payment status indicator list

Payment Status Indicator List (2022) | Addendum A & Addendum B

The payment status indicator list is updated quarterly by OPPS and tells you if a HCPCS code is pay and how. Below you can download the complete list of payment status indicators.

1. What Is A Payment Status Indicator?

Every HCPCS code is assigned a ‘payment status indicator’ by OPPS. A payment status indicator identifies if an HCPCS code is paid by OPPS. It also tells you if the payment is packaged or made seperately.

A payment status indicator can provide extra information on how a HCPCS code is paid by OPPS or by a fee schedule or another payment system

Payment Status Indicator A: These services are paid by another payment system or fee schedule than OPPS.

Payment Status Indicator N: OPPS pays for these services but the payment is packaged into a separately paid service payment.

Payment Status Indicator T: OPPS pays for services that have a payment status indicator N but be aware that a multiple procedure payment reduction will be applied for services billed on the same service date.

Payment Status Indicators List

The OPPS website publishes Addendum A and Addendum B every 3 months. They are so called ‘snapshots’ of the satus indicators of HCPCS codes, OPPS payment rates, and APC groups for that specific quarter.

The updates of Addendum and B reflect the OPPS pricer changes and are part of the recurring update notification transmittals of OPPSS and updated quarterly and published on the CMS website.


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