How do your fees mesh?

November 5, 2004

Here's the latest data on what healthcare providers around the country are charging for the services you do most. Compare your fee schedule to see if you're on track.

In days past, doctors could determine the value of a particular service, attach a fair price, and adjust it by a patient's ability to pay. Today things are a lot more complicated. You have to be savvy about what insurance companies allow.

To help you make sure your fee schedule is on track, here's information on what healthcare providers around the country are charging for the codes you use the most. The data are taken from Medical Fees in the United States 2004: Nationwide Charges for Medicine, Surgery, Laboratory, Radiology and Allied Health Services (copyright Practice Management Information Corporation, Los Angeles, http://www.pmiconline.com). In compiling the data, PMIC looked at claims data from a variety of sources, including physicians, service bureaus, group practices, clinics, universities, and practice management system vendors.

"Data like these are an excellent resource in that they give insight into what others are charging. But fee schedules are academic in the long run because it comes down to what reimbursements you've negotiated in your payer contracts," says David Scroggins, a practice management consultant with Clayton L. Scroggins Associates in Cincinnati.

"Doctors want to hold on to their fees, but they can't negotiate in these inflated ranges unless they're in demand because of their location or specialty."