Forum - Questions & Answers

Aug 26th, 2009 - amy5761

HCPCS Fee Determination

How do you set a HCPCS fee schedule? I am in Radiology.

Aug 26th, 2009 -

The beauty of America...

is that you can charge what you want. The ugly side of capitalism is that the insurance company can pay you what it wants. In reality most set fees at a multiplier of Medicare rates- 140-170% and go from there. Watch your EOB's closely and if any insurer pays you 100% of charge then quickly raise your fee. You always want to charge more than what your best payor pays so you are not leaving money on the table.



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