Where can I find fee schedules?

[andrea]

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So I'm in my practice management month, and I'm learning some coding and reimbursements. For example, medicare will pay something like $80 for one actinic keratosis cryotherapy, but any additional AK removal during that visit is only $7 each. So this intrigues me: A doc would make significantly more money if he or she removed one AK at each patient visit versus multiples at one time. So where do we get this kind of info otherwise? I tried to google fee schedules, but there is too much to wade through. Any ideas? Thanks!

 

[deleted87716]

If that's the kind of thing you want to do, you pretty much have to figure it out on your own.

Nobody is likely to write a book or article called "How to Game the System," for obvious reasons. 😉

That being said, Family Practice Management is a good place to look for articles about maximizing reimbursement.

 

[DD214_DOC]

So I'm in my practice management month, and I'm learning some coding and reimbursements. For example, medicare will pay something like $80 for one actinic keratosis cryotherapy, but any additional AK removal during that visit is only $7 each. So this intrigues me: A doc would make significantly more money if he or she removed one AK at each patient visit versus multiples at one time. So where do we get this kind of info otherwise? I tried to google fee schedules, but there is too much to wade through. Any ideas? Thanks!

I'm going to take a guess and presume that if you submit several separate visits for this procedure, you are unlikely to be reimbursed at all. I'm sure they will say something like, "you could/should have removed these other lesions at the time of the initial one, so we won't pay for them"

 

[deleted87716]

I'm going to take a guess and presume that if you submit several separate visits for this procedure, you are unlikely to be reimbursed at all.

More likely, your patients will hate you for suggesting they come in twelve different times so you can freeze twelve different AKs.

You can only do so much in a single visit, but don't count on a lot of repeat business if you go too far in that direction.

 

[lowbudget]

It's available on Medicare's website under CMS's Physician Fee Schedule Look-Up.