PayorTransparency

Code Hub

Nine HCPCS Level II codes for continence care, with the Medicare policy that governs each one written out and cited. Every statement on a code page names the document it was read from, every source carries the date it was last checked, and where a rule is genuinely unsettled the page says so rather than rounding it off.

What is here is public regulatory fact. Coverage determinations, policy articles, classification decisions and the quarterly Medicare fee schedule are documents anyone can read, and this hub is a reading of them rather than a replacement for them. Where a page here and the governing determination disagree, the determination is right and the page is wrong.

What is not here is a commercial rate. No figure taken from a payer machine-readable file appears on any of these pages. The Medicare and state Medicaid amounts that do appear are published schedules, and each one names the file it came from.

  • Codes

    Nine HCPCS Level II codes, one page each, with the determination and policy article that govern them and the published Medicare allowable.

  • Payers

    What a payer publishes under the Transparency in Coverage rule, and the figures it discloses about its own size. Pages appear as each payer’s terms of use are reviewed.

  • Glossary

    The vocabulary these pages use, from the DMEPOS fee schedule to the Standard Written Order.