Plain-English answers for Medicare and state Medicaid. Every answer is tied to an official public source, a page or section, and a last-verified date.
PPS Playbook covers Medicare FQHC PPS, Medicare Advantage (the MAC supplemental “wrap” payment plus public plan-manual rules), plus Medicaid fee-for-service and managed Medicaid in the states listed above. Every entry was written from an official public document that was read and last checked on the date shown. When a source was old, unofficial, or silent on a point, the card says so in its confidence note. Rates are never estimated.
How sources are checked: each answer was read directly in the cited official document (section or page shown on the card). A script then requests every source link, records its HTTP status, and saves a SHA-256 fingerprint of the file, so a later run shows which documents moved, broke, or changed and need re-reading. Medicare Advantage plan rules come from public plan manuals and can differ by your contract with the plan.
CPT is a registered trademark of the American Medical Association. This site lists CPT code numbers only. HCPCS Level II summaries are written in plain English, in our own words.