2012 Charge Master - procedural and E&M codes, et al - internal logic to fees

[Guest guest]

I am in the process of revamping my Charge Master.How have others revamped their Charge Master?% of Medicare Fees -- ie Medicare allows $10 -- you charge 200% of Medicare or $20 or 150% of Medicare or $15

Multiplier x RVU's for a CPTOther?When my previous group dissolved, I took the charges from the most common codes and transferred them into our new Charge Master.These old charges were based upon that groups charge list that was updated over the years. 

I'm not sure that there was ever any specific logic to the charges -- ie % of Medicare or multiplier on RVU's, etc.But it was what it was.Over the years, I would increase the Charge Master by a % of last year's rates and create a new Charge Master for the current year.

This year, I decided to bring some internal logic to the charges and create a 2012 Charge Master that is a % of a 2011 Medicare Fee Schedule in my EMR.The idea was to take a 99213, figure out what I should be charging - then multiply the 2011 Medicare Rate by a multiplier to equal that new 99213 rate.

Then multiply ALL the Medicare Fee Schedule in my EMR by that same multiplier to create the new 2012 Charge Master.Interestingly, when I do this, the fees I charged for Procedures (ie punch biopsy, colposcopy, etc) went down -- despite a pretty significant increase in my E & M visit code fees.

I guess this means (at least based upon Medicare logic), I was overcharging for my procedural codes.I'm hoping that my increase in E & M codes will make up for a drop in Procedural Code fees -- but that in the end, there will be some internal logic to what I am charging.

I know for many of you, what you charge doesn't matter -- it's what the insurance will pay.We are somewhat unique in our Valley in regards to our contracts and what we charge does make a difference in what is paid - up to a point.

Thoughts? Locke, MD