Sources and references
Find the official documents behind DueMD’s payment explanations and Medicare reference calculations.
Use these references to check a definition, understand remittance information or identify the source behind a Medicare calculation. A link is a reference, not an endorsement of DueMD.
Payment and contract references
Allowed amount ↗
A reference definition, not a commercial contract rate.
Health Care Payment and Remittance Advice ↗
How payment adjustments and financial responsibility are explained. Medicare guidance is not treated as universal commercial contract language.
Guidance on de-identification ↗
Why removing a name is not a blanket assurance that medical information is safe to share.
PFS Relative Value Files ↗
Reference-file directory; this release imports the supplied October 2026 RVU26D snapshot.
PFS lookup: geographic adjustment and limitations ↗
How locality and reference rates work; not commercial adjudication.
PFS documentation and files ↗
RVU components and national/locality fee files.
Overview of coding and classification systems ↗
Distinguishes CMS HCPCS Level II from AMA-copyrighted CPT. A public source is not blanket redistribution permission.
Therapy services: multiple procedure payment reduction ↗
Example of PE-component-specific Medicare therapy reduction; not a universal commercial second-service rule.
PFS status and payment policy indicators ↗
Professional/technical components and supported payment interpretation.
Coordination of Benefits ↗
Why payer order and benefit allocation must be established before arithmetic.
Payment, remittance advice and EFT transactions ↗
Different roles of electronic payment and remittance information.
Original Medicare fee-for-service appeals ↗
Official Medicare appeals starting point. Commercial deadlines must be checked separately.
Sources for the installed Medicare snapshot
The lookup uses October 2026 source files. The dataset page records coverage, import checks and provenance limitations; version details identify the installed snapshot.
PFREV26D: October 2026 national payment amount file ↗
Supplied ZIP parsed: six revised codes across 109 localities and two rate classes. Used for 1,308 independent non-facility amount comparisons, not as the full payment catalog.
RVU26D: October 2026 RVU files ↗
Source components, NA flags, conversion factors and GPCI2026; local supplied bytes parsed; fresh-download hash comparison pending.
CMS ZIP5/ZIP+4 locality crosswalk — October 2026 ↗
Exact fixed-width ZIP5 and ZIP9 records; quarter 20264; no five-digit fallback for split areas.
Using the sources
Check the applicable agreement and the source’s scope before using it for a decision. Medicare guidance does not automatically define a commercial payer’s terms. Procedure codes and other third-party materials remain subject to their owners’ terms.
Source-page checks and imported-file checks are different: importing a file does not verify every possible payment result. See the dataset validation scope and calculation methods.
Other references used in the site
NPI dissemination files ↗
A directory source. An NPI does not verify licensing or credentialing. Not imported into DueMD.
CORE operating rules ↗
Official entry point for operating rules. The checked URL currently redirects to dataspring.com/core. DueMD is not certified or endorsed by CORE.
2026 PFS final rule: QP and non-QP files ↗
The 2026 QP/non-QP distinction. Not an assumption about a commercial agreement.
How to correct a rejected claim ↗
Medicare unprocessable-claim guidance; not generalized as every commercial payer’s appeal process.
CAN-SPAM: guide for business ↗
Email sender identity, postal address and opt-out obligations; not a full international compliance review.
Send email API ↗
Transactional email API and provider acceptance; acceptance is not inbox delivery.
Google Search spam policies ↗
Avoid scaled low-value content and uncontrolled user-generated spam.