20 Miss. Code. R. 2-V
For each procedure, the Fee Schedule table includes the following columns and details (if applicable):
Code Icons
Add-on Codes
+ denotes procedure codes that are considered "add-on" codes as defined in the CPT book.
Modifier 51 Exempt
Ø denotes procedure codes that are exempt from the use of modifier 51 and are not designated as add-on procedures/services as defined in the CPT book. Modifier 51 exempt services and procedures can be found in Appendix E of CPT 2019.
APC J Status
J1 applicable to APC payments. See the Inpatient Hospital and Outpatient Facility Payment Schedule and Rules section for more information.
J1* a Mississippi state-specific status indicator applicable to APC payments. See the Inpatient Hospital and Outpatient Facility Payment Schedule and Rules section for more information
Telemedicine-eligible.
* denotes those CPT codes that may be used for reporting synchronous (real-time) telemedicine services when appended by modifier 95.
State-Specific Code
[INFINITY] indicates a code specific to the State of Mississippi or a code with a description altered by the State of Mississippi.
Code
This Fee Schedule uses 2019 CPT, CDT, HCPCS, and Mississippi state-specific codes.
Modifiers
In the HCPCS section modifiers that affect payment are listed in this column. See the Modifier and Code Rules section for more information regarding the modifiers.
Description
This Fee Schedule uses CPT 2019 medium descriptions. Some HCPCS code descriptions have been modified by the State of Mississippi.
MAR
This column lists the total maximum allowable reimbursement as a monetary amount. Procedures with a $0.00 in the MAR column are not covered or are not reimbursed.
PC Amount
Where there is an identifiable professional and technical component to a procedure, the portion considered to be the maximum allowable reimbursement for the professional component is listed in the PC Amount column. Procedures with a $0.00 in the PC Amount column are considered one hundred percent (100%) technical. See Modifiers and Code Rules for additional information.
TC Amount
Where there is an identifiable professional and technical component to a procedure, the portion considered to be the maximum allowable for the technical component is listed in the TC Amount column. Procedures with a $0.00 in the TC Amount column or where the TC column Amount column is blank are considered one hundred percent (100%) professional. See Modifiers and Code Rules for additional information.
FUD
Follow-up days (FUD) included in a surgical procedure's global charge are listed in this column.
Postoperative periods of 0, 10, and 90 days are designated in the Fee Schedule as 000, 010, and 090 respectively. The following special circumstances are also listed in the postoperative period:
MMM Designates services furnished in uncomplicated maternity care. This includes antepartum, delivery, and postpartum care.
XXX Designates services where the global concept does not apply.
YYY Designates services where the payer must assign a follow-up period based on documentation submitted with the claim. Procedures designated as YYY in the Fee Schedule include unlisted procedure codes.
ZZZ Designates services that are add-on procedures and as such have a global period that is determined by the primary procedure.
Assist Surg
The assistant surgeon column identifies procedures that are approved for an assistant to the primary surgeon whether a physician, physician assistant (PA), registered nurse first assistant (RNFA, RA), or other qualified health care professional for reimbursement as an assistant under the Fee Schedule.
APC Amount
Ambulatory Payment Classification (APC) is a payment method for facility outpatient services. The APC Amount shall constitute the reimbursement amount for both hospital based and freestanding outpatient facilities.
20 Miss. Code. R. 2-V