Use this task to modify a fee schedule.
The fee schedule configuration includes information collected on the following tabs:
Step | Instructions | Additional Information | ||||||||
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1 | From Fee Schedules page, select the fee schedule to be updated. | |||||||||
2 | General Fee Schedule Information Tab Click Update. The Fee Schedule: [name] page opens with the General Fee Schedule Information tab displayed. Update the relevant information via the applicable steps below... | |||||||||
3 | Enter the name of the fee schedule in the Fee Schedule Name field. | |||||||||
4 | Enter additional information to describe the purpose of the fee schedule in the Description field. | |||||||||
5 | Enter or select the Effective Date to begin calculating charged based on the fee schedule. | |||||||||
6 | (Optional) Enter of select the Expiration Date to stop using the fee schedule to calculate charges. | |||||||||
7 | (Optional) Open the Medicare Locality drop down list and select the geographical location if the fee schedule uses GPCI. |
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8 | Open the Calculated Fee Rounding drop down list and select the option for rounding the calculated amount for the RBRVS conversion factor. | |||||||||
9 | Enter the value to use as the conversion factor for relative value units in the RBRVS Conversion Factor field. |
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10 | Enter the general excise tax rate in the General Excise Tax (%) field. | |||||||||
11 | In the Related Payer & Plans section, select the payer and its associated plans to be associated with the fee schedule. | |||||||||
12 | Click Apply. | |||||||||
13 | Anesthesia Billing Information Tab Click the Anesthesia Billing Information tab to modify the ASA conversion factor, minute to time unit conversion, or the method used for rounding time units. | |||||||||
14 | In the ASA Conversion Factor section, enter the value to use as the ASA conversion factor for the fee schedule in the Conversion Factor field. | |||||||||
15 | In the Minute to Time Unit Conversion section, enter the number of minutes that comprise a time unit. | |||||||||
16 | In the Time Unit Rounding section, enter the method to use for rounding time units. | |||||||||
17 | In the Solo Provider Billing section, complete the following:
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18 | In the Directing/Directed Provider Billing section, complete the following:
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19 | In the Supervising Provider Billing section, enter the values of the Base Units and Time Units for services provided by a supervising provider. | |||||||||
20 | To specify the Elective Physical Status Modifiers, enter the values for each physical status modifier (P1 through P5) that will be added to anesthesia procedures for elective cases. | |||||||||
21 | To specify the Emergency Physical Status Modifiers, enter the values for each physical status modifier (P1 through P5) that will be added to anesthesia procedures for emergency cases. |
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22 | To specify the Custom Time Unit Rounding Point, enter the number of minutes that will be used as the interval for rounding time units. | |||||||||
23 | Click Apply. | |||||||||
24 | General Procedures Tab Click the General Procedures tab to modify which procedures are included in the fee schedule. |
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25 | Click Add. The Update General Procedure window opens. |
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26 | Open the Code drop down list and select the procedure being added.
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27 | (Optional) Enter a modifier in the Mod field. | |||||||||
28 | To override the calculated amount for a procedure performed in a facility, enter the amount of the override fee for the procedure when it is performed at a facility in the Override field in the Facility Amount section. | |||||||||
29 | To override the calculated amount for a procedure performed in a non-facility, enter the amount of the override fee for the procedure when it is performed at a facility in the Override field in the Non-Facility Amount section. | |||||||||
30 | (Optional) Click Save & Add Next to add additional procedure codes. Repeat the above steps for each procedure being added. | |||||||||
31 | Click Save once all procedure codes have been added. | |||||||||
32 | Click Apply. | |||||||||
33 | Anesthesia Procedures Tab Click the Anesthesia Procedures tab to update the anesthesia procedures listed in the procedures table. |
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34 | Click Add. The Update Anesthesia Procedure window opens. |
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35 | Open the Code drop down list and select the procedure being added.
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36 | To override the ASA base units, enter the amount of the override fee for the procedure in the Override field in the ASA Base Units section. | |||||||||
37 | To override the maximum minutes, enter the number of minutes for the override in the Maximum field in the Minutes section. | |||||||||
38 | To override the calculated time units, specify the override values via the Calculation Scale section fields (section is enabled upon selecting the Override time unit calculations for this procedure checkbox). | To complete this window::
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39 | To override the fee associated with the procedure, enter the new fee amount in the Override field in the Fee section. | |||||||||
40 | (Optional) Click Save & Add Next to add additional procedure codes. Repeat the above steps for each procedure being added. | |||||||||
41 | Click Save once all procedure codes have been added or updated. | |||||||||
42 | Click Apply. | |||||||||
43 | Miscellaneous Tab Click the Miscellaneous tab to update the modifier details or time based fee calculations. | |||||||||
44 | (Optional) To create a flat fee based on the two character modifier(s) present on a procedure in the Flat Fee by Modifier table:
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45 | (Optional) To create a percentage fee based on the two character modifier(s) present on a procedure in the Fee Calculation Percentage table:
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46 | (Optional) To specify the fee calculation based on specific time internals, select the Calculate fee by time interval checkbox and enter the applicable initial and subsequent interval quantities in the fields provided:
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47 | Click Save to save and close the page. |
Not applicable for this topic |