Medicare Reimbursement Information

Quickly determine the exact Medicare reimbursement amount for thousands of procedures, services, and tests. CodeMap ONLINE includes comprehensive reimbursement information from the following:

• Medicare Physician Fee Schedule
• Medicare Laboratory Fee Schedule
• Outpatient Prospective Payment System and ASC Payments Adjusted by Zip Code
• All States/Localities

Medicare Coverage Policies and Medical Necessity Checker

CodeMap® Online allows your organization to perform Medical Necessity checks and efficiently research Medicare coverage criteria.

• Procedure to Diagnosis Code Edit Check
• National Coverage Decisions (NCDs)
• Local Coverage Decisions (LCDs)
• Local Coverage Articles (LCAs)
• Updated continuously by nationally recognized experts in Medicare coding and reimbursement.

Procedure Coding, Diagnosis Coding, and Coding Edits

CodeMap® Online includes all procedure codes and descriptors listed in Medicare fee-for-service payment systems. Also included are all coding edits employed by Medicare and its contractors. CodeMap® ONLINE also includes all diagnosis codes and descriptors. Easily find what you need, including:

• CPT^® and HCPS codes
• Correct Coding Initiative (CCI) edits 
• Medically Unlikely Edits (MUE)
• ICD-10 codes
• Continuously updated

Additional Resources including Utilization Data and NPI Practice Information

Historical Medicare Utilization Data and NPI Practice information allows users to:

• Research utilization data for all Medicare covered tests and services by CPT code.
• Determine, by procedure, the top 5 ordering specialties, top 5 places of service, average submitted claim amounts, and percentage of claims denied.
• Identify which providers / physicians perform specific tests.
• Determine total Medicare payments by procedure, total number of services performed by procedure code, and total number of beneficiaries treated by procedure code.
• Search for data by procedure, zip code, county