cecim11
New
Hi. I have been doing billing for many years, private office setting, outpatient. The standard for setting UCR has been 200% of the Medicare fee rates. This is now being challenged by a doctor who wishes to set their UCR differently. I can't find any reference regarding how to properly set UCR. And I am realizing the formula I have been following has been based solely on how I was trained many years ago - no particular rule/regulation stipulating how to formulate UCR. Am I wrong? Can the doctor set their fee rate arbitrarily to whatever rate they like for each service code? As the biller, I don't want to do anything that is not within compliance. Does anyone have any advise? Thank you in advance.