SoberAsABird
New
Hey, just wanted to see what other offices are charging for the 992XX office codes in 2025.
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OBGYN E&M Billing Amounts
- Thread starter SoberAsABird
- Start date
Discussion of exact fees is prohibited here. I will provide two very general suggestions for fee setting.
By RVU - decide a cost per RVU, then simply multiply the RVU x $cost = $fee
By your insurance contracted rates. Make sure you are billing out to all carriers with a charge at least what your highest contracted rate for the code is.
By RVU - decide a cost per RVU, then simply multiply the RVU x $cost = $fee
By your insurance contracted rates. Make sure you are billing out to all carriers with a charge at least what your highest contracted rate for the code is.
SoberAsABird
New
Thanks for the info, where was that specified? Edited the post to reflect that. Would you know a good place to actually share data like that? It can't just be the insurance companies that talk to each other otherwise every small office is going to be priced out.
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I know I have seen moderators intervene regarding fee setting, but I don't know exactly where it's specified.
I believe the concept is that your fees are supposed to reflect your expenses with whatever variance you deem appropriate. So my expenses + variance could be very different than someone on Park Avenue in NYC or someone in rural Montana.
I don't have any contracts that pay different based on what I charge. I do know that discussing my fee schedule is prohibited in my insurance contracts.
Honestly, most small offices HAVE been priced out by larger healthcare systems that have negotiating power. Years ago, managing a private practice with a very specialized sub-specialty, I thought I could absolutely be heard by payors and negotiate fee schedules. Every single one said "If you don't like our fees, don't be in our network." We even hired a consultant who promised he could negotiate contracts, but also got nowhere. The only way I know of small practices to have negotiating power is by joining an IPA, which the practice did join for a few years before joining a large healthcare system.
SoberAsABird
New
Thank you so much for the information, I really appreciate it!