Medicare Resources

Summaries of Regulations and Comment letters: Find out how regulations from CMS affect the specialty of otolaryngology - head and neck surgery and read our comments letters to CMS to address these policies.

Updates: Stay current on new and/ revised Medicare payment policies pertinent to otolaryngology - head and neck surgery, our advocacy efforts with Medicare, and more.

Sign-on letters: View advocacy letters that the Academy has sent in conjunction with other national medical associations.

Medicare Physician Fee Schedule Lookup: Obtain the relative value units, fee schedule status indicators, and various payment policy indicators needed for payment adjustments. The Medicare physician fee schedule pricing amounts are adjusted to reflect the variation in practice costs from area to area.

Physician Practice Information Survey (PPIS) - Summary Report for Otolaryngology: The Physician Practice Information Survey (PPIS) is a multi-specialty practice expense survey of physicians and other health care providers (such as podiatrists, audiologists,
chiropractors, etc.) in the US. The primary purpose of the survey was to aggregate practice expense per hour (PE/HR) data to obtain accurate and reliable data on practices’ direct costs for equipment, supplies and wages for clinical staff.  

PPIS Summary Report for All Specialties

Medicare Enrollment: Resources and updates on Medicare enrollment and on National Provider Identifiers (NPI) 

Medicare Administrative Contractors (MAC): Information on the Implementation of the MACs including regional maps of their jurisdictions, weblinks to their local coverage determinations and their effective dates of coverage.

Recovery Audit Contractors (RAC): Get information on the RACs and access their Issues lists.

National Correct Coding Institute (NCCI):CMS created NCCI edits to prevent improper payment when incorrect code combinations are reported.The NCCI contains two tables of edits.The Column One/Column Two Correct Coding Edits table and the Mutually Exclusive Edits table include code pairs that should not be reported together for a number of reasons explained in Medicare's Coding Policy Manual. 

Medically Unlikely Edits (MUE): CMS developed MUEs to reduce the paid claims error rate for Part B claims.  An MUE for a HCPCS/CPT code is the maximum units of service that a provider can report under most circumstances for a patient on a single date of service. CMS updates the MUEs quarterly.

Documents and Forms: Medicare Provider Enrollment forms, Provider Participation Application forms, Appeal forms, and Advance Beneficiary Notice Forms.

Updated on March 10, 2011