016-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2016", "2016-emergency-CR9495" ], "legal_basis": "MACRAannualupdate with RVUbudgetneutrality and misvalued-codetargetadjustments.", "date_and_retroactivity_notes": "EmergencyCR9495effectiveJan1revisesfiles; usecorrected35.8043throughyear, notinitial35.8279.", "days": 366, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2016.csv", "https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r3438cp.pdf" ] }, { "year": 2017, "category": "Unified", "cf": 35.8887, "cf_decimal": "35.8887", "effective_start": "2017-01-01", "effective_end": "2017-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2017" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2017.csv" ] }, { "year": 2017, "category": "Unified", "cf": 35.8887, "cf_decimal": "35.8887", "effective_start": "2017-01-01", "effective_end": "2017-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2017" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2017.csv" ] }, { "year": 2018, "category": "Unified", "cf": 35.9996, "cf_decimal": "35.9996", "effective_start": "2018-01-01", "effective_end": "2018-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2018" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2018.csv" ] }, { "year": 2018, "category": "Unified", "cf": 35.9996, "cf_decimal": "35.9996", "effective_start": "2018-01-01", "effective_end": "2018-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2018" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2018.csv" ] }, { "year": 2019, "category": "Unified", "cf": 36.0391, "cf_decimal": "36.0391", "effective_start": "2019-01-01", "effective_end": "2019-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2019" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2019.csv" ] }, { "year": 2019, "category": "Unified", "cf": 36.0391, "cf_decimal": "36.0391", "effective_start": "2019-01-01", "effective_end": "2019-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2019" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2019.csv" ] }, { "year": 2020, "category": "Unified", "cf": 36.0896, "cf_decimal": "36.0896", "effective_start": "2020-01-01", "effective_end": "2020-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2020" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 366, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2020.csv" ] }, { "year": 2020, "category": "Unified", "cf": 36.0896, "cf_decimal": "36.0896", "effective_start": "2020-01-01", "effective_end": "2020-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2020" ], "legal_basis": "Annual CMSPFS conversion factor, applies fullcalendar year.", "date_and_retroactivity_notes": "Currentofficial historical CMSPFSindicator value andyearcoverage; no within-yearCFchangeidentified.", "days": 366, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2020.csv" ] }, { "year": 2021, "category": "Unified", "cf": 34.8931, "cf_decimal": "34.8931", "effective_start": "2021-01-01", "effective_end": "2021-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2021", "2025-compliance-guide" ], "legal_basis": "Consolidated Appropriations Act2021 provides3.75percent increase forCY2021.", "date_and_retroactivity_notes": "UsecorrectedCF34.8931, notoriginalfinalrule32.4085.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2021-10-21-2021.csv", "https://www.cms.gov/files/document/cms-1807-f.pdf" ] }, { "year": 2021, "category": "Unified", "cf": 34.8931, "cf_decimal": "34.8931", "effective_start": "2021-01-01", "effective_end": "2021-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2021", "2025-compliance-guide" ], "legal_basis": "Consolidated Appropriations Act2021 provides3.75percent increase forCY2021.", "date_and_retroactivity_notes": "UsecorrectedCF34.8931, notoriginalfinalrule32.4085.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2021-10-21-2021.csv", "https://www.cms.gov/files/document/cms-1807-f.pdf" ] }, { "year": 2022, "category": "Unified", "cf": 34.6062, "cf_decimal": "34.6062", "effective_start": "2022-01-01", "effective_end": "2022-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2022", "2025-compliance-guide" ], "legal_basis": "Temporary3.0percent paymentincrease forCY2022.", "date_and_retroactivity_notes": "Full-yearCF34.6062; do notsubstituteunadoptedorwithoutlegislationCF33.5983.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2022-09-12.csv", "https://www.cms.gov/files/document/cms-1807-f.pdf" ] }, { "year": 2022, "category": "Unified", "cf": 34.6062, "cf_decimal": "34.6062", "effective_start": "2022-01-01", "effective_end": "2022-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2022", "2025-compliance-guide" ], "legal_basis": "Temporary3.0percent paymentincrease forCY2022.", "date_and_retroactivity_notes": "Full-yearCF34.6062; do notsubstituteunadoptedorwithoutlegislationCF33.5983.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2022-09-12.csv", "https://www.cms.gov/files/document/cms-1807-f.pdf" ] }, { "year": 2023, "category": "Unified", "cf": 33.8872, "cf_decimal": "33.8872", "effective_start": "2023-01-01", "effective_end": "2023-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2023", "2025-compliance-guide" ], "legal_basis": "CAA2023 temporary2.5percentincrease forCY2023.", "date_and_retroactivity_notes": "Full-yearCF33.8872; CMSsomeolderwebpagesstilldisplaywithoutlegislation33.0607.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2023-09-28.csv", "https://www.cms.gov/files/document/cms-1807-f.pdf" ] }, { "year": 2023, "category": "Unified", "cf": 33.8872, "cf_decimal": "33.8872", "effective_start": "2023-01-01", "effective_end": "2023-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2023", "2025-compliance-guide" ], "legal_basis": "CAA2023 temporary2.5percentincrease forCY2023.", "date_and_retroactivity_notes": "Full-yearCF33.8872; CMSsomeolderwebpagesstilldisplaywithoutlegislation33.0607.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2023-09-28.csv", "https://www.cms.gov/files/document/cms-1807-f.pdf" ] }, { "year": 2024, "category": "Unified", "cf": 32.7442, "cf_decimal": "32.7442", "effective_start": "2024-01-01", "effective_end": "2024-03-08", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2024A", "2024-legislation-summary" ], "legal_basis": "CAA2024 changes temporarypaymentincrease from1.25percent to2.93percent forMarch9–December31.", "date_and_retroactivity_notes": "ActualpricingdateMarch9, notquarter/half-yearboundary. 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Do notapplya2.5percent efficiencycuttoCF: thatseparateRVUpolicyexemptsE/Mcodes.", "days": 365, "track": "nonqp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2026-09-01.csv", "https://www.govinfo.gov/content/pkg/FR-2025-11-05/html/2025-19787.htm", "https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f" ] }, { "year": 2026, "category": "QP", "cf": 33.5675, "cf_decimal": "33.5675", "effective_start": "2026-01-01", "effective_end": "2026-12-31", "inclusive_dates": true, "status": "historical_or_current", "source_ids": [ "cms-indicators-2026", "2026-final-rule", "2026-fact-sheet" ], "legal_basis": "SSA§1848(d)(20): separateQP0.75percent/nonQP0.25percentupdates; one-year2.50percent increase and0.49percentbudgetneutrality.", "date_and_retroactivity_notes": "SplitbeginsJan1,2026. Do notapplya2.5percent efficiencycuttoCF: thatseparateRVUpolicyexemptsE/Mcodes.", "days": 365, "track": "qp", "sources": [ "https://pfs.data.cms.gov/sites/default/files/data/indicators2026-09-01.csv", "https://www.govinfo.gov/content/pkg/FR-2025-11-05/html/2025-19787.htm", "https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f" ] }, { "year": 2027, "category": "Non-QP", "cf": 32.6286, "cf_decimal": "32.6286", "effective_start": "2027-01-01", "effective_end": "2027-12-31", "inclusive_dates": true, "status": "final_future", "source_ids": [ "2027-final-rule" ], "legal_basis": "CMS-1848-F,D-B1andD-B2, effectiveJan1,2027: QP32.9548,nonQP32.6286.", "date_and_retroactivity_notes": "FinalfutureyearasofNov5,2026. One-year2026increaseexpires. QPstatusisCFeligibility; B2ACOeligibilityisaseparatetest.", "days": 365, "track": "nonqp", "sources": [ "https://public-inspection.federalregister.gov/2026-22743.pdf" ] }, { "year": 2027, "category": "QP", "cf": 32.9548, "cf_decimal": "32.9548", "effective_start": "2027-01-01", "effective_end": "2027-12-31", "inclusive_dates": true, "status": "final_future", "source_ids": [ "2027-final-rule" ], "legal_basis": "CMS-1848-F,D-B1andD-B2, effectiveJan1,2027: QP32.9548,nonQP32.6286.", "date_and_retroactivity_notes": "FinalfutureyearasofNov5,2026. One-year2026increaseexpires. QPstatusisCFeligibility; B2ACOeligibilityisaseparatetest.", "days": 365, "track": "qp", "sources": [ "https://public-inspection.federalregister.gov/2026-22743.pdf" ] }, { "year": 1992, "track": "nonqp", "effective_start": "1992-01-01", "effective_end": "1992-12-31", "cf": 31.001, "category": "Unified", "sources": [ "https://www.govinfo.gov/content/pkg/FR-1991-11-25/pdf/FR-1991-11-25.pdf" ] }, { "year": 1992, "track": "qp", "effective_start": "1992-01-01", "effective_end": "1992-12-31", "cf": 31.001, "category": "Unified", "sources": [ "https://www.govinfo.gov/content/pkg/FR-1991-11-25/pdf/FR-1991-11-25.pdf" ] }, { "year": 1993, "track": "nonqp", "effective_start": "1993-01-01", "effective_end": "1993-12-31", "cf": 31.249, "category": "Other Nonsurgical", "sources": [ "https://www.govinfo.gov/content/pkg/FR-1992-11-25/pdf/FR-1992-11-25.pdf" ] }, { "year": 1993, "track": "qp", "effective_start": "1993-01-01", "effective_end": "1993-12-31", "cf": 31.249, "category": "Other Nonsurgical", 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"cms-indicators-2009", "title": "Indicators for 2009", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2009.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/04e9c94a-c446-4a1d-a26d-6c09929d2686", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2009-01-01", "endDate": "2009-12-31T11:59:59Z" } ], "description": "2009 Physician Fee Schedule Data", "sha256": "c598becd28a92f3d0e5867882b8fcb9eb39471311fc8c474a0a5b6c561e0f866", "check_rows": [ { "year": "2009", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit, est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.92", "trans_nfac_pe": "0.75", "trans_nfac_pe_naflag": "", "full_nfac_pe": "0.77", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.29", "trans_fac_pe_naflag": "", "full_fac_pe": "0.3", "full_fac_pe_naflag": "", "rvu_mp": "0.03", "trans_nfac_total": "1.7", "full_nfac_total": "1.72", "trans_fac_total": "1.24", "full_fac_total": "1.25", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "36.0666", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2011", "title": "Indicators for 2011", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2011.