Overview

The Fee Schedule: New and Fee Schedule: [name] pages are comprised of six tabs:

The Miscellaneous tab specifies includes two sections of information for a fee schedule: Modifier Calculations and Time Based Fee Calculations.

The Custom Modifier Logic section includes two tabs:

  • Flat Fee by Modifier - to specify modifier codes and flat fee calculations (Note: to be used for for anesthesia codes)
  • Fee Calculation Percentage - to specify modifier codes and percentage calculations (Note: to be used for non-anesthesia codes)

See the Configuring Fee Schedules topic for additional details.

How to Get Here?

To open the Miscellaneous tab for new fee schedule:

From the Home Page:
From the Menus:
Via Shortcut Keys: 
  1. Click Fee Schedules from the Admin list.
  2. Click Create.
  3. Click the Miscellaneous tab.
  1. Open the Admin menu and select Fee Schedules.
  2. Click Create.

  3. Click the Miscellaneous tab.

  1. From the Fee Schedules page, press [Alt] + [C].
  2. Click the Miscellaneous tab. 


To open the Miscellaneous tab for existing fee schedule:

From the Home Page:
From the Menus:
Via Shortcut Keys: 
  1. Click Fee Schedules from the Admin list.
  2. Select the fee schedule to be modified.
  3. Click Update*.
  4. Click the Miscellaneous tab.

*Alternate Navigation: Double-click the fee schedule from the list.

  1. Open the Admin menu and select Fee Schedules.

  2. Select the fee schedule to be modified.

  3. Click Update*.
  4. Click the Miscellaneous tab.

*Alternate Navigation: Double-click the fee schedule from the list.

  1. From the Fee Schedules page, select the fee schedule to be modified.
  2. Press [Alt] + [U].
  3. Click the Miscellaneous tab.

 

(Click an image below to enlarge.)

Fee Schedule: New Page / Miscellaneous Tab


Fee Schedule: [name] Page / Miscellaneous Tab


Field Definitions

Field

Type

Required

Description

Custom Modifier Logic Section


Flat Fee by Modifier Tab Table with created/updated Modifiers / FeesNo

This option overrides the default fee amount logic when the specified provider modifier exists on an anesthesia procedure. Instead of calculating the fee amount based on the procedure and anesthesia provider time, the expected amount will be set at the specified flat fee amount. This override does not apply if the billed amount is less than the flat fee specified in the table. For example, if the AA modifier is specified with a $534.55 fee and the procedure included an AA provider with a billed amount of $218.56, the expected fee amount would default to $218.56.

The Flat Fee by Modifier table includes 3 buttons for modifying the table:

  • Add - Opens window for inputting the two-character modifier and expected flat fee you wish to assign if the fee is less than the total billed amount on the procedure
  • Remove - Deletes the selected modifier/fee from the table
  • Update - Opens window to modify the modifier or related expected fee.
Fee Calculation PercentageTable with created/updated Modifiers / FeesNo

This option overrides the default fee amount logic when the specified provider modifier exists on a non-anesthesia procedure. Instead of calculating the fee amount based on the procedure and anesthesia provider time, the expected amount will be set as a percentage of the billing or expected amount (depending on the type of fee schedule).

The Fee Calculation Percentage table includes 3 buttons for modifying the table:

  • Add - Opens window for inputting the two-character modifier and fee calculation percentage
  • Remove - Deletes the selected modifier/fee from the table
  • Update - Opens window to modify the modifier or related expected fee.
Time Based Fee Calculation Section 


Calculate fee by time interval CheckboxNo

Check this option to calculate fees based on time intervals outside of typical default fee calculation methods. This type of fee calculation is optional and uses minute values to specify one initial time period interval and related fee, and one repeating time period interval and related fee (one fee for each subsequent time interval). For example, a total fee for procedure X is set to $150 for the first 30 minutes (initial), then $50 for every 15-minute period after that (subsequent). If this procedure spanned a duration of three hours, the time-based fee calculation for this would be $150 + [(150 min/15) x $50] = $650.

If checked, all other fields in this section are required.

Initial interval (minutes) Free TextYes - if Calculate fee by time interval is checkedThe first time interval (in minutes) used when calculating fees based on time.
Initial interval fee Free TextYes - if Calculate fee by time interval is checkedThe fee for the first time interval when using time based fee calculations.
Subsequent interval (minutes) Free TextYes - if Calculate fee by time interval is checkedThe next time interval (after the initial one) set in minutes.
Subsequent interval fee Free TextYes - if Calculate fee by time interval is checkedThe fee charges for the subsequent time intervals following the first one.

Button Descriptions

Button

Shortcut Keys

Description

Step-By-Step Guides

Add[Alt] + [D]

Depending on the tab you are in:

  • Add a new flat fee by modifier.
  • Add a new fee percentage calculation by modifier.

Refer to the Configuring Fee Schedules topic for additional details.

Remove[Alt] + [R]

Depending on the tab you are in:

  • Delete a flat fee by modifier from the list.
  • Delete a fee percentage by modifier from the list.


  1. Select the modifier from the list that is to be deleted.
  2. Click Remove. The modifier and fee is removed from the table.
Update[Alt] + [U] 

Depending on the tab you are in:

  • Modify a flat fee by modifier.
  • Modify a fee percentage by modifier.

Refer to the Updating Fee Schedules topic for additional details.





 

Related Topics

Fee Schedules

Fee Schedules Page

Fee Schedule / General Fee Schedule Information Tab

Fee Schedule / Anesthesia Billing Information Tab

Fee Schedule / General Procedures Tab

Fee Schedule / Anesthesia Procedures Tab

Fee Schedule / Audit Tab

Configuring Fee Schedules

Updating Fee Schedules

Deleting Fee Schedules

Cloning Fee Schedules

Recalculating Fee Schedules



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