Don’t Let Fee Schedules Stress You Out

Fee Schedules. They ensure your practice is fairly compensated for the services you provide and can make or break your profitability. That’s why it’s one of the first things we look at when we begin working with a new client.

Unfortunately, almost every practice we work with has at least one CPT code that they’re not maximizing, which means they’re leaving money on the table.

The good news is that remedying the situation doesn’t have to be complicated. It just has to be intentional.

When we work with clients, we look at prices two different ways: with RVUs for your geographic location and also with your contracted rates.

Many practices get lost in the weeds of the RVU calculator. So for an easy approach, you can use in your office, try this streamlined contracted rate process below:

  1. Review your insurance contracts & CPT codes. Identify the highest reimbursement rate for each CPT code. It’s rare that one insurance company is always paying the best rate.
  2. Set your fees at least 25% higher than the highest reimbursement rate for each CPT code (from step #1). Since many contracts will pay either their rate or 80% of your rate (whichever is lower), this will ensure you’re always maximizing your reimbursement.
  3. Revisit your fee schedule quarterly. When insurance companies change their rates or policies, you should be changing your fee schedule.

Need an extra set of eyes on your fee schedule? Set up a call and let’s make sure you’re not leaving money on the table.