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/0bf883e9-0eeb-46d0-a365-64ae3fc0570d", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2011-01-01", "endDate": "2011-12-31T11:59:59Z" } ], "description": "2011 Physician Fee Schedule Data", "sha256": "32655c0d19e7c8327c7b2cbf3c1698f24d691a8a5295174422946f9b8626e113", "check_rows": [ { "year": "2011", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "0.99", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.05", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.41", "trans_fac_pe_naflag": "", "full_fac_pe": "0.47", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.03", "full_nfac_total": "2.09", "trans_fac_total": "1.45", "full_fac_total": "1.51", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "33.9764", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2013", "title": "Indicators for 2013", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2013.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/ba12c534-c165-4409-96ef-bc51c41f77e0", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2013-01-01", "endDate": "2013-12-31T11:59:59Z" } ], "description": "The CY 2013 PFS final rule with comment period was placed on display at the Federal Register on November 1, 2012. It was published in the Federal Register on November 16, 2012. The final rule addresses changes to the physician fee schedule, payments for Part B drugs, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also implements provisions of the Affordable Care Act by establishing a face-to-face encounter as a condition of payment for certain durable medical equipment (DME) items. Effective January 1, 2013, the CY 2013 Medicare Physician Fee Schedule (MPFS) Conversion Factor is $34.0230, which reflects 2013 calendar year zero percent update, with the non-budget neutral GPCI 1.0 work floor extenders, as directed by section 601(a) of the American Taxpayer Relief Act of 2012 (passed by Congress on January 1, 2013).", "sha256": "492437a67179c23fa1b73c73cb870cb0c0510ddbdbcde9c12c101c9d795eb562", "check_rows": [ { "year": "2013", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.1", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.1", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.42", "trans_fac_pe_naflag": "", "full_fac_pe": "0.42", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.14", "full_nfac_total": "2.14", "trans_fac_total": "1.46", "full_fac_total": "1.46", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "34.023", "phy_superv": "9 ", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2014", "title": "Indicators for 2014", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2014.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/ae7b9a2e-eab6-4d92-bcce-452a5eb29a50", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2014-01-01", "endDate": "2014-12-31T11:59:59Z" } ], "description": "The CY 2014 PFS final rule with comment period was placed on display at the Federal Register on November 27, 2013. It was published in the Federal Register on December 10, 2013. The final rule addresses changes to the physician fee schedule, payments for Part B drugs, and other Medicare Part B payment policies, to ensure that our payment systems are updated to reflect changes in current medical practices and the relative value of those services. Effective January 1, 2014 to March 31, 2014, as directed by the Congressional passage of the \"Pathway for SGR Reform Act of 2013\" on December 18, 2013, the Medicare Physician Fee Schedule (MPFS) Conversion Factor is $35.8228. This reflects a 0.5 percent increase from the previous year. The \"Pathway for SGR Reform Act of 2013\" also extends the non-budget neutral work GPCI floor (1.0) to April 1, 2014.", "sha256": "79df313ac66c0749823d5baa1fe3957ccd4a88a841a17da801922ecf1795f755", "check_rows": [ { "year": "2014", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.04", "full_nfac_total": "2.04", "trans_fac_total": "1.44", "full_fac_total": "1.44", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.8228", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2016", "title": "Indicators for 2016", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2016.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/01ba021c-78a6-4d16-bfa9-b93975f4ef4c", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2016-01-01", "endDate": "2016-12-31T11:59:59Z" } ], "description": "The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the Medicare sustainable growth rate (SGR) update formula for payments under the Medicare Physician Fee Schedule. For 2016, the Physician Fee Schedule update factor is 0.5% and the conversion factor is 35.8043.", "sha256": "9b4d911d25794d669315b0d76af43cbd16447d46246f37376287d035238efea3", "check_rows": [ { "year": "2016", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.01", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.01", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.05", "full_nfac_total": "2.05", "trans_fac_total": "1.44", "full_fac_total": "1.44", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.8043", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2017", "title": "Indicators for 2017", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2017.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/095c3b0b-e0b8-4144-a528-c4390782abac", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2017-01-01", "endDate": "2017-12-31T11:59:59Z" } ], "description": "The Medicare Physician Fee Schedule update factor for 2017 is 0.5% and the conversion factor is 35.8887*.*", "sha256": "ecfdb30bfcffc17e7f272b1f08d78c50f9dab3e3e8a2b7392c2bb90ce753a8ac", "check_rows": [ { "year": "2017", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.02", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.02", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.06", "full_nfac_total": "2.06", "trans_fac_total": "1.44", "full_fac_total": "1.44", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.8887", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2018", "title": "Indicators for 2018", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2018.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/ad59cee1-0da5-41dc-97c5-bd64f865906c", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2018-01-01", "endDate": "2018-12-31T11:59:59Z" } ], "description": "The Medicare Physician Fee Schedule update factor for 2018 is 0.5% and the conversion factor is 35.9996.", "sha256": "2fe09d20d20184203e513539c251c8bc3dca5df9a510dee7b3424bba7fe20927", "check_rows": [ { "year": "2018", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.02", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.02", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.41", "trans_fac_pe_naflag": "", "full_fac_pe": "0.41", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.06", "full_nfac_total": "2.06", "trans_fac_total": "1.45", "full_fac_total": "1.45", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.9996", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2019", "title": "Indicators for 2019", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2019.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/02a20400-9821-4a55-b4c4-94584f31e2f9", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2019-01-01", "endDate": "2019-12-31T11:59:59Z" } ], "description": "The Medicare Physician Fee Schedule update factor for 2019 is 0.25% and the conversion factor is 36.0391.", "sha256": "ba8c4ff4c87a978970a4c892eeae3d203325865bf0a7af55ce00433d13ed6d9e", "check_rows": [ { "year": "2019", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.05", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.05", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.09", "full_nfac_total": "2.09", "trans_fac_total": "1.44", "full_fac_total": "1.44", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "36.0391", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2020", "title": "Indicators for 2020", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2020.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/157a7eb8-9382-4663-ac8a-a892d8c5fe0d", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2020-01-01", "endDate": "2020-12-31T11:59:59Z" } ], "description": "The Medicare Physician Fee Schedule update factor for 2020 is 0.00% and the conversion factor is 36.0896.", "sha256": "2cd8eed153a1be0c31ae54527af0966c3c434410f73c6fe81fb425a27fd1cbfc", "check_rows": [ { "year": "2020", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.06", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.06", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.08", "trans_nfac_total": "2.11", "full_nfac_total": "2.11", "trans_fac_total": "1.45", "full_fac_total": "1.45", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "36.0896", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2008A", "title": "Indicators for 2008A", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators208a.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/fec74595-eaca-4829-9737-2656007c9129", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2008-01-01", "endDate": "2008-06-30T11:59:59Z" } ], "description": "The Medicare Improvements for Patients and Providers Act of 2008 was enacted on July 15, 2008. As a result, the mid-year 2008 Medicare Physician Fee Schedule (MPFS) rate of -10.6 percent was replaced with a 0.5 percent update, retroactive to July 1, 2008. In the year dropdown box above, select \"2008A\" for fees effective January 1, 2008 through June 30, 2008 and select \"2008B\" for fees effective July 1, 2008 through December 31, 2008.", "sha256": "334b182fe4a02fad920bfd91db8f3a0a80fbcb29e36209a7dd9ca6e47dea4ed3", "check_rows": [ { "year": "208A", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit, est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.92", "trans_nfac_pe": "0.73", "trans_nfac_pe_naflag": "", "full_nfac_pe": "0.76", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.26", "trans_fac_pe_naflag": "", "full_fac_pe": "0.28", "full_fac_pe_naflag": "", "rvu_mp": "0.03", "trans_nfac_total": "1.68", "full_nfac_total": "1.71", "trans_fac_total": "1.21", "full_fac_total": "1.23", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "38.087", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "0.8806", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2008B", "title": "Indicators for 2008B", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators208b.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/3d04f182-05de-4b68-99ae-3fa8271f4a30", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2008-07-01", "endDate": "2008-12-31T11:59:59Z" } ], "description": "The Medicare Improvements for Patients and Providers Act of 2008 was enacted on July 15, 2008. As a result, the mid-year 2008 Medicare Physician Fee Schedule (MPFS) rate of -10.6 percent was replaced with a 0.5 percent update, retroactive to July 1, 2008. In the year dropdown box above, select \"2008A\" for fees effective January 1, 2008 through June 30, 2008 and select \"2008B\" for fees effective July 1, 2008 through December 31, 2008.", "sha256": "c75aefa9fcfe36f05c13df18472ca05862793390eed2483c1f89de0af7ebe130", "check_rows": [ { "year": "208B", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit, est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.92", "trans_nfac_pe": "0.73", "trans_nfac_pe_naflag": "", "full_nfac_pe": "0.76", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.26", "trans_fac_pe_naflag": "", "full_fac_pe": "0.28", "full_fac_pe_naflag": "", "rvu_mp": "0.03", "trans_nfac_total": "1.68", "full_nfac_total": "1.71", "trans_fac_total": "1.21", "full_fac_total": "1.23", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "38.087", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "0.8806", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2010A", "title": "Indicators for 2010A", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators210a.