2010 HCPCS Schedule - DE Medical Assistance Program

Pricing Action
Code Description
1 PAY PERCENTAGE OF BILLED AMOUNT.
3 LOWER OF BILLED OR ALLOWED AMOUNT.
5 MANUAL PRICE - INDIVIDUAL CONSIDERATION. SET EDIT TO SUSPEND.
6 MANUAL PRICE - NO REASONABLE CHARGE ESTABLISHED. SET EDIT TO SUSPEND.
7 ONLY LEVEL I PRICING SHOULD BE USED. SET EDIT TO SUSPEND.
9 NON-COVERED. SET EDIT TO AUTODENY.
A LOWER OF BILLED AMOUNT OR ((RVU + BILLED UNITS) X CONVERSION FACTOR DOLLAR AMOUNT) .
O OBSOLETE. SET EDIT TO AUTODENY.