Wiki 2 Fee Schedules

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Christina Sachs

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Our company has always been under the impression that having more than one fee schedule is illegal. We recently brought on a client who states otherwise in that they have always used one fee schedule for Medicare patients and then another for all other payors. Our business is in Illinois. Does anyone have any definate info on this or know where I can find out? Thanks!
 
One fee schedule

One fee schedule, but your allowable adjustment will vary based on the contract with the individual payer.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
having more than one fee schedule is not illegal - it just does not make sense at all. If you have more than one, the one not used for Medicare cannot bill less than the Medicare fee schedule.

Why would you want more than one? All you need to do is the allowed adjustment and then you are set with one fee schedule!
 
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