Why Are Medicare Fee Schedules Important?

A Medicare fee schedule details how much providers can be paid. Without it, serious complications would arise.

A Medicare fee schedule is a simple sheet that shows what fees doctors and other providers have earned for services provided. No matter the service, these schedules let the government know just how much to compensate providers when it comes time to settle accounts. These schedules are important for a variety of different reasons.

Fee For Service Agreement

These schedules detail exactly how much a given provider can be paid for a given service. This eliminates complications and arguments about price, since this information is available to all hospitals, ambulances, etc. It also provides Medicare with a simple, easy way to figure out what services on a bill need to be reimbursed with what fees. So they work from both sides of the equation.

What Do These Schedules Cover?

If there is a medical expense that’s covered by Medicare, it’s on this list. Doctor’s visits, ambulance rides, prosthetic prices and more are all carefully itemized and listed on the Medicare fee schedule. So whether a hospital or other provider is looking to be reimbursed for laboratory work and blood tests, or for therapy sessions and medication, it’s all on the list.

How Do I Find The Schedule in My Area?

CMS.gov, the Center for Medicare and Medicaid Services, keeps records of all the schedules online. All you need to do is go to the page for the schedules and search them by zipcode. This will bring up a quick, easy and local file that shows exactly what can be expected and covered in a provider’s area. Due to different costs in different locations, the Medicare fee schedule needs to be adjusted accordingly. Different locations come with different expenses, thus higher/lower fees.

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