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Medicare Physician Fee Schedule Lookup Tool


The Medicare Fee Physician Schedule Lookup Tool (MPFS) is a handy resource to search for pricing, codes, and payment indicators for Medicare-approved services. Below we share all the details about the tool – including how it works, how to find it, and how to use its data.

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CMS Medicare Physician Fee Schedule Lookup Tool

Managed by the Centers for Medicare and Medicaid Services, the MPFS tool provides a detailed list of the fees Medicare pays doctors or suppliers for visits, tests, and procedures. This tool also provides information about over 10,000 physician services, related codes, fees, and adjusted payments supplied by Medicare.

There are even fee schedules for laboratory services, ambulance services, medical equipment and supplies. However, you typically only pay 20% of the amount.

Why do Physicians Use Searchable MPFS?

Physician Fee Schedules are the master list of fees and the primary payment method for all Medicare-accepting doctors and facilities. So, if your doctor accepts Medicare assignment, they must follow the fee schedule.

The fee schedule includes any health services provided by suppliers, doctors, and other healthcare providers in hospital-based and private practice. Suppliers can consist of, mammography centers, skilled nursing facilities, comprehensive outpatient rehabilitation facilities (CORFs), and hospital facilities.

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When using a Private-Fee-For-Service plan, your determined payment will be the lesser of the MPFS amount or the doctor’s agreed charges. Therefore, it is important to check the MPFS tool to ensure you are not overpaying for services. Your doctor should have this information available in their office, however, it is important to have first-hand knowledge of the fee schedule.

Changes in the Medicare Fee Schedule Lookup Tool

Each quarter, the MFPS tool is updated to reflect changes in codes, fees, or coverage. Changes are found on CMS.gov in the MPFS overview. So, it is important to check the tool regularly to ensure changes have not occurred.

Each year, a Final Rule is issued that takes effect the following year. The biggest takeaway from a recent Final Rule is that Medicare will now cover certain telehealth audio-only visits for mental health. Medicare also updated the payment regulations for Medical Nutrition Therapy services. Lastly, the Final Rule implemented a 3.75% increase in MPFS payments.

How to use the Medicare Physician Fee Schedule Lookup Tool

Using the tool is simple and instructions are easy to follow. To begin your search, open the Medicare Physician Fee Schedule Lookup Tool and choose your desired search type. Search results populate when all required fields are complete.

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All search types on this tool are available to healthcare professionals and the public to ensure transparency in all medical practices. Therefore, if you are unclear about the search results, you can always ask your doctor for assistance.

Utilizing MPFS Tool Search Options

When using the Medicare Physician Fee Schedule Lookup tool, it is important to filter your search results to give you the information you need rather than all the information the tool provides to reduce confusion.

  • Pricing Information helps provide the maximum fee schedule amount from the HCPCS code. This can be obtained from your healthcare provider or facility.
  • Payment Policy Indicators help give you a clearer picture of your exact costs for specific tests and procedures. This is an advanced search option that requires additional information to complete. Search results can include specific code coverages, level of supervision by a physician, number of days post-op that receive coverage, and any additional modifiers that could affect cost.
  • Relative Value Units (RVUs) help medical professionals find information regarding malpractice and work costs, as well as practice expenses. RVU’s show the costs of supplies, medical equipment, time, malpractice insurance, and operating room fees. These costs are important to understand as they can be equivalent to about 50 percent of the total payment.
  • Geographic Practice Cost Indices show the differences in cost across different regions in the United States. This search option pulls RVU’s and compares them regionally and nationally to show areas where procedures are more cost-effective.

How to Find the Medicare Physician Fee Schedule Lookup Tool

Many pages on the web state they have an MPFS tool for Medicare beneficiaries. However, to ensure you are using the most up-to-date version, visit cms.gov for the official Medicare Physician Fee Schedule Lookup tool.

For those looking for help with paying the out-of-pocket costs that come with Medicare, our licensed agents can walk you through the process of obtaining supplemental Medicare coverage. To reach a Medicare expert, fill out our online rate form. Want to speak to an agent now? Give us a call at the number above.

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

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