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/86d5d860-2b95-4557-8325-39cb604c0c52", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2010-01-01", "endDate": "2010-06-30T11:59:59Z" } ], "description": "Payment files reflect a change in the conversion factor as a result of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which President Obama signed into law on June 25, 2010. This legislation provides for a 2.2 percent update to the 2010 Medicare Physician Fee Schedule (MPFS), effective for dates of service June 1, 2010, through November 30, 2010. For 2010A: Payment files reflect changes as a result of practice expense (PE) and malpractice (MP) relative value unit (RVU) corrections and provisions of the Patient Protection and Affordable Care Act (the Affordable Care Act), as modified by the Health Care and Education Reconciliation Act of 2010, which President Obama signed into law on March 23, 2010, and March 30, 2010, respectively.", "sha256": "4dc98f4fd97664286fc3ba44331a6cd8005554d59a809637fda63db6f9d0fb4a", "check_rows": [ { "year": "210A", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit, est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "0.79", "trans_nfac_pe_naflag": "", "full_nfac_pe": "0.88", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.32", "trans_fac_pe_naflag": "", "full_fac_pe": "0.39", "full_fac_pe_naflag": "", "rvu_mp": "0.05", "trans_nfac_total": "1.81", "full_nfac_total": "1.9", "trans_fac_total": "1.34", "full_fac_total": "1.41", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "36.0791", "phy_superv": "9 ", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "0 ", "fac_pe": "0", "fac_pe_naflag": "0 ", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2010B", "title": "Indicators for 2010B", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators210b.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/672b90d2-fb79-4657-87b0-b5f5dbd5ff66", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2010-07-01", "endDate": "2010-12-31T11:59:59Z" } ], "description": "Payment files reflect a change in the conversion factor as a result of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which President Obama signed into law on June 25, 2010. This legislation provides for a 2.2 percent update to the 2010 Medicare Physician Fee Schedule (MPFS), effective for dates of service June 1, 2010, through November 30, 2010. For 2010A: Payment files reflect changes as a result of practice expense (PE) and malpractice (MP) relative value unit (RVU) corrections and provisions of the Patient Protection and Affordable Care Act (the Affordable Care Act), as modified by the Health Care and Education Reconciliation Act of 2010, which President Obama signed into law on March 23, 2010, and March 30, 2010, respectively.", "sha256": "ce152bac5f83bf81b1f5e3e8954c3cd6224195d75fe1b30061ea36406cd17a39", "check_rows": [ { "year": "210B", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit, est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "0.79", "trans_nfac_pe_naflag": "", "full_nfac_pe": "0.88", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.32", "trans_fac_pe_naflag": "", "full_fac_pe": "0.39", "full_fac_pe_naflag": "", "rvu_mp": "0.05", "trans_nfac_total": "1.81", "full_nfac_total": "1.9", "trans_fac_total": "1.34", "full_fac_total": "1.41", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "36.8729", "phy_superv": "9 ", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "0 ", "fac_pe": "0", "fac_pe_naflag": "0 ", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2012A", "title": "Indicators for 2012A", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators212a.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/9befd04c-f37a-451b-94ce-9d60d292fe5a", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2012-01-01", "endDate": "2012-06-30T11:59:59Z" } ], "description": "Physician Fee Schedule - March 2012 release. This file contains the revisions identified in the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA). Medicare payment rates under the Medicare Physician Fee Schedule (MPFS) are set according to statutory criteria. The following 2012 MPFS payment rates are reflective of the CY 2012 Medicare Physician Fee Schedule Final Rule, which was published in the Federal Register on November 28, 2011, and the CY 2012 Medicare Physician Fee Schedule Final Rule Correction Notice, which was published in the Federal Register on January 4, 2012. These payment rates are based on current law, including the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA), which provides for a zero percent update through December 31, 2012. The MCTRJCA extends several provisions of the Temporary Payroll Tax Cut Continuation Act of 2011 (TPTCCA). Please note that MCTRJCA does NOT extend add-on payments for mental health services and minimum payment for bone mass measurement (sections 307 and 309 of the TPTCCA, respectively). As such, effective March 1, 2012, the MPFS payment rates for these services have changed. 2012A: Medicare payment rates under the Medicare Physician Fee Schedule (MPFS) are set according to statutory criteria. The following 2012 MPFS payment rates are reflective of the CY 2012 Medicare Physician Fee Schedule Final Rule, which was published in the Federal Register on November 28, 2011, and the CY 2012 Medicare Physician Fee Schedule Final Rule Correction Notice that was put on display at the Office of the Federal Register on December 30, 2011. These payment rates are based on current law, including the Temporary Payroll Tax Cut Continuation Act of 2011, which provides for a zero percent update for the period of January 1, 2012 to February 29, 2012. The Centers for Medicare and Medicaid Services will work quickly to update MPFS payment rates in the event Congress passes legislation to prevent the negative update from going into effect on March 1, 2012. Please be on the alert for more information about the 2012 physician update as it becomes available. ", "sha256": "9b4923e631bdd55d5d0a6c3962e68e62a5c904b0ce4f42ce09cc140ecd6fe883", "check_rows": [ { "year": "212A", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.03", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.07", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.42", "trans_fac_pe_naflag": "", "full_fac_pe": "0.44", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.07", "full_nfac_total": "2.11", "trans_fac_total": "1.46", "full_fac_total": "1.48", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "34.0376", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2012B", "title": "Indicators for 2012B", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators212b.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/756800fc-4259-486d-95c3-2e251428dac9", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2012-07-01", "endDate": "2012-12-31T11:59:59Z" } ], "description": "Physician Fee Schedule - March 2012 release. This file contains the revisions identified in the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA). Medicare payment rates under the Medicare Physician Fee Schedule (MPFS) are set according to statutory criteria. The following 2012 MPFS payment rates are reflective of the CY 2012 Medicare Physician Fee Schedule Final Rule, which was published in the Federal Register on November 28, 2011, and the CY 2012 Medicare Physician Fee Schedule Final Rule Correction Notice, which was published in the Federal Register on January 4, 2012. These payment rates are based on current law, including the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA), which provides for a zero percent update through December 31, 2012. The MCTRJCA extends several provisions of the Temporary Payroll Tax Cut Continuation Act of 2011 (TPTCCA). Please note that MCTRJCA does NOT extend add-on payments for mental health services and minimum payment for bone mass measurement (sections 307 and 309 of the TPTCCA, respectively). As such, effective March 1, 2012, the MPFS payment rates for these services have changed. 2012A: Medicare payment rates under the Medicare Physician Fee Schedule (MPFS) are set according to statutory criteria. The following 2012 MPFS payment rates are reflective of the CY 2012 Medicare Physician Fee Schedule Final Rule, which was published in the Federal Register on November 28, 2011, and the CY 2012 Medicare Physician Fee Schedule Final Rule Correction Notice that was put on display at the Office of the Federal Register on December 30, 2011. These payment rates are based on current law, including the Temporary Payroll Tax Cut Continuation Act of 2011, which provides for a zero percent update for the period of January 1, 2012 to February 29, 2012. The Centers for Medicare and Medicaid Services will work quickly to update MPFS payment rates in the event Congress passes legislation to prevent the negative update from going into effect on March 1, 2012. Please be on the alert for more information about the 2012 physician update as it becomes available.", "sha256": "2ff05beedc646fb9fd0a8f5398b8ec81b86e30d00351d0337f8cfb1f1954cc4d", "check_rows": [ { "year": "212B", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.03", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.07", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.42", "trans_fac_pe_naflag": "", "full_fac_pe": "0.44", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.07", "full_nfac_total": "2.11", "trans_fac_total": "1.46", "full_fac_total": "1.48", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "34.0376", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2015A", "title": "Indicators for 2015A", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators215a.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/76f463df-37db-4204-b833-8c940e695834", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2015-01-01", "endDate": "2015-06-30T11:59:59Z" } ], "description": " For January 1, 2015 through March 31, 2015, the PFS update was set at 0.0 percent by the Protecting Access to Medicare Act. After applying the budget neutrality adjustment of 0.9981, the conversion factor for January 1, 2015, through March 31, 2015 is $35.7547. Under the provisions of current law regarding the SGR, the conversion factor will change to $28.1872 on April 1, 2015 in the absence of Congressional action. In addition, the geographic practice cost index work floor of 1.0 expires on March 31, 2015 in the absence of legislative action.", "sha256": "411769f9cba5473857edeffc98d3ae1a6b356e2aba149bfa3e213f67220308bc", "check_rows": [ { "year": "215A", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.01", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.01", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.06", "trans_nfac_total": "2.04", "full_nfac_total": "2.04", "trans_fac_total": "1.43", "full_fac_total": "1.43", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.7547", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2015B", "title": "Indicators for 2015B", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators215b.