Insurance News:

NGS Medicare Fee Schedule Update

by Dr. Mariangela Penna, NY Medicare CAC Representative | 1/15/2016 11:13:16 AM

The Medicare 2016 Fee Schedule has been released.

To access the fee schedule, go to www.ngsmedicare.com and click on the red fee schedule lookup tab. Under the heading "Enter Search Criteria," select "Medicare Physician Fee Schedule Pricing."
  • Enter the Result Type
    • It is easier to look up 98940, 98941 and 98942 individually.  To look codes up individually, choose "Specific to Fee Code"
  • Enter the Date of Service
  • Enter the Procedure Code (if looking up codes individually)
  • Enter your region
    • If you are not sure scroll to bottom of page for New York Locality/Area and County Information under the heading Fee Schedule Assistance
  • Click Search
  • The fee schedule information will appear below under Code Search Results
    • The limiting charge is listed in the top chart: par or non-par and, for most of us, non-facility. This is the limiting charge if you successfully participated in both PQRS and HER.
      • The second chart lists the penalties to the limiting charge if you did not successfully participate. You should have received a letter in December letting you know.
Please be advised that the schedule is likely to change again in March or April when the 2% sequestration reduction is removed.

If you have not participated in PQRS previously, start now as more penalties are added in coming years.

If you have any questions please send an email to committees@nysca.com.  Please remember include the best phone number to reach you.

Mariangela Penna, DC
NYSCA Medicare Committee
Medicare CAC representative

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