What do the table columns mean?
Procedure code: CPT/HCPCS code
State: the state for which the rate is calculated
Provider class: the provider’s level of education or type of certification (i.e. M.D., D.O., LPN etc.)
Modifier: the CPT modifiers (also referred to as Level I modifiers) are used to supplement information or adjust care descriptions to provide extra details concerning a procedure or service provided by a physician; code modifiers help further describe a procedure code without changing its definition
Effective date: the beginning date of service applicable to the record
Expiration date: the through date of service applicable to the record
Revision date: the date the state prevailing rate was last reviewed or revised
Rate: the fee per unit for the CPT/HCPCS code
Active: A "Y" value indicates that the rate is active; "N" value indicates the record is not currently active
Why are there multiple rows for one procedure code?
The state prevailing rate table provides the current rate as well as historical rates. Lines may also be added for multiple provider classes and/or modifiers.