What is a payment status indicator (SI)?
An SI will be assigned to every HCPCS code to identify how the code would be paid under OPPS and which OPPS payment policies apply. Only one status indicator will be assigned to each APC and to each HCPCS code. SI codes will appear on the EOB. The following chart includes a description of the SI and the particular services each indicator identifies: Status Indicator / Description • A Services paid under another TRICARE reimbursement methodology • B More appropriate code required for TRICARE OPPS • C Inpatient services not paid under OPPS • E Items or services not covered by TRICARE • F Acquisition of corneal tissue, payable on an allowable charge basis, and certain CRNA services and hepatitis B vaccines that are paid on an allowable charge basis • G Indicates drug and biological pass-through payments that are paid in separate APCs under OPPS • H Indicates pass-through device categories, brachytherapy sources and radiopharmaceutical agents allowed on a cost basis • K Non pass-through dr
