Our Commonly Asked Question: "What is the fee schedule for more insurance?" or "What am I going to get paid?"
Answer: Please remember that you are all independently credentialed providers. Therefore, we often times do not have access to the contracts that you sign with various insurance companies. Insurance companies determine fee schedules (essentially what you will get paid) on a provider-by-provider, plan-by-plan and often client-by-client basis. When you sign a contract with a new insurance carrier, they will release a fee schedule to you. Please consult your contract with the insurance company to see what that is. You can also call to get this information from them directly.
We do our best to keep up with estimates once claims are billed, but this is ALWAYS a contract being you and the insurance company and varies greatly -- this is typically why you cannot search for this information online. As always, if you have questions, you can reach out to us and we will do our best to give you direction.
Medicare does release its Fee Schedule annually with estimates on reimbursements for their providers. Many insurances base their reimbursements off of the Medicare Fee Schedule.
To access the Medicare Fee Schedule:
1. Visit their website & fee schedule look-up tool at: Fee Schedule Look-up Tool
2. Follow the prompts until you get to a screen that looks like this:
3. Enter requested information including:
- HCPCS Code (otherwise known as a CPT code)
- Select your specific MAC (i.e. 01182 for Southern California)
- You will be given a list of reimbursements. If your MAC is broken down into different localities, you can verify your MAC locality here.
Again, please note, the best way to estimate your payments for various insurance companies is to consult your contract with that organization. They will outline