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/7e970632-5d58-44b2-9897-4e873b8e2561", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2015-07-01", "endDate": "2015-12-31T11:59:59Z" } ], "description": "For January 1, 2015 through March 31, 2015, the PFS update was set at 0.0 percent by the Protecting Access to Medicare Act. After applying the budget neutrality adjustment of 0.9981, the conversion factor for January 1, 2015, through March 31, 2015 is $35.7547. Under the provisions of current law regarding the SGR, the conversion factor will change to $28.1872 on April 1, 2015 in the absence of Congressional action. In addition, the geographic practice cost index work floor of 1.0 expires on March 31, 2015 in the absence of legislative action.", "sha256": "6cb75b857249ad159e4a7f3c1d45860c7448e1db698b8363287d3a56958a6e85", "check_rows": [ { "year": "215B", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.01", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.01", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.06", "trans_nfac_total": "2.04", "full_nfac_total": "2.04", "trans_fac_total": "1.43", "full_fac_total": "1.43", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.9335", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ] }, { "source_id": "cms-indicators-2021", "title": "Indicators for 2021", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2021-10-21-2021.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/43DCy8MC-mfUA-HFp8-eXnO-es8yxWyLMHgj", "modified": "2021-10-21T05:00:00Z", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2021-01-01T06:00:00Z", "endDate": "2021-12-31T17:59:59Z" } ], "description": "On December 27, 2020, the Consolidated Appropriations Act modified the Medicare Physician Fee Schedule (MPFS) for Calendar Year (CY) 2021. Payment RVUs were recalculated due to this legislation and the CY 2021's Conversion Factor settled to $34.8931 (even with a one-time 3.75% increase).", "sha256": "6427ef8e26f55e219d8c28ac5afa16e533527749e63820bf1c50b8f04fdf761e", "check_rows": [ { "year": "2021", "hcpc": "99213", "modifier": " ", "sdesc": "Office o/p est low 20-29 min", "proc_stat": "A", "nused_for_med": "", "rvu_work": "1.30", "trans_nfac_pe": "1.25", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.25", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.55", "trans_fac_pe_naflag": "", "full_fac_pe": "0.55", "full_fac_pe_naflag": "", "rvu_mp": "0.10", "trans_nfac_total": "2.65", "full_nfac_total": "2.65", "trans_fac_total": "1.95", "full_fac_total": "1.95", "pctc": "0", "global": "XXX", "pre_op": "0.00", "intra_op": "0.00", "post_op": "0.00", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "34.8931", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0.00", "opps_fac_pe": "0.00", "opps_mp": "0.00", "work_adjustor": "1.0000", "update_val": "0.000", "nfac_pe": "0.00", "nfac_pe_naflag": "", "fac_pe": "0.00", "fac_pe_naflag": "", "nfac_total": "0.00", "fac_total": "0.00" } ] }, { "source_id": "cms-indicators-2022", "title": "Indicators for 2022", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2022-09-12.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/a01c53ef-a80b-47b6-b60a-7524df81d8c8", "modified": "2022-10-01T05:00:00Z", "temporal": null, "description": "The CY 2022 Medicare Physician Fee Schedule updates various related policies and CPT/HCPCS codes for the new calendar year. This includes implementing all recent legislation directed by Congress starting January 1, 2022 and the upcoming conversion factor of $34.6062. The Geographic Practice Cost Index (GPCI) work floor of 1.0 continues to be extended through the end of CY 2023. Medicare co-insurance for certain colorectal cancer screening tests will begin its phased in waiver. Mental Health services through telehealth will be expanded following the end of the PHE.", "sha256": "2a8becdd75e05ee7db25fc83dee01054c7a5340321873fa2133d46c6deed39b3", "check_rows": [ { "year": "2022", "hcpc": "99213", "modifier": " ", "sdesc": "Office o/p est low 20-29 min", "proc_stat": "A", "nused_for_med": "", "rvu_work": "1.30", "trans_nfac_pe": "1.26", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.26", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.55", "trans_fac_pe_naflag": "", "full_fac_pe": "0.55", "full_fac_pe_naflag": "", "rvu_mp": "0.10", "trans_nfac_total": "2.66", "full_nfac_total": "2.66", "trans_fac_total": "1.95", "full_fac_total": "1.95", "pctc": "0", "global": "XXX", "pre_op": "0.00", "intra_op": "0.00", "post_op": "0.00", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "34.6062", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0.00", "opps_fac_pe": "0.00", "opps_mp": "0.00", "work_adjustor": "1.0000", "update_val": "0.000", "nfac_pe": "0.00", "nfac_pe_naflag": "", "fac_pe": "0.00", "fac_pe_naflag": "", "nfac_total": "0.00", "fac_total": "0.00" } ] }, { "source_id": "cms-indicators-2023", "title": "Indicators for 2023", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2023-09-28.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/2698e4b1-8506-4cc8-97a4-d73bedea1d88", "modified": "2023-10-01", "temporal": null, "description": "2023: The CY 2023 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes for this latest calendar year. This includes implementing all recent legislation as directed by Congress and enacted by the Consolidated Appropriations Act (CAA) of 2023, signed into law of December 29, 2022, of which becomes effective starting January 1, 2023, with PFS conversion factor of $33.8872. The Geographic Practice Cost Index (GPCI) work floor of 1.0 continues to be extended through to the end of CY 2023. ", "sha256": "c3ec860b01cbedaf021d903cc62785c1372e3617dbe44ef49dcd74874e6c4cee", "check_rows": [ { "year": "2023", "hcpc": "99213", "modifier": " ", "sdesc": "Office o/p est low 20-29 min", "proc_stat": "A", "nused_for_med": "", "rvu_work": "1.30", "trans_nfac_pe": "1.28", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.28", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.55", "trans_fac_pe_naflag": "", "full_fac_pe": "0.55", "full_fac_pe_naflag": "", "rvu_mp": "0.10", "trans_nfac_total": "2.68", "full_nfac_total": "2.68", "trans_fac_total": "1.95", "full_fac_total": "1.95", "pctc": "0", "global": "XXX", "pre_op": "0.00", "intra_op": "0.00", "post_op": "0.00", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "33.8872", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0.00", "opps_fac_pe": "0.00", "opps_mp": "0.00", "work_adjustor": "1.0000", "update_val": "0.000", "nfac_pe": "0.00", "nfac_pe_naflag": "", "fac_pe": "0.00", "fac_pe_naflag": "", "nfac_total": "0.00", "fac_total": "0.00" } ] }, { "source_id": "cms-indicators-2024A", "title": "Indicators for 2024A", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2024A-03-28-2024.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/b9841b4a-9811-41e2-ae5a-c00d51b19df1", "modified": "2024-04-02", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2024-01-01", "endDate": "2024-03-08" } ], "description": "The CY 2024 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes. For January 1, 2024, through March 8, 2024, the PFS conversion factor is $32.7442. For March 9, 2024, through December 31, 2024, the CY 2024 Medicare Physician Fee Schedule has been updated by new legislation that revises the PFS conversion factor to $33.2875.", "sha256": "5865cc48e4c4fd5656354405c2ff8372a918c083db002af87c9c420da4d54310", "check_rows": [ { "year": "224A", "hcpc": "99213", "modifier": " ", "sdesc": "Office o/p est low 20 min", "proc_stat": "A", "nused_for_med": "", "rvu_work": "1.30", "trans_nfac_pe": "1.33", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.33", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.56", "trans_fac_pe_naflag": "", "full_fac_pe": "0.56", "full_fac_pe_naflag": "", "rvu_mp": "0.10", "trans_nfac_total": "2.73", "full_nfac_total": "2.73", "trans_fac_total": "1.96", "full_fac_total": "1.96", "pctc": "0", "global": "XXX", "pre_op": "0.00", "intra_op": "0.00", "post_op": "0.00", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "32.7442", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0.00", "opps_fac_pe": "0.00", "opps_mp": "0.00", "work_adjustor": "1.0000", "update_val": "0.000", "nfac_pe": "0.00", "nfac_pe_naflag": "", "fac_pe": "0.00", "fac_pe_naflag": "", "nfac_total": "0.00", "fac_total": "0.00" } ] }, { "source_id": "cms-indicators-2024B", "title": "Indicators for 2024B", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2024B-09-18-2024.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/1ea4bd37-a2ed-4608-b27d-809699d37f82", "modified": "2024-10-01", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2024-03-09", "endDate": "2024-12-31" } ], "description": "The CY 2024 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes. For January 1, 2024, through March 8, 2024, the PFS conversion factor is $32.7442. For March 9, 2024, through December 31, 2024, the CY 2024 Medicare Physician Fee Schedule has been updated by new legislation that revises the PFS conversion factor to $33.2875.", "sha256": "30fc1739438238e1527827a6ab9551573249547d1090f0f9e25e26ef5c355d22", "check_rows": [ { "year": "224B", "hcpc": "99213", "modifier": " ", "sdesc": "Office o/p est low 20 min", "proc_stat": "A", "nused_for_med": "", "rvu_work": "1.30", "trans_nfac_pe": "1.33", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.33", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.56", "trans_fac_pe_naflag": "", "full_fac_pe": "0.56", "full_fac_pe_naflag": "", "rvu_mp": "0.10", "trans_nfac_total": "2.73", "full_nfac_total": "2.73", "trans_fac_total": "1.96", "full_fac_total": "1.96", "pctc": "0", "global": "XXX", "pre_op": "0.00", "intra_op": "0.00", "post_op": "0.00", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "33.2875", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0.00", "opps_fac_pe": "0.00", "opps_mp": "0.00", "work_adjustor": "1.0000", "update_val": "0.000", "nfac_pe": "0.00", "nfac_pe_naflag": "", "fac_pe": "0.00", "fac_pe_naflag": "", "nfac_total": "0.00", "fac_total": "0.00" } ] }, { "source_id": "cms-indicators-2025", "title": "Indicators for 2025", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2025-09-23-2025.