Contractor Status “C” Updates
PCG gets requests for pricing for codes that are carrier priced. CMS does not establish fees for C status codes; they are priced per Contractor discretion. Each year these code prices are reviewed and revised (price increase and/or decrease varies from code to code). Normally, prices are not determined until they are billed. The review of medical records assists the MAC in the evaluation and pricing of these services. Updates to contractor priced fees are posted quarterly on the MAC’s website. These two postings are from the Noridian site and are an example of where you can obtain pricing for carrier priced codes.