Annual Medicare Physician Fee Schedule File Information

The CMS transmits the annual Medicare Physician Fee Schedule (MPFS) file electronically for carriers/MACs to download each year around late-October.  The annual MPFS files (including anesthesia and purchased diagnostic) are effective January 1st.  Carriers/MACs must implement these files each January, unless otherwise directed by CMS.

NOTE:  There will be an annual recurring change request for the implementation of the yearly Medicare Physician Fee Schedule Files.

The CMS will advise all contractors, via email notification, when annual MPFS files are available for download from the mainframe. Carriers/MACs can retrieve the new files and begin the process of testing and loading the new fees into the system. Carriers/MACs must place the new fees, including the anesthesia conversion factor(s), on their Web site after the MPFS final rule is placed on display. (The CMS will send notification of when the MPFS final rule is put on display via email.)

In addition, there may be last minute corrections, therefore you may have to retrieve one or more MPFS corrected files. Notification of the availability of any correction files, including the file names, will be made via an email to Carriers and MACs.