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/1a4e7cb4-65db-48fd-8250-a64a3cc6e583", "modified": "2025-10-01", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2025-01-01", "endDate": "2025-09-30" } ], "description": "2025: The CY 2025 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes for this latest calendar year, which becomes effective starting January 1, 2025, with PFS conversion factor of $32.3465.", "sha256": "76c8807fc63e5a7ead8b8b4bcbe9ed90174bc57522ed292627d3ecdced7c808f", "check_rows": [ { "year": "2025", "hcpc": "99213", "modifier": "", "sdesc": "Office o/p est low 20 min", "proc_stat": "A", "nused_for_med": "", "rvu_work": "1.30", "trans_nfac_pe": "1.35", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.35", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.57", "trans_fac_pe_naflag": "", "full_fac_pe": "0.57", "full_fac_pe_naflag": "", "rvu_mp": "0.10", "trans_nfac_total": "2.75", "full_nfac_total": "2.75", "trans_fac_total": "1.97", "full_fac_total": "1.97", "pctc": "0", "global": "XXX", "pre_op": "0.00", "intra_op": "0.00", "post_op": "0.00", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "32.3465", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0.00", "opps_fac_pe": "0.00", "opps_mp": "0.00", "work_adjustor": "1.0000", "update_val": "0.000", "nfac_pe": "0.00", "nfac_pe_naflag": "", "fac_pe": "0.00", "fac_pe_naflag": "", "nfac_total": "0.00", "fac_total": "0.00" } ] }, { "source_id": "cms-indicators-2026", "title": "Indicators for 2026", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2026-09-01.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/7c7df311-5315-4f38-b9ed-fd62f8bebe11", "modified": "2026-10-01T10:00:00Z", "temporal": null, "description": "2026: The CY 2026 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes for this latest calendar year, which becomes effective starting January 1, 2026, with PFS conversion factor of $33.4009.", "sha256": "c78aff75ae729882d42657170294f8608376cee0187e74ced30cb7c7d2a9ab72", "check_rows": [ { "year": "2026", "hcpc": "99213", "modifier": " ", "sdesc": "Office o/p est low 20 min", "proc_stat": "A", "nused_for_med": "", "rvu_work": "1.30", "trans_nfac_pe": "1.46", "trans_nfac_pe_naflag": "", "full_nfac_pe": 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"full_nfac_pe": "1.46", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.33", "trans_fac_pe_naflag": "", "full_fac_pe": "0.33", "full_fac_pe_naflag": "", "rvu_mp": "0.09", "trans_nfac_total": "2.85", "full_nfac_total": "2.85", "trans_fac_total": "1.72", "full_fac_total": "1.72", "pctc": "0", "global": "XXX", "pre_op": "0.00", "intra_op": "0.00", "post_op": "0.00", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "price_ind": "9", "endobase": "", "conv_fact": "33.4009", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0.00", "opps_fac_pe": "0.00", "opps_mp": "0.00", "work_adjustor": "1.0000", "update_val": "0.000", "nfac_pe": "0.00", "nfac_pe_naflag": "", "fac_pe": "0.00", "fac_pe_naflag": "", "nfac_total": "0.00", "fac_total": "0.00" } ] }, { "source_id": "2015-macra-CR9152", "url": "https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3259CP.pdf", "sha256": 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In the year dropdown box above, select \"2008A\" for fees effective January 1, 2008 through June 30, 2008 and select \"2008B\" for fees effective July 1, 2008 through December 31, 2008.", "sha256": "c75aefa9fcfe36f05c13df18472ca05862793390eed2483c1f89de0af7ebe130", "check_rows": [ { "year": "208B", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit, est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.92", "trans_nfac_pe": "0.73", "trans_nfac_pe_naflag": "", "full_nfac_pe": "0.76", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.26", "trans_fac_pe_naflag": "", "full_fac_pe": "0.28", "full_fac_pe_naflag": "", "rvu_mp": "0.03", "trans_nfac_total": "1.68", "full_nfac_total": "1.71", "trans_fac_total": "1.21", "full_fac_total": "1.23", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "38.087", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "0.8806", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2008B" }, { "source_id": "cms-indicators-2009", "title": "Indicators for 2009", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2009.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/04e9c94a-c446-4a1d-a26d-6c09929d2686", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2009-01-01", "endDate": "2009-12-31T11:59:59Z" } ], "description": "2009 Physician Fee Schedule Data", "sha256": "c598becd28a92f3d0e5867882b8fcb9eb39471311fc8c474a0a5b6c561e0f866", "check_rows": [ { "year": "2009", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit, est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.92", "trans_nfac_pe": "0.75", "trans_nfac_pe_naflag": "", "full_nfac_pe": "0.77", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.29", "trans_fac_pe_naflag": "", "full_fac_pe": "0.3", "full_fac_pe_naflag": "", "rvu_mp": "0.03", "trans_nfac_total": "1.7", "full_nfac_total": "1.72", "trans_fac_total": "1.24", "full_fac_total": "1.25", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "36.0666", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2009" }, { "source_id": "cms-indicators-2010A", "title": "Indicators for 2010A", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators210a.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/86d5d860-2b95-4557-8325-39cb604c0c52", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2010-01-01", "endDate": "2010-06-30T11:59:59Z" } ], "description": "Payment files reflect a change in the conversion factor as a result of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which President Obama signed into law on June 25, 2010. This legislation provides for a 2.2 percent update to the 2010 Medicare Physician Fee Schedule (MPFS), effective for dates of service June 1, 2010, through November 30, 2010. For 2010A: Payment files reflect changes as a result of practice expense (PE) and malpractice (MP) relative value unit (RVU) corrections and provisions of the Patient Protection and Affordable Care Act (the Affordable Care Act), as modified by the Health Care and Education Reconciliation Act of 2010, which President Obama signed into law on March 23, 2010, and March 30, 2010, respectively.", "sha256": "4dc98f4fd97664286fc3ba44331a6cd8005554d59a809637fda63db6f9d0fb4a", "check_rows": [ { "year": "210A", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit, est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "0.79", "trans_nfac_pe_naflag": "", "full_nfac_pe": "0.88", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.32", "trans_fac_pe_naflag": "", "full_fac_pe": "0.39", "full_fac_pe_naflag": "", "rvu_mp": "0.05", "trans_nfac_total": "1.81", "full_nfac_total": "1.9", "trans_fac_total": "1.34", "full_fac_total": "1.41", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "36.0791", "phy_superv": "9 ", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "0 ", "fac_pe": "0", "fac_pe_naflag": "0 ", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2010A" }, { "source_id": "cms-indicators-2010B", "title": "Indicators for 2010B", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators210b.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/672b90d2-fb79-4657-87b0-b5f5dbd5ff66", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2010-07-01", "endDate": "2010-12-31T11:59:59Z" } ], "description": "Payment files reflect a change in the conversion factor as a result of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which President Obama signed into law on June 25, 2010. This legislation provides for a 2.2 percent update to the 2010 Medicare Physician Fee Schedule (MPFS), effective for dates of service June 1, 2010, through November 30, 2010. For 2010A: Payment files reflect changes as a result of practice expense (PE) and malpractice (MP) relative value unit (RVU) corrections and provisions of the Patient Protection and Affordable Care Act (the Affordable Care Act), as modified by the Health Care and Education Reconciliation Act of 2010, which President Obama signed into law on March 23, 2010, and March 30, 2010, respectively.", "sha256": "ce152bac5f83bf81b1f5e3e8954c3cd6224195d75fe1b30061ea36406cd17a39", "check_rows": [ { "year": "210B", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit, est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "0.79", "trans_nfac_pe_naflag": "", "full_nfac_pe": "0.88", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.32", "trans_fac_pe_naflag": "", "full_fac_pe": "0.39", "full_fac_pe_naflag": "", "rvu_mp": "0.05", "trans_nfac_total": "1.81", "full_nfac_total": "1.9", "trans_fac_total": "1.34", "full_fac_total": "1.41", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "36.8729", "phy_superv": "9 ", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "0 ", "fac_pe": "0", "fac_pe_naflag": "0 ", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2010B" }, { "source_id": "cms-indicators-2011", "title": "Indicators for 2011", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2011.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/0bf883e9-0eeb-46d0-a365-64ae3fc0570d", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2011-01-01", "endDate": "2011-12-31T11:59:59Z" } ], "description": "2011 Physician Fee Schedule Data", "sha256": "32655c0d19e7c8327c7b2cbf3c1698f24d691a8a5295174422946f9b8626e113", "check_rows": [ { "year": "2011", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "0.99", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.05", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.41", "trans_fac_pe_naflag": "", "full_fac_pe": "0.47", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.03", "full_nfac_total": "2.09", "trans_fac_total": "1.45", "full_fac_total": "1.51", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "33.9764", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2011" }, { "source_id": "cms-indicators-2012A", "title": "Indicators for 2012A", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators212a.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/9befd04c-f37a-451b-94ce-9d60d292fe5a", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2012-01-01", "endDate": "2012-06-30T11:59:59Z" } ], "description": "Physician Fee Schedule - March 2012 release. This file contains the revisions identified in the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA). Medicare payment rates under the Medicare Physician Fee Schedule (MPFS) are set according to statutory criteria. The following 2012 MPFS payment rates are reflective of the CY 2012 Medicare Physician Fee Schedule Final Rule, which was published in the Federal Register on November 28, 2011, and the CY 2012 Medicare Physician Fee Schedule Final Rule Correction Notice, which was published in the Federal Register on January 4, 2012. These payment rates are based on current law, including the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA), which provides for a zero percent update through December 31, 2012. The MCTRJCA extends several provisions of the Temporary Payroll Tax Cut Continuation Act of 2011 (TPTCCA). Please note that MCTRJCA does NOT extend add-on payments for mental health services and minimum payment for bone mass measurement (sections 307 and 309 of the TPTCCA, respectively). As such, effective March 1, 2012, the MPFS payment rates for these services have changed. 