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A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis.

You can call the provider representative at the insurance company (payer) and ask them to fax you a copy of your contract with an updated fee schedule. Go to the provider section on the insurance company's website, and download a copy of the fee schedule.

The Centers for Medicare and Medicaid Services (CMS) determines the final relative value unit (RVU) for each code, which is then multiplied by the annual conversion factor (a dollar amount) to yield the national average fee. Rates are adjusted according to geographic indices based on provider locality.

An insurance company will negotiate a fee schedule within its network of preferred doctors for members to use. Since a provider is able to bill any amount, this allows insurance companies to pay less than billed charges while still allowing the providers to be reimbursed an amount they deem reasonable.

In its simplest form, a conversion factor (CF) is a value used to convert some unit of measurement into a charge.For our purposes here, the conversion factor is a per725bunit value that is multiplied by the relative value units (RVU) to convert it into a fee (or charge) for a particular medical service or procedure.

Most payers determine fee schedules first by establishing relative weights (also referred to as relative value units) for the list of service codes and then by using a dollar conversion factor to establish the fee schedule.

Reimbursement schedule also called a fee schedule is a complete listing of fees that are used by medicare.

Oklahoma Schedule of Reimbursement

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What is a fee schedule?

How do insurance companies get fee schedules?

How does Medicare determine its fee schedule?

How do fee schedules work?

How is the conversion factor for the fee schedule determined?

Do healthcare providers set fee schedule?

How are fee schedules determined?

What are fee schedules based on?

What is a reimbursement schedule?

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