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The fee schedule is the single most important financial tool within any business – a medical practice is no exception.  When considering what to charge for a service or procedure, the practice should take into consideration such things as cost, competition, complexity, uniqueness and other market dynamics.  A significant part of this is the ability to benchmark against peer activity by specialty on both a state and national level – which is now easy to do with our Fee Schedule Workbooks.  In any case, the fee schedule should be based on logical and defensible methods, both of which are necessary for negotiating profitable managed care contracts.
 
Each Microsoft Excel 2003 workbook deals with a single specialty and state.  To simplify finding the information you need, the results are partitioned onto a set of worksheets:

1. Matrix of the national and state average charges and conversion factors for each procedure.
    
2. Charge statistics for the specialty, in that state.  In addition to average charge, we include the standard deviation and the bounds for the 95% confidence interval.
    
3. Charge statistics for the specialty, using nation-wide figures.
    
4. Statistics for the average charge for each procedure for all specialties for that state.
    
5. Statistics for the average charge for each procedure for all specialties for the nation.

 
The Fee Schedule Workbook is available at an introductory price of only $99.

To see a sample, click here: Sample Fee Schedule Workbook

To order, click here:  Purchase Fee Schedule Workbook

For volume pricing, please contact us at support@mitsi.org

The data for this workbook comes from the Physician/Supplier Procedure Summary Master File (P/SPSMF), which contains 100% of all claims submitted to CMS during any given calendar year.  In total, the database consists of over 5.4 billion claim lines that include nearly every specialty and every physician in the U.S.  The data is aggregated by 11 dimensions to produce a file with more than 13 million records, each containing data on charges for that group.  Average charges are calculated by dividing the total charges by the total number of claim lines for each of the stratified groups and this data is then used to compile the statistics found in the worksheet.  Based on four studies we have conducted over the past two years, we have concluded that just over 93% of physicians submit their retail (usual and customary) charge to Medicare when submitting a Medicare claim.  Therefore, we are confident that the average charges and conversion factors reported in this worksheet accurately represent the market dynamics of retail charges for physicians and their practices.