2012A: Medicare payment rates under the Medicare Physician Fee Schedule (MPFS) are set according to statutory criteria. The following 2012 MPFS payment rates are reflective of the CY 2012 Medicare Physician Fee Schedule Final Rule, which was published in the Federal Register on November 28, 2011, and the CY 2012 Medicare Physician Fee Schedule Final Rule Correction Notice that was put on display at the Office of the Federal Register on December 30, 2011. These payment rates are based on current law, including the Temporary Payroll Tax Cut Continuation Act of 2011, which provides for a zero percent update for the period of January 1, 2012 to February 29, 2012. The Centers for Medicare and Medicaid Services will work quickly to update MPFS payment rates in the event Congress passes legislation to prevent the negative update from going into effect on March 1, 2012. Please be on the alert for more information about the 2012 physician update as it becomes available. ", "sha256": "9b4923e631bdd55d5d0a6c3962e68e62a5c904b0ce4f42ce09cc140ecd6fe883", "check_rows": [ { "year": "212A", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.03", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.07", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.42", "trans_fac_pe_naflag": "", "full_fac_pe": "0.44", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.07", "full_nfac_total": "2.11", "trans_fac_total": "1.46", "full_fac_total": "1.48", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "34.0376", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2012A" }, { "source_id": "cms-indicators-2012B", "title": "Indicators for 2012B", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators212b.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/756800fc-4259-486d-95c3-2e251428dac9", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2012-07-01", "endDate": "2012-12-31T11:59:59Z" } ], "description": "Physician Fee Schedule - March 2012 release. This file contains the revisions identified in the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA). Medicare payment rates under the Medicare Physician Fee Schedule (MPFS) are set according to statutory criteria. The following 2012 MPFS payment rates are reflective of the CY 2012 Medicare Physician Fee Schedule Final Rule, which was published in the Federal Register on November 28, 2011, and the CY 2012 Medicare Physician Fee Schedule Final Rule Correction Notice, which was published in the Federal Register on January 4, 2012. These payment rates are based on current law, including the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA), which provides for a zero percent update through December 31, 2012. The MCTRJCA extends several provisions of the Temporary Payroll Tax Cut Continuation Act of 2011 (TPTCCA). Please note that MCTRJCA does NOT extend add-on payments for mental health services and minimum payment for bone mass measurement (sections 307 and 309 of the TPTCCA, respectively). As such, effective March 1, 2012, the MPFS payment rates for these services have changed. 2012A: Medicare payment rates under the Medicare Physician Fee Schedule (MPFS) are set according to statutory criteria. The following 2012 MPFS payment rates are reflective of the CY 2012 Medicare Physician Fee Schedule Final Rule, which was published in the Federal Register on November 28, 2011, and the CY 2012 Medicare Physician Fee Schedule Final Rule Correction Notice that was put on display at the Office of the Federal Register on December 30, 2011. These payment rates are based on current law, including the Temporary Payroll Tax Cut Continuation Act of 2011, which provides for a zero percent update for the period of January 1, 2012 to February 29, 2012. The Centers for Medicare and Medicaid Services will work quickly to update MPFS payment rates in the event Congress passes legislation to prevent the negative update from going into effect on March 1, 2012. Please be on the alert for more information about the 2012 physician update as it becomes available.", "sha256": "2ff05beedc646fb9fd0a8f5398b8ec81b86e30d00351d0337f8cfb1f1954cc4d", "check_rows": [ { "year": "212B", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.03", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.07", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.42", "trans_fac_pe_naflag": "", "full_fac_pe": "0.44", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.07", "full_nfac_total": "2.11", "trans_fac_total": "1.46", "full_fac_total": "1.48", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "34.0376", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2012B" }, { "source_id": "cms-indicators-2013", "title": "Indicators for 2013", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2013.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/ba12c534-c165-4409-96ef-bc51c41f77e0", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2013-01-01", "endDate": "2013-12-31T11:59:59Z" } ], "description": "The CY 2013 PFS final rule with comment period was placed on display at the Federal Register on November 1, 2012. It was published in the Federal Register on November 16, 2012. The final rule addresses changes to the physician fee schedule, payments for Part B drugs, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also implements provisions of the Affordable Care Act by establishing a face-to-face encounter as a condition of payment for certain durable medical equipment (DME) items. Effective January 1, 2013, the CY 2013 Medicare Physician Fee Schedule (MPFS) Conversion Factor is $34.0230, which reflects 2013 calendar year zero percent update, with the non-budget neutral GPCI 1.0 work floor extenders, as directed by section 601(a) of the American Taxpayer Relief Act of 2012 (passed by Congress on January 1, 2013).", "sha256": "492437a67179c23fa1b73c73cb870cb0c0510ddbdbcde9c12c101c9d795eb562", "check_rows": [ { "year": "2013", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.1", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.1", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.42", "trans_fac_pe_naflag": "", "full_fac_pe": "0.42", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.14", "full_nfac_total": "2.14", "trans_fac_total": "1.46", "full_fac_total": "1.46", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "34.023", "phy_superv": "9 ", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2013" }, { "source_id": "cms-indicators-2014", "title": "Indicators for 2014", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2014.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/ae7b9a2e-eab6-4d92-bcce-452a5eb29a50", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2014-01-01", "endDate": "2014-12-31T11:59:59Z" } ], "description": "The CY 2014 PFS final rule with comment period was placed on display at the Federal Register on November 27, 2013. It was published in the Federal Register on December 10, 2013. The final rule addresses changes to the physician fee schedule, payments for Part B drugs, and other Medicare Part B payment policies, to ensure that our payment systems are updated to reflect changes in current medical practices and the relative value of those services. Effective January 1, 2014 to March 31, 2014, as directed by the Congressional passage of the \"Pathway for SGR Reform Act of 2013\" on December 18, 2013, the Medicare Physician Fee Schedule (MPFS) Conversion Factor is $35.8228. This reflects a 0.5 percent increase from the previous year. The \"Pathway for SGR Reform Act of 2013\" also extends the non-budget neutral work GPCI floor (1.0) to April 1, 2014.", "sha256": "79df313ac66c0749823d5baa1fe3957ccd4a88a841a17da801922ecf1795f755", "check_rows": [ { "year": "2014", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.04", "full_nfac_total": "2.04", "trans_fac_total": "1.44", "full_fac_total": "1.44", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.8228", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2014" }, { "source_id": "cms-indicators-2015A", "title": "Indicators for 2015A", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators215a.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/76f463df-37db-4204-b833-8c940e695834", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2015-01-01", "endDate": "2015-06-30T11:59:59Z" } ], "description": " For January 1, 2015 through March 31, 2015, the PFS update was set at 0.0 percent by the Protecting Access to Medicare Act. After applying the budget neutrality adjustment of 0.9981, the conversion factor for January 1, 2015, through March 31, 2015 is $35.7547. Under the provisions of current law regarding the SGR, the conversion factor will change to $28.1872 on April 1, 2015 in the absence of Congressional action. In addition, the geographic practice cost index work floor of 1.0 expires on March 31, 2015 in the absence of legislative action.", "sha256": "411769f9cba5473857edeffc98d3ae1a6b356e2aba149bfa3e213f67220308bc", "check_rows": [ { "year": "215A", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.01", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.01", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.06", "trans_nfac_total": "2.04", "full_nfac_total": "2.04", "trans_fac_total": "1.43", "full_fac_total": "1.43", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.7547", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2015A" }, { "source_id": "cms-indicators-2015B", "title": "Indicators for 2015B", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators215b.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/7e970632-5d58-44b2-9897-4e873b8e2561", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2015-07-01", "endDate": "2015-12-31T11:59:59Z" } ], "description": "For January 1, 2015 through March 31, 2015, the PFS update was set at 0.0 percent by the Protecting Access to Medicare Act. After applying the budget neutrality adjustment of 0.9981, the conversion factor for January 1, 2015, through March 31, 2015 is $35.7547. Under the provisions of current law regarding the SGR, the conversion factor will change to $28.1872 on April 1, 2015 in the absence of Congressional action. In addition, the geographic practice cost index work floor of 1.0 expires on March 31, 2015 in the absence of legislative action.", "sha256": "6cb75b857249ad159e4a7f3c1d45860c7448e1db698b8363287d3a56958a6e85", "check_rows": [ { "year": "215B", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.01", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.01", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.06", "trans_nfac_total": "2.04", "full_nfac_total": "2.04", "trans_fac_total": "1.43", "full_fac_total": "1.43", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.9335", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2015B" }, { "source_id": "cms-indicators-2016", "title": "Indicators for 2016", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2016.