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medicare fee schedule
Old 05-03-2013, 03:36 PM   #1
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medicare fee schedule

I recently had a short hospital stay and got a nice 9K bill. Was looking on the internet to see what medicare's fee schedule would charge for same coded procedures but unable to find it. Anyone have any idea how to find this info? Would like to discuss bill with the hospital and this info would be nice to have.
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Old 05-03-2013, 04:37 PM   #2
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You can try this link

How to Look Up CPT Codes for Free
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Old 05-03-2013, 07:52 PM   #3
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Quote:
Originally Posted by rbmrtn View Post
You can try this link

How to Look Up CPT Codes for Free
Thanks for the site... a little homework and the codes are available...

Another related point... before dealing direct with the hospital and doctor, check to see if the hospital has a patient advocate. Many years ago we had a similar sitution re: a very large (150+K) bill. Between all parties including the health insurer working together, it was settled to everyone's satisfaction, with almost no anxiety.
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Old 05-04-2013, 10:53 AM   #4
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Quote:
Originally Posted by rbmrtn View Post
You can try this link

How to Look Up CPT Codes for Free
Thanks for this info. Once I get an itemized bill I can compare. It does say there is a limit to the number of cpt codes it will give info on.
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Old 05-09-2013, 02:15 PM   #5
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Quote:
Originally Posted by mn54 View Post
I recently had a short hospital stay and got a nice 9K bill. Was looking on the internet to see what medicare's fee schedule would charge for same coded procedures but unable to find it.
Quote:
Originally Posted by rbmrtn
You can try this link

How to Look Up CPT Codes for Free
I learned from this site that there are multipliers applied to the Medicare costs depending on your location. It's called a "relative value amount" (RVU)

Quote:
Using RVUs to Determine How Much Your Provider Was Paid

Each CPT code is given a value - an amount of money Medicare will pay a hospital or a physician for that service as an average. Then, cities and other geographic areas are assigned an RVU - relative value amount - that is a percentage, higher or lower, of the average CPT payment.

Here's how that works: Depending on what state and city you live in, the RVU will be higher or lower than the average, based on the cost of doing business. So, for example, say CPT Code X is worth an average of $100 across the United States. The RVU for New York City might be 1.3 which means Code X is worth $130. In Birmingham, Alabama, which has a much lower cost of doing business, the RVU might be .75 - making that CPT code worth $75 in Birmingham, Alabama.
A friend of mine's Mom was recently treated in the hospital and my friend mentioned that she thought such an adjuster existed. I didn't think it did, but unfortunately, I guess I'm wrong and just found another criteria to add to the list for picking a place to retire to.
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