Setting Fee Schedule

Lynne77

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Location
Duluth, GA
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Hello! We recently upped our fee schedule and some of our providers are concerned the fees are too high and will be "off-putting" to patients. So, I'm just curious... how did your practice set it's fee schedule? Was it a certain percentage above MCR and, if so, how much?

Thanks!
 
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281
Location
Selden
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From my experience, unless you have self pay patients, or out of network and balance billing, the patients are not typically concerned about the amount billed. In private practice, we used approximately 350% of Medicare fees, and rounded. I didn't update it annually, but if there was a code that I realized changed significantly in value, I would update the fee for just that code. Our practice is now part of a larger healthcare system and the fees are set as a percentage of the United Healthcare fee schedule. Each service line has a different contract, and therefore a different fee schedule.
 

vanessamoldovan

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Local Chapter Officer
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Location
Des Plaines, IL
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Hello! We recently upped our fee schedule and some of our providers are concerned the fees are too high and will be "off-putting" to patients. So, I'm just curious... how did your practice set it's fee schedule? Was it a certain percentage above MCR and, if so, how much?

Thanks!
In my experience working with physician groups and private practices, the fee schedule is set between 150%-200% of Medicare and then there is a separate self pay/OON fee schedule which is usually a percentage of the practice fee schedule.

I hope this helps.

Vanessa
 

jhendrix08

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In our office (private practice with one MD and one NP), we set the fee schedule at 200% of Medicare and we have a separate self-pay schedule for our patients that are uninsured. Hope that helps.
 
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