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/01ba021c-78a6-4d16-bfa9-b93975f4ef4c", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2016-01-01", "endDate": "2016-12-31T11:59:59Z" } ], "description": "The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the Medicare sustainable growth rate (SGR) update formula for payments under the Medicare Physician Fee Schedule. For 2016, the Physician Fee Schedule update factor is 0.5% and the conversion factor is 35.8043.", "sha256": "9b4d911d25794d669315b0d76af43cbd16447d46246f37376287d035238efea3", "check_rows": [ { "year": "2016", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.01", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.01", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.05", "full_nfac_total": "2.05", "trans_fac_total": "1.44", "full_fac_total": "1.44", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.8043", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2016" }, { "source_id": "cms-indicators-2017", "title": "Indicators for 2017", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2017.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/095c3b0b-e0b8-4144-a528-c4390782abac", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2017-01-01", "endDate": "2017-12-31T11:59:59Z" } ], "description": "The Medicare Physician Fee Schedule update factor for 2017 is 0.5% and the conversion factor is 35.8887*.*", "sha256": "ecfdb30bfcffc17e7f272b1f08d78c50f9dab3e3e8a2b7392c2bb90ce753a8ac", "check_rows": [ { "year": "2017", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.02", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.02", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.06", "full_nfac_total": "2.06", "trans_fac_total": "1.44", "full_fac_total": "1.44", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.8887", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2017" }, { "source_id": "cms-indicators-2018", "title": "Indicators for 2018", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2018.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/ad59cee1-0da5-41dc-97c5-bd64f865906c", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2018-01-01", "endDate": "2018-12-31T11:59:59Z" } ], "description": "The Medicare Physician Fee Schedule update factor for 2018 is 0.5% and the conversion factor is 35.9996.", "sha256": "2fe09d20d20184203e513539c251c8bc3dca5df9a510dee7b3424bba7fe20927", "check_rows": [ { "year": "2018", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.02", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.02", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.41", "trans_fac_pe_naflag": "", "full_fac_pe": "0.41", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.06", "full_nfac_total": "2.06", "trans_fac_total": "1.45", "full_fac_total": "1.45", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "35.9996", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2018" }, { "source_id": "cms-indicators-2019", "title": "Indicators for 2019", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2019.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/02a20400-9821-4a55-b4c4-94584f31e2f9", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2019-01-01", "endDate": "2019-12-31T11:59:59Z" } ], "description": "The Medicare Physician Fee Schedule update factor for 2019 is 0.25% and the conversion factor is 36.0391.", "sha256": "ba8c4ff4c87a978970a4c892eeae3d203325865bf0a7af55ce00433d13ed6d9e", "check_rows": [ { "year": "2019", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.05", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.05", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.07", "trans_nfac_total": "2.09", "full_nfac_total": "2.09", "trans_fac_total": "1.44", "full_fac_total": "1.44", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "36.0391", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2019" }, { "source_id": "cms-indicators-2020", "title": "Indicators for 2020", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2020.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/157a7eb8-9382-4663-ac8a-a892d8c5fe0d", "modified": "2020-04-20", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2020-01-01", "endDate": "2020-12-31T11:59:59Z" } ], "description": "The Medicare Physician Fee Schedule update factor for 2020 is 0.00% and the conversion factor is 36.0896.", "sha256": "2cd8eed153a1be0c31ae54527af0966c3c434410f73c6fe81fb425a27fd1cbfc", "check_rows": [ { "year": "2020", "hcpc": "99213", "modifier": "", "sdesc": "Office/outpatient visit est", "proc_stat": "A", "nused_for_med": "", "rvu_work": "0.97", "trans_nfac_pe": "1.06", "trans_nfac_pe_naflag": "", "full_nfac_pe": "1.06", "full_nfac_pe_naflag": "", "trans_fac_pe": "0.4", "trans_fac_pe_naflag": "", "full_fac_pe": "0.4", "full_fac_pe_naflag": "", "rvu_mp": "0.08", "trans_nfac_total": "2.11", "full_nfac_total": "2.11", "trans_fac_total": "1.45", "full_fac_total": "1.45", "pctc": "0", "global": "XXX", "pre_op": "0", "intra_op": "0", "post_op": "0", "mult_surg": "0", "bilt_surg": "0", "asst_surg": "0", "co_surg": "0", "team_surg": "0", "endobase": "", "conv_fact": "36.0896", "phy_superv": "09", "chemo_flag": "0", "family_ind": "99", "opps_nfac_pe": "0", "opps_fac_pe": "0", "opps_mp": "0", "work_adjustor": "1", "update_val": "0", "nfac_pe": "0", "nfac_pe_naflag": "", "fac_pe": "0", "fac_pe_naflag": "", "nfac_total": "0", "fac_total": "0" } ], "hash_scope": "retained source bytes", "id": "cms-indicators-2020" }, { "source_id": "cms-indicators-2021", "title": "Indicators for 2021", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2021-10-21-2021.csv", "dataset_url": "https://pfs.data.cms.gov/dataset/43DCy8MC-mfUA-HFp8-eXnO-es8yxWyLMHgj", "modified": "2021-10-21T05:00:00Z", "temporal": [ { "@type": "PeriodOfTime", "startDate": "2021-01-01T06:00:00Z", "endDate": "2021-12-31T17:59:59Z" } ], "description": "On December 27, 2020, the Consolidated Appropriations Act modified the Medicare Physician Fee Schedule (MPFS) for Calendar Year (CY) 2021. 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Mental Health services through telehealth will be expanded following the end of the PHE.", "hash_scope": "retained source bytes" }, { "id": "indicators-for-2023", "title": "Indicators for 2023", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2023-09-28.csv", "sha256": "c3ec860b01cbedaf021d903cc62785c1372e3617dbe44ef49dcd74874e6c4cee", "modified": "2023-10-01", "description": "2023: The CY 2023 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes for this latest calendar year. This includes implementing all recent legislation as directed by Congress and enacted by the Consolidated Appropriations Act (CAA) of 2023, signed into law of December 29, 2022, of which becomes effective starting January 1, 2023, with PFS conversion factor of $33.8872. The Geographic Practice Cost Index (GPCI) work floor of 1.0 continues to be extended through to the end of CY 2023. ", "hash_scope": "retained source bytes" }, { "id": "indicators-for-2024a", "title": "Indicators for 2024A", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2024A-03-28-2024.csv", "sha256": "5865cc48e4c4fd5656354405c2ff8372a918c083db002af87c9c420da4d54310", "modified": "2024-04-02", "description": "The CY 2024 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes. For January 1, 2024, through March 8, 2024, the PFS conversion factor is $32.7442. For March 9, 2024, through December 31, 2024, the CY 2024 Medicare Physician Fee Schedule has been updated by new legislation that revises the PFS conversion factor to $33.2875.", "hash_scope": "retained source bytes" }, { "id": "indicators-for-2024b", "title": "Indicators for 2024B", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2024B-09-18-2024.csv", "sha256": "30fc1739438238e1527827a6ab9551573249547d1090f0f9e25e26ef5c355d22", "modified": "2024-10-01", "description": "The CY 2024 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes. For January 1, 2024, through March 8, 2024, the PFS conversion factor is $32.7442. For March 9, 2024, through December 31, 2024, the CY 2024 Medicare Physician Fee Schedule has been updated by new legislation that revises the PFS conversion factor to $33.2875.", "hash_scope": "retained source bytes" }, { "id": "indicators-for-2025", "title": "Indicators for 2025", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2025-09-23-2025.csv", "sha256": "76c8807fc63e5a7ead8b8b4bcbe9ed90174bc57522ed292627d3ecdced7c808f", "modified": "2025-10-01", "description": "2025: The CY 2025 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes for this latest calendar year, which becomes effective starting January 1, 2025, with PFS conversion factor of $32.3465.", "hash_scope": "retained source bytes" }, { "id": "indicators-for-2026", "title": "Indicators for 2026", "url": "https://pfs.data.cms.gov/sites/default/files/data/indicators2026-09-01.csv", "sha256": "c78aff75ae729882d42657170294f8608376cee0187e74ced30cb7c7d2a9ab72", "modified": "2026-10-01T10:00:00Z", "description": "2026: The CY 2026 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes for this latest calendar year, which becomes effective starting January 1, 2026, with PFS conversion factor of $33.4009.", "hash_scope": "retained source bytes" }, { "url": "https://www.govinfo.gov/content/pkg/FR-1991-11-25/pdf/FR-1991-11-25.pdf", "title": "Medicare Program; Fee Schedule for Physicians Services, final rule, November 25, 1991", "sha256": "e75dac01bfc91c7179e25833c2121483863cade8dc5b5a1735e2e81f75f81251", "rvu_pdf_page": 399, "rvu_printed_page": "59763", "table": "Addendum B, Relative Value Units and Related Information, B-133", "cf_pdf_page": 148, "cf_printed_page": "59512", "hash_scope": "retained source bytes", "id": "original-1992" }, { "year": 1993, "url": "https://www.govinfo.gov/content/pkg/FR-1992-11-25/pdf/FR-1992-11-25.pdf", "sha256": "e5ce25f45188ec0e8fb7bbc9943d74e57f2dace9ca3e6245642becc18dc17921", "publication_date": "1992-11-25", "hash_scope": "retained source bytes", "id": "original-1993" }, { "year": 1994, "url": "https://www.govinfo.gov/content/pkg/FR-1993-12-02/pdf/FR-1993-12-02.pdf", "sha256": "340adc78e522ed213c2528126d0e3026b3a69dff9314555fbdee703754430a59", "publication_date": "1993-12-02", "hash_scope": "retained source bytes", "id": "original-1994" }, { "year": 1995, "url": "https://archives.federalregister.gov/issue_slice/1994/12/8/63407-63667.pdf", "sha256": "e8bacf31523ac6238bddfa9869219623781470165505b20551d77c1fca5914fe", "publication_date": "1994-12-08", "hash_scope": "retained source bytes", "id": "original-1995" }, { "year": 1996, "url": "https://www.govinfo.gov/content/pkg/FR-1995-12-08/pdf/X95-11208.pdf", "sha256": "bcef135ecd23b2e02c62477a6ad5227a70344fa32aece1bb786ddd75e1166946", "publication_date": "1995-12-08", "hash_scope": "retained source bytes", "id": "original-1996" }, { "year": 1997, "url": "https://www.govinfo.gov/content/pkg/FR-1996-11-22/pdf/96-29558.pdf", "sha256": "15e84abdf705950be4508ffe9c6d9e68220ad0ff475e84e0a00a9ae8cdb10d62", "publication_date": "1996-11-22", "hash_scope": "retained