Glossary · Updated Jul 6, 2026
PFS Status Indicators
A status indicator is a single-letter code that tells you how Medicare treats a service under the Physician Fee Schedule — whether it is separately payable, bundled into another service, carrier-priced, or not covered. Payability is driven by this status, not by whether a code happens to have RVUs.
Payable statuses
Status A (active) codes are separately payable and have a national payment amount. Status R (restricted) codes are payable under specific coverage conditions. Status T codes are payable only when no other Physician Fee Schedule service is billed on the same day. These are the statuses for which a national amount is calculated.
Carrier-priced
Status C means the code is carrier-priced: there is no national payment amount, and the local Medicare Administrative Contractor sets the price. A rate engine should report that a national amount is unavailable rather than invent a figure.
Not separately payable
Statuses B (bundled), I (not valid for Medicare), N (non-covered), P (bundled/excluded), M (measurement), X (statutory exclusion), and E (excluded by regulation) are not separately payable under the fee schedule. A code can carry these statuses whether or not RVU values are present.
Anesthesia (status J)
Status J codes are anesthesia services, priced under a separate formula — base units plus time units, multiplied by an anesthesia conversion factor and a locality adjuster — rather than the RVU-based PFS formula. A rate lookup for a status J code with a locality returns the anesthesia conversion factor for that locality instead of an RVU-based amount.
Status indicators at a glance
Every status letter above, in one table:
| Status | Meaning | Separately payable? |
|---|---|---|
| A | Active — separately payable with a national amount | Yes |
| R | Restricted — payable under specific coverage conditions | Yes |
| T | Payable only when no other PFS service is billed the same day | Yes |
| C | Carrier-priced — the local MAC sets the price | No national amount |
| J | Anesthesia — priced by the separate anesthesia formula | Via anesthesia formula |
| B | Bundled into payment for another service | No |
| I | Not valid for Medicare | No |
| N | Non-covered by Medicare | No |
| P | Bundled or excluded | No |
| M | Measurement code, used for reporting | No |
| X | Statutory exclusion from the PFS | No |
| E | Excluded from the PFS by regulation | No |
Frequently asked
Which status codes are payable?
A, R, and T are separately payable and have a national amount. C is carrier-priced (no national amount). J (anesthesia) is priced under a separate formula, not the RVU-based PFS formula. B, I, N, P, M, X, and E are not separately payable.
A code has RVUs but is not paying — why?
Payability follows the status indicator, not the presence of RVUs. A non-payable status will not produce a payment even if RVU values exist.
Sources
- CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field)
- CMS Physician Fee Schedule overview (cms.gov)
Written from primary CMS sources — see how we source, compute, and verify everything on this site.
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