• Category
1: Services of Doctors of Medicine (MDs), Doctors of Osteopathy
(DOs), optometrists, podiatrists, psychologists, oral surgeons,
audiologists, and Certified Nurse Midwives (CNMs) provided in a
facility including hospitals (both inpatient and outpatient and
billed with the appropriate revenue code for the outpatient department
where the services were rendered), Residential Treatment Centers
(RTCs), ambulances, hospices, MTFs/eMSMs, psychiatric facilities,
Community Mental Health Centers (CMHCs), Skilled Nursing Facilities
(SNFs), Ambulatory Surgical Centers (ASCs), etc.
• Category 2: Services
of MDs, DOs, optometrists, podiatrists, psychologists, oral surgeons,
audiologists, and CNMs provided in a non-facility including provider
offices, home settings, and all other non-facility settings. The
non-facility CMAC rate applies to Occupational Therapy (OT), Physical
Therapy (PT), or Speech Therapy (ST) regardless of the setting.
• Category 3: Services,
of all other providers not found in Category 1, provided in a facility including
hospitals (both inpatient and outpatient and billed with the appropriate revenue
code for the outpatient department where the services were rendered),
RTCs, ambulances, hospices, MTFs/eMSMs, psychiatric facilities,
CMHCs, SNFs, ASCs, etc.
• Category 4: Services,
of all other providers not found in Category 2, provided in a non-facility
including provider offices, home settings, and all other non-facility
settings.