September 2, 2021
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – October 2021 Update
Below is a summary of the changes for the October update to the 2021 MPFSDB. Unless otherwise stated, these changes are effective for dates of service on and after January 1, 2021.
The following HCPCS code has a change to the Bilateral Surgery Indicator. This change is effective for dates of service January 1, 2021, and after.
Code |
Action |
---|---|
31591 |
Bilateral Surgery = 1 |
The following HCPCS codes have changes to the Diagnostic Imaging Family Indicator. These changes are effective for dates of service July 1, 2021, and after.
Code |
Modifier |
Action |
---|---|---|
0648T |
|
Diagnostic Imaging Family Indicator = 88 |
0648T |
TC |
Diagnostic Imaging Family Indicator = 88 |
0648T |
26 |
Diagnostic Imaging Family Indicator = 88 |
There is a revision to the short descriptor for the following HCPCS codes:
Code |
Descriptor |
---|---|
M0243 |
Casirivi and imdevi inj |
M0244 |
Casirivi and imdevi inj hm |
The following are HCPCS codes from the July 2021 HCPCS file update. For more information on the new codes, please reference: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/HCPCS-Quarterly-Update.
Code |
Action |
Effective Date |
---|---|---|
M0201 |
Procedure Status = X; payment policy indicators do not apply. |
June 08, 2021 |
M0247 |
Procedure Status = X; payment policy indicators do not apply. |
May 26, 2021 |
M0248 |
Procedure Status = X; payment policy indicators do not apply. |
May 26, 2021 |
Q0247 |
Procedure Status = X; payment policy indicators do not apply. |
May 26, 2021 |
The following new HCPCS code is from the October 2021 HCPCS file update. It is effective for dates of service June 3, 2021, and after.
Code |
Action |
---|---|
Q0244 |
Procedure Status = X; payment policy indicators do not apply. |
The following new HCPCS codes are from the October 2021 HCPCS file update. They are effective for dates of service June 24, 2021, and after.
Code |
Action |
---|---|
M0249 |
Procedure Status = X; payment policy indicators do not apply. |
M0250 |
Procedure Status = X; payment policy indicators do not apply. |
Q0249 |
Procedure Status = X; payment policy indicators do not apply. |
The following new HCPCS codes are from the October 2021 HCPCS file update. They are effective for dates of service October 1, 2021, and after.
Code |
Action |
---|---|
J0699 |
Procedure Status = E; payment policy indicators do not apply. |
J0741 |
Procedure Status = E; payment policy indicators do not apply. |
J1305 |
Procedure Status = E; payment policy indicators do not apply. |
J1426 |
Procedure Status = E; payment policy indicators do not apply. |
J1445 |
Procedure Status = E; payment policy indicators do not apply. |
J1448 |
Procedure Status = E; payment policy indicators do not apply. |
J2406 |
Procedure Status = E; payment policy indicators do not apply. |
J9247 |
Procedure Status = E; payment policy indicators do not apply. |
Q2054 |
Procedure Status = X; payment policy indicators do not apply. |
Q4251 |
Procedure Status = E; payment policy indicators do not apply. |
Q4252 |
Procedure Status = E; payment policy indicators do not apply. |
Q4253 |
Procedure Status = E; payment policy indicators do not apply. |
The following HCPCS codes are deleted from the MPFS effective for dates of service October 1, 2021, and after.
Code |
Action |
---|---|
J0693 |
Procedure Status = I |
Q4228 |
Procedure Status = I |
Q4236 |
Procedure Status = I |