Wiki Need Some Advice for Pricing?!?!?!?

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brinktwins

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I work in a Pain Management office and doctors are looking at the prices they are currently charging for they injectable meds. they use for procedures (e.g. Omnipaque, Kenalog, Versed, etc, etc....) Is there a magic formula to figure out the markup on drug pricing? Can anyone give me some advice!!!! Please!!!!

Thank you in advance!
 
Medicare and medicaid have a drug fee schedule, most of the commercial carriers are following the medicare fee schedule. Also your HCPCS can help in guiding you on dosage/pricing.
 
Pricing?!!

Thank you for the help! Leann (I'm a very new coder) how do I use HCPCS to help me? I've looked in my HCPCS book but can't find anywhere that shows me pricing? Also I printed out the Medicare and Medicaid fee schedule. So if it says the reimbursement is $0.017 that's all we would get paid. However, work comp may reimburse $1.20 on the same drug/ dosage. So my docs are feeling like we should price slightly higher than work comp reimburses.

Thoughts in this?!?

Thank you again for your help!
 
Pricing!!!

Some countries follows standard prices on drugs.

Even they mentioned with the manufactures also. Choose your drugs and check the prices compare with your country price.

This can be a optional to weight the drug price.

Thanks


brinktwins said:
I work in a Pain Management office and doctors are looking at the prices they are currently charging for they injectable meds. they use for procedures (e.g. Omnipaque, Kenalog, Versed, etc, etc....) Is there a magic formula to figure out the markup on drug pricing? Can anyone give me some advice!!!! Please!!!!

Thank you in advance!
Click to expand...
 
Fellow pain management!! I actually use my own method, simply because the payers vary so much in reimbursements. I always charge more than what we pay for the drugs (no exact formula), hoping that between self-pay, w/c, commercial, and mcare/mcaid we will at least break even.
 
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