(Latest Fee Revisions: 11/12/2008)
Using the table below, download files containing the 2009 Medicare Fee Schedule and Limiting Charge information. These files include the fees and limiting charges effective for services rendered on or after January 1, 2009. These files are self extracting zip files. This means after downloading the file, you need to run it to un-zip the fee schedule file. The fee schedule file is a tab delineated text file. It can easily be opened in a spreadsheet or word processing package.
Payment Areas
Pennsylvania has two payment areas for physician services. They are charge classes 01 and 99. Pennsylvania charge class 01 consists of the following 5 counties: Bucks, Chester, Delaware, Montgomery, Philadelphia. Pennsylvania charge class 99 covers the remainder of the state.
New Jersey has two payment areas for physician services. They are charge classes 01 and 99. New Jersey charge class 01 consists of the following counties: Bergen, Essex, Hudson, Hunterdon, Middlesex, Morris, Passaic, Somerset, Sussex, Union, Warren. New Jersey charge class 99 covers the remainder of the state.
Maryland has two payment areas for physician services. They are charge classes 01 and 99. Maryland charge class 01 consists of the following counties: Anne Arundel, Baltimore, Carroll, Harford and Howard. Maryland charge class 99 covers the remainder of the state.
Delaware has one payment area for physician services. Charge class 01 consists of the entire state.
DCMA has one payment area for physician services. Charge class 01 consists of the following areas: Arlington and Fairfax counties in Virginia, the city of Alexandria, the District of Columbia and Montgomery and Prince George's counties in Maryland.
Download The 2009 Medicare Fee Schedule
Pennsylvania |
New Jersey |
Delaware |
Maryland |
DCMA |
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|---|---|---|---|---|---|---|---|---|---|---|
Text Delimited Format |
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Charge Class 01 |
PA 01 | NJ 01 | DE | MD 01 | DCMA | |||||
Charge Class 99 |
PA 99 | NJ 99 | MD 99 | |||||||
Microsoft Excel |
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Charge Class 01 |
PA 01 | NJ 01 | DE | MD 01 | DCMA | |||||
Charge Class 99 |
PA 99 | NJ 99 | MD 99 | |||||||
Adobe PDF |
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Charge Class 01 |
PA 01 | NJ 01 | DE | MD 01 | DCMA | |||||
Charge Class 99 |
PA 99 | NJ 99 | MD 99 |
Looking for more detailed fee information? Access CMS's Fee Schedule Look-Up site.
Here are some details about this year's Fee Schedule:
Below are the column headings and descriptions of the information provided in each column of the report.
Note: The non-participating fee schedule and limiting charge do not apply to practitioners.
- Code: The procedure codes used are from the Centers for Medicare & Medicaid Services (CMS) Common Procedure Coding System (HCPCS). The five-digit numeric codes were obtained from the Physician’s Current Procedural Terminology (CPT). The alpha-numeric codes were developed by the Health Care Financing Administration.
- Par Fee: This is the allowance for participating providers before the application of co-insurance or payment limitations.
- NonPar Fee: This is the allowance for non-participating providers before the application of co-insurance or payment limitations. This amount is 95 percent of the participating allowance.
- LC: This is the Limiting Charge. This is the maximum amount that non-participating providers may bill their Medicare patients on non-assigned claims. For 2009, the limiting charge is always equal to 115 percent of the non-participating allowance.
Payment allowance for procedures not included on this report may be requested by writing to the following addresses:
Highmark Medicare Services
PO Box 890413
Camp Hill, PA 17089-0413
Beginning January 1, 2009, you may obtain fee schedule and Limiting Charge information for 5 or fewer procedure codes by calling our customer services telephone lines.
Note: The customer service representatives will verify your fees and Limiting Charge on line.
Instructions for Downloading the Fee Schedules
Note: The files above are self-extracting .EXE files. Utilize the following instructions to download the file.
1. Click on the .EXE file.
2. Click "Save" to save the file to your desktop or a folder on your computer.
3. A pop up box will appear when the download is complete. You may have to click a "close" button.
4. Navigate to your desktop or the folder where you saved the file. Double-click the file to open it.
5. A Security Warning box may appear. If so, click on the "run" button.
4. A WinZip Self-Extractor box will appear. Press the "Browse" button.
5. Select "Desktop" or choose a file where you'd like to extract the contents of the file. Click on the "OK" button.
6. Click "Unzip" to extract the file to the folder you have selected. (This will convert the file to a .TXT file)
7. Navigate to your desktop or the folder where you unzip the file. Double click on the .TXT file to open it.