Fee
Information
The standard way that physicians are paid for services today
is based on a very specific system known as HCPC (Healthcare Common Procedure
Codes) There is nothing simple about this system. The book of
codes to use is several hundred pages long. Staff attend week-long
programs to learn to determine proper codes for services rendered. Every
aspect of care you receive in a doctor's office is paid according to its HCPC
code. There are dozens of codes for mole removals, ten codes for office
visits, combinations of codes for an immunization, etc.
We would like to state a definitive price for your services,
but unfortunately, this can not be known in advance. Physicians who sign
up for DOCTROIT have agreed to a discount fee schedule for their
patients. Physicians price their service on DOCTROIT at the Medicare Fee
Schedule or at some percent above the Medicare Fee Schedule. During your
visit the doctor will identify the services provided to you and determine the
HCPC code. They will then provide you with a bill based on their agreed
to rates. If you know the HCPC code for a particular item you can look
up the Medicare fee yourself on their web
site. Generally you can expect the doctors office to know these
rates after your service is provided.
Here are some sample codes for your review based on Medicare's
payments in the Detroit Michigan Area. Note, some doctors may charge a
premium above these stated rates. Some may charge a flat rate. See their fee notes in the doctor
listing.
|
New Patient |
Established
Patient |
| Level |
HCPC
Code |
New Patient |
HCPC Code |
Fee |
| Lowest |
99201 |
$38.95 |
99211 |
$22.76 |
| Modest |
99202 |
$71.03 |
99212 |
$40.50 |
| Average |
99203 |
$106.21 |
99213 |
$57.31 |
| Complicated |
99204 |
$148.69 |
99214 |
$88.65 |
| Highly Complex |
99205 |
$188.07 |
99215 |
$129.05 |
Physical Exam: Prices for physical exams
vary based on the age of the patient.
| |
New
Patient |
Established
Patient |
| Age |
HCPC Code |
Fee |
HCPC Code |
Fee |
| 0-1 year old |
99381 |
$109.59 |
99391 |
$83.35 |
| 1-4 years old |
99382 |
$117.76 |
99392 |
$93.70 |
| 5-11 years old |
99383 |
$115.44 |
99393 |
$92.54 |
| 12-17 years old |
99384 |
$125.80 |
99394 |
$101.87 |
| 18-39 years old |
99385 |
$125.80 |
99395 |
$103.04 |
| 40 - 64 years old |
99386 |
$147.81 |
99396 |
$114.17 |
| over 65 years old |
99387 |
$159.86 |
99397 |
$125.44 |
Other items may be necessary during your visit.
| Item |
HCPC Code |
Rate |
| Chest x-ray |
71020 |
$40.43 |
| Pulmonary Function Test |
94010 |
$35.66 |
| EKG |
93000 |
$29.46 |
| Minor excision (cryosurg) |
17000 |
$65.44 |
| TB Test |
86580 |
$12.12 |
| Allergies |
95117 |
$21.42 |
| Hearing Test |
92552 |
$21.15 |
Injections: Your doctor may recommend
injections for vaccinations or other purposes
*note: immunizations will also add a fee for administration and
disposable supplies.