Overview
The Fee Schedules page allows you to access and manage billing and expected fee schedules for the practice. There are three available types of fee schedules: Billing, Expected, and Compensation.
The billing fee schedule contains the fee structure for the following procedure types: anesthesia, medicine services, pathology and laboratory, radiology services, surgery, and pain management, including professional modifier (26) and technical modifier (TC). This fee schedule contains the fees for services, conversion factors, modifiers, and relative value units (RVU).
The expected fee schedule contains the expected payment for the following procedure types: anesthesia, medicine services, pathology and laboratory, radiology services, surgery, and pain management, including professional modifier (26) and technical modifier (TC). This is often used for calculating the allowed amount expected for services rendered to an insured of a specific payer. This fee schedule contains the flat rates and fees that are not going to be calculated by the billing fee schedule.
The compensation fee schedule is used for practices that compensate providers per procedure. This fee schedule contains the rates and fees that are going to be calculated based on compensation.
When creating or updating a fee schedule, the information displays in six tabs:
- General Fee Schedule Information Tab
- Anesthesia Billing Information Tab
- General Procedures Tab
- Anesthesia Procedures Tab
- Miscellaneous Tab
- Audit Tab
See the Configuring Fee Schedules topic for additional details.
Field Definitions
Field | Type | Required | Description |
|---|---|---|---|
| Type | Display Only (pulled from created/updated Fee Schedules) | Yes | The categorization, or type, of fee schedule. Options include: Billing, Expected, and Compensation. |
| Name | Display Only (pulled from created/updated Fee Schedules) | Yes | The name of the fee schedule as established in the fee schedule configuration. |
| Description | Display Only (pulled from created/updated Fee Schedules) | No | The description of the fee schedule as established in the fee schedule configuration. |
| Effective | Display Only (pulled from created/updated Fee Schedules) | Yes | The date the fee schedule became effective. The fee schedule is used to calculate fees for procedures with a date of service from the Effective date onward. |
| Expiration | Display Only (pulled from created/updated Fee Schedules) | No | The date the fee schedule is no longer used for calculating fees for procedures. The fee schedule is used to calculate fees for procedures with a date of service prior to, and including, the Expiration date. |
| Status | Display Only (pulled from created/updated Fee Schedules) | Yes | The current active status of the fee schedule. The values are Active or Archived. The status displays as Archived if the Archive checkbox is selected on the Fee Schedule / General Fee Schedule Information tab. |
Button Descriptions
Button | Shortcut Keys | Description | Step-By-Step Guides |
|---|---|---|---|
| Search | [Alt] + [S] | Search for a fee schedule(s) in the list. |
|
| Create | [Alt] + [C] | Add a new fee schedule to the table. | Configuring Fee Schedules |
| Update | [Alt] + [U] | Modify the selected fee schedule configuration. | |
| Delete | [Alt] + [D] | Removes the fee schedule from the master list. | Deleting Fee Schedules |
| Clone | [Alt] + [N] | Creates a copy of a fee schedule. | Cloning Fee Schedules |
| Recalculate | [Alt] + [R] | Update expected amount on all applicable lines. | Recalculating Fee Schedules |
| View Attachment | [Alt] + [V] | Opens the Image Viewer page to display or add an attachment to the fee schedule. |
If the fee schedule has any attachments, open the Set ID drop down list and select the attachment to view. If no attachments currently exist, a new attachment can be added to the fee schedule record by scanning or importing the image and attaching it. |
