US · guidance
CMS Pub. 100-04, ch. 4, § 10.1.1
Payment Status Indicators
An OPPS payment status indicator is assigned to every HCPCS code. The status
indicator identifies whether the service described by the HCPCS code is paid under the
OPPS and if so, whether payment is made separately or packaged. The status indicator
may also provide additional information about how the code is paid under the OPPS or
under another payment system or fee schedule. For example, services with status
indicator A are paid under a fee schedule or payment system other than the OPPS.
Services with status indicator N are paid under the OPPS, but their payment is packaged
into payment for a separately paid service. Services with status indicator T are paid
separately under OPPS but a multiple procedure payment reduction applies when two or
more services with a status indicator of T are billed on the same date of service.
The full list of status indicators and their definitions is published in Addendum D1 of the
OPPS/ASC proposed and final rules each year. The status indicator for each HCPCS
code is shown in OPPS Addendum B.
History
(Rev. 1445; Issued: 02-08-08; Effective: 01-01-08; Implementation: 03-10-08)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
10d83efde0d76c3e4f761eeb712836f7eac8348fc2cc6f0efaa43d53bb50d7a6
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.