Free checklist
Fee schedule checklist for medical practices.
One page: the payers to cover, your codes by volume, effective dates, renewal and notice dates, and how each payer compares with Medicare. The steps RateBench does for you are marked.
Get the fee schedule checklist
A one-page PDF. Enter your email and it downloads straight away; we’ll email you a copy too.
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What’s on it
Seven steps, from your payer list to what you were paid.
Every payer you bill, ranked by last year’s allowed amounts, with the networks you’re in and the TIN and NPI each contract is under.
RateBench reads the rate for your NPI and shows which network it sits in.
Twelve months of claims totalled by CPT code. A short list of codes usually carries most of the money; those are the rates to know first.
RateBench starts you from your specialty’s common codes.
Each rate with its source and date, office and facility kept apart, payers side by side.
RateBench builds this sheet from the rates your payers publish.
When each contract’s rates took effect and how they move: fixed, tied to a Medicare year, or the payer’s schedule “as amended”.
RateBench re-reads your rates on the 1st of each month and emails you when one changes.
Each contract’s term, renewal date and notice period, in your calendar, with preparation starting about six months ahead.
Each payer’s rate as a percentage of Medicare’s for your locality, code by code, same year and setting.
RateBench adds Medicare’s rate for your locality as a column.
Allowed amounts, not paid amounts, against the rate, with payment-changing modifiers set aside.
RateBench’s underpayment check does this from your totals.
Using it well
Start with your biggest payer and your top codes.
Your fee schedule isn’t one document. Each payer, network and NPI can carry its own rate for the same code, and what you charge isn’t what you’re paid. So build it payer by payer, starting with the payer and the codes that bring in the most.
Put the renewal and notice dates in your calendar the day you fill them in. Miss a notice period and the contract can renew for another term at the same rates.
When you check what you were paid, compare the allowed amount with the rate, not the paid amount. Allowed vs paid vs contracted, explained →
Skip the hand work
Let RateBench fill in the rates.
The slow part of this checklist is step 3: finding the rate for each code at each payer. RateBench reads the rate each payer published for your practice, lays your payers out side by side with Medicare, and re-reads them every month. On every paid plan, from $99 a month.
Questions
The checklist, answered.
Is the checklist free?
Yes. Enter your email and it downloads straight away; we email you a copy too. RateBench itself, which builds your fee schedule from the rates your payers publish, is a paid plan from $99 a month.
What should a medical practice’s fee schedule include?
For each payer you bill: the rate for the codes that carry most of your revenue, where each rate came from and its date, office and facility rates kept apart, when the rates change, the contract’s renewal and notice dates, and how each rate compares with Medicare’s for your locality.
How often should I review my fee schedule?
Go through the whole checklist once a year and before any contract renewal, and recheck rates monthly: payers update their published rates every month, and Medicare’s physician fee schedule changes each 1 January. RateBench re-reads your rates on the 1st of each month and emails you when one changes.
How do I compare a payer’s rates with Medicare?
Divide the payer’s rate for a code by Medicare’s rate for the same code in your locality, in the same setting and year. The result is that payer’s percentage of Medicare. RateBench puts Medicare’s rate for your locality next to your commercial payers, code by code.
Where do the rates come from?
Under the federal Transparency in Coverage rules, commercial payers publish the rates they pay each in-network practice, by billing code, and update them monthly. RateBench reads the rate for your NPI from those files.