Administration
Fee schedules
A fee schedule row says what one payer pays for one procedure code (with any modifiers), from a given date. Charges are priced at the rate in force on their date of service.
Written for: Organisation administrators · Billing leads
How to get there
RCM: Settings → Fee schedules · Rehab: Outpatient → Fee schedules
What a rate holds
| Field or control | What it means |
|---|---|
| Payer | From your payer list - add payers first - or Default rate, which applies when no payer-specific rate matches and is also the self-pay price. A payer-specific rate always wins over the default. |
| Procedure code and modifiers | The billed code, with up to four modifiers. |
| Rate | The amount, stored in cents. |
| Effective from | The date the rate starts to apply. |
| Notes | Optional, for example the contract the rate comes from. |
Changing a rate
A rate is never edited in place. Supersede closes the current rate and opens a new one from a new date, so charges already posted - including ones already on a submitted claim - keep the price they were billed at. The only change allowed on a live rate is deactivating it.