US · guidance
CMS Pub. 100-04, ch. 4, § 250.11.1
Use of Payment Policy Indicators for Determining Bilateral
Procedures Eligible for 150 Percent Payment Adjustment
(Rev. 1777; Issued: 07-24-09; Effective Date: 01-01-08; Implementation Date: 01- 04-10)
Medicare uses the payment policy indicators on the Medicare Physician Fee Schedule
Database (MPFSDB) to determine if a bilateral procedure is authorized for a specific
HCPCS/CPT code. The MPFSDB is located at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/index.html. The A/B MACs (A) have
access to the payment policy indicators via the Physician Fee Schedule Payment Policy
Indicator File in the FISS.
See the Physician Fee Schedule Payment Policy Record Layout in §250.2 for a
description of the bilateral procedure payment policy indicators.
History
(Rev. 1777; Issued: 07-24-09; Effective Date: 01-01-08; Implementation Date: 01- 04-10)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
4b55340c3c9e70653f3d164dfd5a6443eebec2ff9daff81ab203d5bf9cc911f9
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