Table 1 Reference Files

Physician Services

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/Clinical-Laboratory-Fee-Schedule-Files.html

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/How_to_MPFS_Booklet_ICN901344.pdf

PPRVUYY_VMMDD

csv, txt, or xlsx RVUPUFYY.docx

Clinical laboratory

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/clinlab.html

CLABYYYY.EffJan1.Full plus

CLABYYYY.EffMMM.XCodes

if available csv, txt, or xlsx

DMEPOS

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.html

DMEYYYY MMM

csv, txt, or xlsx

Parenteral and enteral nutrition items and services

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.html

DMEYYYY MMM PEN PUF

csv, txt, or xlsx

Part B drug average sales price

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/index.html

ASP pricing files csv or xlsx

Gap codes

https://www.optum360coding.com/Category/100037/100197/ (Optum360, Inc)

Modifiers

https://www.wpsgha.com/wps/portal/mac/site/claims/guides-and-resources/modifiers/

By modifier

Anesthesia conversion factors

http://www.cms.gov/Center/Provider-Type/Anesthesiologists-Center.html

Conversion factors

Anesthesia base units

http://www.cms.gov/Center/Provider-Type/Anesthesiologists-Center.html

Base units

Cost to charge ratios^a

ResDAC: http://www.resdac.org/media/calculating-cost-cost-charge-ratios

UB revenue code by line

Internal list mapped for each institution

Inflation factors

http://www.bea.gov/iTable/iTable.cfm?ReqID=9&step=1#reqid=9&step=3&isuri=1&903=13

Table 1.1.9. Implicit Price Deflators for Gross Domestic Product

Impute rates

Internally calculated on a year-to-date basis for every service year for each institution