{"identifier":"79b85c96-f118-4661-ac0c-c1d57bc06e25","data":{"title":"Physician Supplier Procedure Summary Data Dictionary","fields":[{"name":"HCPCS_CD","label":"HCPCS Code","description":"The Health Care Common Procedure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs. The codes are divided into three levels, or groups as described below:\n\nLevel I\nCodes and descriptors copyrighted by the American Medical Association\u0027s Current Procedural Terminology, Fourth Edition (CPT-4). These are 5 position numeric codes representing physician and nonphysician services.\n\n**** Note: ****\nCPT-4 codes including both long and short descriptions shall be used in accordance with the CMS\/AMA agreement. Any other use violates the AMA copyright.\n\nLevel II\nIncludes codes and descriptors copyrighted by the American Dental Association\u0027s Current Dental Terminology, Third Edition (CDT-3). These are 5 position alpha-numeric codes comprising the D series. All other level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). These are 5 position alpha-numeric codes representing primarily items and nonphysician services that are not represented in the level I codes.\n\nLevel III\nCodes and descriptors developed by Medicare carriers for use at the local (carrier) level. These are 5 position alpha-numeric codes in the W, X, Y or Z series representing physician and nonphysician services that are not represented in the level I or level II codes."},{"name":"HCPCS_INITIAL_MODIFIER_CD","label":"HCPCS Initial Modifier Code","description":"A first modifier to the HCPCS procedure code to enable a more specific procedure identification for the line item service on the noninstitutional claim."},{"name":"PROVIDER_SPEC_CD","label":"Provider Specialty Code","description":"CMS specialty code used for pricing the line item service on the noninstitutional claim."},{"name":"CARRIER_NUM","label":"Carrier Number","description":"The identification number assigned by CMS to a carrier authorized to process claims from a physician or supplier."},{"name":"PRICING_LOCALITY_CD","label":"Pricing Locality Code","description":"Code denoting the carrier-specific locality used for pricing the service for this line item on the carrier claim (non-DMERC). For DMERCs, this field contains the beneficiary SSA State Code."},{"name":"TYPE_OF_SERVICE_CD","label":"Type of Service Code","description":"Code indicating the type of service, as defined in the CMS Medicare Carrier Manual, for this line item on the non-institutional claim."},{"name":"PLACE_OF_SERVICE_CD","label":"Place of Service Code","description":"The code indicating the place of service, as defined in the Medicare Carrier Manual, for this line item on the noninstitutional claim."},{"name":"HCPCS_SECOND_MODIFIER_CD","label":"HCPCS Second Modifier Code","description":"A second modifier to the HCPCS procedure code to make it more specific than the first modifier code to identify the line item procedures for this claim."},{"name":"PSPS_SUBMITTED_SERVICE_CNT","label":"Physician\/Supplier Procedure Summary (PSPS) Submitted Service Count","description":"The count of the total number of submitted services.\nFormat:\u00a0 9999999999.999"},{"name":"PSPS_SUBMITTED_CHARGE_AMT","label":"Physician\/Supplier Procedure Summary (PSPS) Submitted Charge Amount","description":"The amount of charges submitted by the provider to Medicare.\nFormat:\u00a0 +999999999.99"},{"name":"PSPS_ALLOWED_CHARGE_AMT","label":"Physician\/Supplier Procedure Summary (PSPS) Allowed Charge Amount","description":"The amount that is approved (allowed) for Medicare.\nFormat:\u00a0 +999999999.99"},{"name":"PSPS_DENIED_SERVICES_CNT","label":"Physician\/Supplier Procedure Summary (PSPS) Denied Services Count","description":"The count of the number of submitted services that are denied by Medicare.\nFormat:\u00a0 9999999999.999"},{"name":"PSPS_DENIED_CHARGE_AMT","label":"Physician\/Supplier Procedure Summary (PSPS) Denied Charge Amount","description":"The amount of submitted charges for which Medicare payment was denied.\nFormat:\u00a0 +999999999.99"},{"name":"PSPS_ASSIGNED_SERVICES_CNT","label":"Physician\/Supplier Procedure Summary (PSPS) Assigned Services Count","description":"The count of the number of services from providers accepting Medicare assignment.\nFormat:\u00a0 9999999999.999"},{"name":"PSPS_NCH_PAYMENT_AMT","label":"Physician\/Supplier Procedure Summary (PSPS) NCH Payment Amount","description":"The amount of payment made from the trust fund (after deductible and coinsurance amounts have been paid).\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\nFormat:\u00a0 +999999999.99"},{"name":"PSPS_HCPCS_ASC_IND_CD","label":"Physician\/Supplier Procedure Summary (PSPS) HCPCS ASC Indicator Code","description":"A Y\/N code used to indicate whether the procedure is approved to be performed in an Ambulatory Surgical\u00a0Center (ASC)."},{"name":"PSPS_ERROR_IND_CD","label":"Physician Supplier Procedure Summary (PSPS) Error Indicator Code","description":"The code used to indicate combinations of errors on key fields."},{"name":"HCPCS_BETOS_CD","label":"HCPCS Berenson-Eggers Type of Service Code (BETOS)","description":"This field is valid beginning with 2003 data. The Berenson-Eggers Type of Service (BETOS) for the procedure code based on generally agreed upon clinically meaningful groupings of procedures and services."}]}}