Defensible Fee Schedule Toolkit
Especially as new payment models are being introduced and patient financial responsibility for their health care increases, it is critical that physician practices both understand what it actually costs them to provide services and establish their fee schedules based on the costs of providing services, rather than on what a third-party payer or other entity decides is fair payment. To help physicians and practice staff recognize this and establish fair, accurate fee schedules, the AMA has developed the educational resource “Fee schedule analysis: Using your complete practice cost as a guide
This resource includes a 12-step guide to help you create your own unique physician practice fee schedule with the help of an easy-to-complete spreadsheet.
Obtaining, uploading and utilizing your contracted fee schedule
Obtaining, uploading and utilizing contracted fee schedules can be a very complex process, but doing so can save your practice countless hours and hassles down the line.
It is important that physicians understand how a negotiated fee schedule can impact their practice’s bottom line. This understanding leads to informed decisions about participation in a health plan before contracts are signed. The California Medical Association (CMA) has developed a simple worksheet to help physicians analyze proposed fee schedules and assess the effect fee schedule changes may have on physician practices, based on commonly billed CPT codes.
Would you like to provide feedback on this toolkit?
Email the AMA Practice Management Center.