MC_PRICER_METADATA

Description:

This table contains a variety of metadata returned from the Epic Pricer.

Primary Key

Column Name	Ordinal Position
PRICER_MSG_ID	1

Column Information

	Name	Type	Discontinued?
1	PRICER_MSG_ID	NUMERIC	No
	The unique identifier for the Epic Pricer message record.
2	MC_PRICER_TYPE_C_NAME	VARCHAR	No
	The pricer type calculated by the Epic Pricer. May contain organization-specific values: No Category Entries: Outpatient PPS Inpatient PPS Multi-Pricer Home Health Agency Ambulatory Surgery Center End Stage Renal Disease Skilled Nursing Facility Inpatient Psychiatric Facility Inpatient Rehabilitation Facility Long Term Care Critical Access Hospital - Outpatient Critical Access Hospital - Inpatient All Patient Refined DRG Medicare Severity DRG Ambulatory Patient Group External PPS Pricer Federally Qualified Health Center Hospice Fee Schedule Physician Anesthesia Durable Medical Equipment, Prosthetics/Orthotics & Supplies Drugs and Biologicals Laboratory Services Ambulance Cost Based Rural Health Center Comprehensive Outpatient Rehabilitation Facility Opioid Treatment Program Home Infusion Therapy Medicare Diabetes Prevention Program Vaccine Radiopharmaceutical Medicare Contractor Priced Codes
3	PRICER_RETURN_CODE	VARCHAR	No
	The return code returned from the Epic Pricer.
4	PRICER_PROV_CCN	VARCHAR	No
	The CMS Certified Numer (CCN) used when the Epic Pricer was invoked.
5	PRICER_CCN_EFF_DATE	DATETIME	No
	The effective date associated with the CCN in column PRICER_PROV_CCN for the Epic Pricer.
6	MC_PRICER_PROV_TYPE_C_NAME	VARCHAR	No
	The Instituional provider type defined by CMS. May contain organization-specific values: No Category Entries: Short Term Facility Long Term Psychiatric Rehabilitation Facility Pediatric Hospital Distinct Parts (Deprecated) Rural Referral Center Indian Health Service Cancer Facility Medicare Dependent Hospital (Deprecated) Medicare Dependent Hospital/Referral Center (Deprecated) Re-based Sole Community Hospital Re-based Sole Community Hospital/ Referral Center Medical Assistance Facility Essential Access Community Hospital Essential Access Community Hospital/Referral Center Rural Primary Care Hospital Nursing Home Case Mix Quality Demo Project - Phase II Nursing Home Case Mix Quality Demo Project - Phase III - Step 1 Reserved Hospice Home Health Agency Critical Access Hospital Skilled Nursing Facility (SNF) - For non-demo PPS SNFs Hospital Based ESRD Facility Independent ESRD Facility Federally Qualified Health Centers Religious Non-Medical Health Care Institutions Rural Health Clinics-Free Standing Rural Health Clinics-Provider Based Comprehensive Outpatient Rehab Facilities Community Mental Health Centers Outpatient Physical Therapy Services Psychiatric Distinct Part Rehabilitation Distinct Part Short-Term Hospital - Swing Bed Long-Term Care Hospital - Swing Bed Rehabilitation Facility - Swing Bed Critical Access Hospital - Swing Bed
7	MPFS_STATUS_INDICATOR_C_NAME	VARCHAR	No
	The status indicator returned for a service priced using a physician fee schedule. The released values are extracted from the CMS Medicare physician fee schedule and are owned by CMS. May contain organization-specific values: No Category Entries: Active code Bundled code Contractor priced code Deleted code Excluded from fee schedule by regulation Deleted modifier Not valid for Medicare Anesthesia service Local code Measurement code Non-covered service Bundled/excluded code Restricted coverage Injection Statutory exclusion Unknown
8	ASC_PAYMENT_INDICATOR_C_NAME	VARCHAR	No
	The payment indicator returned for a service priced using an ASC fee schedule. The released values are extracted from the CMS ASC fee schedule and are owned by CMS. May contain organization-specific values: No Category Entries: Surgical procedure; payment based on OPPS relative payment weight Alternative code may be available; no payment made Inpatient surgical procedure under OPPS; no payment made Ancillary dental service/item: no separate payment made Non-office based dental procedure added in CY2024 and later Deleted/discontinued code; no payment made Surgical Procedure/item not valid for Medicare purposes because of coverage, regulation and/or statute; no payment made Corneal tissue acquisition, hepatitis B vaccine; paid at reasonable cost Non-office based surgical procedure; payment based on OPPS relative payment weight Brachytherapy source paid separately; payment based on OPPS rate Brachytherapy source paid separately; payment contractor-priced Device-intensive procedure; paid at adjusted rate (OBSOLETE) OPPS pass-through device paid separately; payment contractor-priced Device-intensive procedure; paid at adjusted rate Drugs and biologicals paid separately; payment based on OPPS rate Items, codes, and services for which pricing information and claims data are not available; No payment made Unclassified drugs and biologicals; payment contractor-priced Influenza vaccine; pneumococcal vaccine; Packaged item/service; no separate payment made New Technology Intraocular Lens (NTIOL); special payment No payment made; paid under another fee schedule Packaged service/item; no separate payment made Office-based surgical procedure with Medicare Physician Fee Schedule nonfacility practice expense relative value units; payment based on OPPS relative payment weight Office-based surgical procedure with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs Office-based surgical procedure without MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight Service not surgical in nature; and not a radiology service payable under the OPPS, drug/biological, or brachytherapy source. Packaged item/service; no separate payment made Surgical unlisted service excluded from ASC payment. No payment made Unsafe surgical procedure in ASC. No payment made Non-Surgical Procedure/item not valid for Medicare purposes because of coverage, regulation and/or statute; no payment made Radiology service paid separately; payment based on OPPS relative payment weight Radiology service paid separately; payment based on MPFS nonfacility PE RVUs Unknown