Wiki Creating Charge Amounts for CPT codes

[knperry]

Hello All!
Can anyone give me some info on how to create a charge amount for cpt codes. Is it 3X the medicare allowed amount or something else? Thanks

 

[thomas7331]

There isn't a standard formula for charges - that will be a business decision your practice will need to make. The practices I've worked for have generally set their fees anywhere between 150% and 250% of Medicare rates, but I know there are others that will set them even higher. An important factor to consider is your other payer contracts. As a general rule, you don't want to set your fees lower than what your commercial payers are allowing or you'll be missing out on revenue.

 

[knperry]

Thank you!