Blackhorse
Guru
Medicare fee schedule for 62321 is $314.94 with POS 11. We got paid $265 and was told it is paid based on RBRVS by AppleCare. Is RBRVS a fee schedule just like the physician fee schedule? How do I search for a price for 62321?
I see, thank you so much!!! RBRVS is on the physician fee schedule. I really appreciate your helpWhen you search in the Physician Fee Schedule, one of the options is "National Payment Amount". You'll see the non-facility price as $277.75.
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If your locality is 0118226 (Orange County), then you will see that that is a more expensive area, and you would get paid more:
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So it appears that Applecare does not use the geographic portion of the fee schedule, but instead uses the National Payment Amount. Here is the fee schedule lookup tool (click me). On the drop-down box that says "MAC Option", choose "National Payment Amount."