Fee Schedule Setup (Procedure Codes)
A key component of setting up your account is building your Fee Schedule. We’ve pre-populated your account with commonly used procedure codes and set them to inactive. In this article, we’ll show you how to search for codes, make them active, and add your charge amounts.
Tip: Once the integration is enabled, any code that is billed in the WebPT EMR that isn’t already established in your fee schedule will appear in your incomplete constants.
Activate Your Procedure Codes
First, enable all your standard CPT/HCPCS codes.
- Begin by going to Charges and select Procedure Codes.
- Type in the code you want to activate and include in your fee schedule. Check the Include Inactive box (this ensures the code will display in your search results), click Search.
- Double-click on the procedure code to open. Note: If no code populates in the search results, review the Add Procedure Code section below. This typically occurs for custom codes.
- The code’s required information will be populated for you. It’s important that you do not update the Revenue Center field, as this impacts how the charge is billed.
- Enter the Standard Charge Amount. This is the amount that will be charged for each unit billed. Important: This is your default charge amount, not a contracted rate.
Optionally, you can include the Medicare Allowable Amount based on your regional medicare fee schedule, look it up here: Physician Fee Schedule Search Tool. This will help you track the patient’s progress towards the Medicare Medical Review Threshold.
- Check the Is Active box.
- Click Save in the bottom right corner.
Add Procedure Code
Use the following process to add custom codes. These are typically Wellness Programs, Fees (no show/late cancel, etc.), and anything else you charge for outside of the standard code set.
- From the search results screen, click the New button.
- On the Procedure Code Add screen, complete the necessary fields and checkboxes for the procedure code.
- Procedure Code: Enter the Procedure Code as the therapist will add it to Documentation. Note: This field is for internal tracking only. The Alternate Procedure Code is what appears on your claims (if this code is billed to insurance).
- Procedure Description: This should be the actual description from the CPCS or CPT book (if this is a code you are billing to insurance). The description can be shortened if necessary.
- Revenue Center: Add in the relevant revenue center. Click here for a list of commonly used Revenue Center Codes. Click here to learn more about Revenue Centers.
- Standard Charge Amount: Enter the amount you’d like to charge for this procedure code.
- Medicare Allowable Amount: This field is optional but we recommend completing the allowed amount if the code will be submitted to Medicare. This will help you track the patient’s progress towards the Medicare Medical Review Threshold.
- Alternative Procedure Code: If the procedure code billed on claims is not the same as the Procedure Code, enter the HCPCS or CPT code as it should appear on the claim.
- Note: Add any notes (not required).
- Procedure Type: Click the drop-down to select which type best describes the procedure code
- Durable Medical Equipment: Check the box this is a DME supply code.
- Audit Required: Checking this box automatically places charges with this code on the Charge Audit page. This means the code will not bill automatically and must be manually released by a user.
- Never Bill: Check this box for procedure codes that you do not want to bill to insurance or patients. These are typically codes used to track specific internal programs.
- CMS Therapy Code: Check this box if this code is listed on the Physician Fee Schedule Search Tool. Important: If this code is part of the standard set, it’s likely already available in your company as inactive, follow the instructions in the Activate Procedure Codes section above.
- Is Active: Check this box to use this code. Only active codes are recognized by WebPT Billing.
- Click Save.
Revenue Center Code Definitions
|1||Evaluation Codes||Use for Evaluation Codes|
|2||Procedure Codes||Please check HCPCS Coding Book: This is used for general PT codes|
|3||Modalities||Please check HCPCS Coding Book: This is used for general PT codes|
|4||Supplies||Supply Codes: Do not use with L Codes (Use 14 for L Codes)|
|7||Missed Appointments/Cancelled Appointments/No Shows||Any Missed or No Show Appointment Charge|
|8||Fitness Programs||Cash-based Fitness Programs|
|8||Special Programs||Any Programs, such as Wellness Packages, etc.|
|9||Administrative HMO Code||Postage, Admin Fees|
|10||Medical Records||Medical Record Charges|
|12||Tax||Sales tax charge - only used for states that charge tax (i.e. Minnesota).|
|14||HCPCS L Codes||Splints: L Codes Only|
|19||Miscellaneous||Admin Use Only|
|20||Finance Charges||Interest Charge Revenue|