source bytes", "id": "original-1997" }, { "year": 1998, "url": "https://www.govinfo.gov/content/pkg/FR-1997-10-31/pdf/97-28973.pdf", "sha256": "62889ff581b9220812f8f0310aa2d1e6c6459a06525ba04b58b5be6e8ba53133", "publication_date": "1997-10-31", "hash_scope": "retained source bytes", "id": "original-1998" }, { "year": 1999, "url": "https://www.govinfo.gov/content/pkg/FR-1998-11-02/pdf/98-29181.pdf", "sha256": "eeefb623fea890b3b4d318dcd1411143254bf6c050eab99229224e3e0209a7be", "publication_date": "1998-11-02", "hash_scope": "retained source bytes", "id": "original-1999" }, { "year": 2000, "url": "https://www.govinfo.gov/content/pkg/FR-1999-11-02/pdf/99-28367.pdf", "sha256": "e94fb3739baaa9f50f715c8edf5135cb4ada29cb06c56e6a291e59c05ee41986", "publication_date": "1999-11-02", "hash_scope": "retained source bytes", "id": "original-2000" }, { "url": "https://www.govinfo.gov/content/pkg/FR-2000-11-01/pdf/00-27833.pdf", "title": "Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2001; final rule with comment period, November1 2000", "sha256": "55c432584d90fb66c9c0119db051ecd245eddc854800567d657ee635d76859af", "rvu_pdf_page": 180, "rvu_printed_page": "65555", "table": "Addendum B; Year2001 Transitional Non-Facility Total column", "cf_pdf_page": 1, "cf_printed_page": "65376", "conversion_factor_text": "65376 Federal Register / Vol. 65, No. 212 / Wednesday, November 1, 2000 / Rules and Regulations\nDEPARTMENT OF HEALTH AND\nHUMAN SERVICES\nHealth Care Financing Administration\n42 CFR Parts 410 and 414\n[HCFA±1120±FC]\nRIN 0938±AK11\nMedicare Program; Revisions to\nPayment Policies Under the Physician\nFee Schedule for Calendar Year 2001\nAGENCY: Health Care Financing\nAdministration (HCFA), HHS.\nACTION: Final rule with comment period.\nSUMMARY: This final rule with comment\nperiod makes several changes affecting\nMedicare Part B payment. The changes\ninclude: refinement of resource-based\npractice expense relative value units\n(RVUs); the geographic practice cost\nindices; resource-based malpractice\nRVUs; critical care RVUs; care plan\noversight and physician certification\nand recertification for home health\nservices; observation care codes; ocular\nphotodynamic therapy and other\nophthalmological treatments; electrical\nbioimpedance; antigen supply; and the\nimplantation of ventricular assist\ndevices. This rule also addresses the\ncomments received on the May 3, 2000\ninterim final rule on the supplemental\nsurvey criteria and makes modifications\nto the criteria for data submitted in\n2001. Based on public comments we are\nwithdrawing our proposals related to\nthe global period for insertion, removal,\nand replacement of pacemakers and\ncardioverter defibrillators and low\nintensity ultrasound. This final rule also\ndiscusses or clarifies the payment policy\nfor incomplete medical direction, pulse\noximetry services, outpatient therapy\nsupervision, outpatient therapy caps,\nHCPCS ``G'' Codes, and the second 5-\nyear refinement of work RVUs for\nservices furnished beginning January 1,\n2002. In addition, we are finalizing the\ncalendar year (CY) 2000 interim\nphysician work RVUs and are issuing\ninterim RVUs for new and revised codes\nfor CY 2001. We are making these\nchanges to ensure that our payment\nsystems are updated to reflect changes\nin medical practice and the relative\nvalue of services. This final rule also\nannounces the CY 2001 Medicare\nphysician fee schedule conversion\nfactor under the Medicare\nSupplementary Medical Insurance (Part\nB) program as required by section\n1848(d) of the Social Security Act. The\n2001 Medicare physician fee schedule\nconversion factor is $38.2581.\nDATES: Effective date: This rule is\neffective January 1, 2001.\nComment date: Comments on interim\nRVUs for selected procedure codes\nidentified in Addendum C and on\ninterim practice expense RVUs and\nmalpractice RVUs for all codes as\nshown in Addendum B will be\nconsidered if we receive them at the\nappropriate address, as provided below,\nno later than 5 p.m. on January 2, 2001.\nADDRESSES: Mail written comments (1\noriginal and 3 copies) to the following\naddress only: Health Care Financing\nAdministration, Department of Health\nand Human Services, Attention: HCFA±\n1120±FC, P.O. Box 8013, Baltimore, MD\n21244±8013.\nPlease allow sufficient time for mailed\ncomments to be timely received in the\nevent of delivery delays. If you prefer,\nyou may deliver your written comments\nby courier (1 original and 3 copies) to\none of the following addresses:\nRoom 443±G, Hubert H. Humphrey\nBuilding, 200 Independence Avenue,\nSW., Washington, DC 20201 or Room\nC5±14±03, 7500 Security Boulevard,\nBaltimore, MD 21244.\nComments mailed to the two above\naddresses may be delayed and received\ntoo late to be considered. Because of\nstaff and resource limitations, we cannot\naccept comments by facsimile (FAX)\ntransmission. In commenting, please\nrefer to file code HCFA±1120±FC.\nComments received timely will be\navailable for public inspection as they\nare received, generally beginning\napproximately 3 weeks after publication\nof a document, in Room 443±G of the\nDepartment's office at 200\nIndependence Avenue, SW.,\nWashington, DC, on Monday through\nFriday of each week from 8:30 to 5 p.m.\n(phone: (202) 690±7890).\nFOR FURTHER INFORMATION CONTACT :\nCarolyn Mullen, (410) 786±4589 or Marc\nHartstein, (410) 786±4539, (for issues\nrelated to resource-based practice\nexpense relative value units).\nKenneth Marsalek, (410) 786±4502\n(for issues related to supplemental\npractice expense survey data).\nBob Ulikowski, (410) 786±5721 (for\nissues related to resource-based\nmalpractice relative value units and\ngeographic practice cost index changes).\nRick Ensor, (410) 786±5617 (for issues\nrelated to care plan oversight and\nphysician certification/recertification).\nCathleen Scally, (410) 786±5714 (for\nissues related to observation care codes).\nJim Menas, (410) 786±4507 (for issues\nrelated to incomplete medical direction\nand the 5-year review).\nRoberta Epps, (410) 786±4503 (for\nissues related to outpatient/therapy).\nMarc Hartstein, (410) 786±4539 (for\nissues related to the physician fee\nschedule update, the sustainable growth\nrate, the conversion factor, and the\nregulatory impact analysis).\nDiane Milstead, (410) 786±3355 (for\nall other issues).\nSUPPLEMENTARY INFORMATION:\nCopies: To order copies of the Federal\nRegister containing this document, send\nyour request to: New Orders,\nSuperintendent of Documents, P.O. Box\n371954, Pittsburgh, PA 15250±7954.\nSpecify the date of the issue requested\nand enclose a check or money order\npayable to the Superintendent of\nDocuments, or enclose your Visa,\nDiscover, or Master Card number and\nexpiration date. Credit card orders can\nalso be placed by calling the order desk\nat (202) 512±1800 or by faxing to (202)\n512±2250. The cost for each copy is $8.\nAs an alternative, you can view and\nphotocopy the Federal Register\ndocument at most libraries designated\nas Federal Depository Libraries and at\nmany other public and academic\nlibraries throughout the country that\nreceive the Federal Register.\nTo order the disks containing this\ndocument, send your request to:\nSuperintendent of Documents,\nAttention: Electronic Products, P.O. Box\n37082, Washington, DC 20013±7082.\nPlease specify, ``Medicare Program;\nRevisions to Payment Policies Under the\nPhysician Fee Schedule for Calendar\nYear 2001,'' and enclose a check or\nmoney order payable to the\nSuperintendent of Documents, or\nenclose your VISA, Discover, or\nMasterCard number and expiration date.\nCredit card orders can be placed by\ncalling the order clerk at (202) 512±1530\n(or toll free at 1±888±293±6498) or by\nfaxing to (202) 512±1262. The cost of the\nfour disks is $25.\nThis Federal Register document is\nalso available from the Federal Register\nonline database through GPO Access, a\nservice of the U.S. Government Printing\nOffice. The Website address is: http://\nwww.access.gpo.gov/nara/index.html.\nInformation on the physician fee\nschedule can be found on our\nhomepage. You can access this data by\nusing the following directions:\n1. Go to the HCFA homepage (http:/\n/www.hcfa.gov).\n2. Click on ``Medicare.''\n3. Click on ``Professional/Technical\nInformation.''\n4. Select Medicare Payment Systems.\n5. Select Physician Fee Schedule.\nOr, you can go directly to the Physician\nFee Schedule page by typing the\nfollowing: http://www.hcfa.gov/\nmedicare/pfsmain.htm.\nVerDate 112000 18:19 Oct 31, 2000 Jkt 194001 PO 00000 Frm 00002 Fmt 4701 Sfmt 4700 E:\\FR\\FM\\01NOR2.SGM pfrm11 PsN: 01NOR2", "hash_scope": "retained source bytes", "id": "original-2001" } ], "coverage": [ { "year": 1992, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 1992, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 1993, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 1993, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 1994, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 1994, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 1995, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 1995, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 1996, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 1996, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 1997, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 1997, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 1998, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 1998, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 1999, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 1999, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2000, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2000, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2001, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2001, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2002, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2002, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2003, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2003, "track": 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"year": 2018, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2018, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2019, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2019, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2020, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2020, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2021, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2021, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2022, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2022, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2023, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2023, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2024, "track": "nonqp", "codes": 8, "full_calendar": true }, { "year": 2024, "track": "qp", "codes": 8, "full_calendar": true }, { "year": 2025, "track": 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