The Centers for Medicare and Medicaid Service (CMS) assigns status indicators to procedure codes to show whether the code is included in the National Physician Fee Schedule (NPFS) or whether the code is separately payable if the service is covered. According to CMS, a NPFS status indicator of "B" describes a "bundled code" and reimbursement for these services is always included in the reimbursement for another service.

 

CMS assigns status indicators to procedure codes to show whether the code is included in the physician fee schedule or whether the code is separately payable if the service is covered. For Status Indicator B codes there are no RVUs or payment amount for these codes and no separate payment is allowed. Payment for these services are included in the payment for the services to which they are incident.  

Mercy Care Plan and Mercy Maricopa Integrated Care follow all CMS and AHCCCS requirements.  In accordance with the above, codes with a Status Indicator B will not be paid separately.   While we have inadvertently paid for these in the past, effective immediately, they will no longer be payable.  

We are in the process of reviewing claims payment during the past year to identify any overpayments that were made for Status Indicator B codes. Services with a Status Indicator B will be recouped. 

Please review the current  CMS Physician Fee Schedule for status indicators.