Important Content Update Message
We are currently updating the OP Help Center content for the release of OP 20. OP 20 (official version 20.0.x) is the certified, 2015 Edition, version of the Office Practicum software. This is displayed in your software (Help tab > About) and in the Help Center tab labeled Version 20.0. We appreciate your patience as we continue to update all of our content.

Fee Schedules

Version 14.19
Path: Billing tab > Procedure (CPT) Codes

Overview

The Fee Schedule is a complete listing of fees charged for service.  Fee schedules may be viewed and/or edited for an individual CPT code or by CPT code category. If it is necessary to edit an entire fee schedule, use the Modify Fee Schedules button rather than editing individual CPT codes or CPT Code categories. Once fee schedules are entered, they can be assigned to the specific insurance payers by going to Billing tab > Payers. The appropriate fee schedule must be displayed in the Fee Schedule field in order for that schedule to be used on claims for the specific Insurance Payers.

User Permission: Only users who have the permission to edit the CPT Code table may make edits to Fee Schedules. The necessary permission is Billing_FeeSched_Modify. If access to this code table is not given, the staff member needing access should contact their practice administrator.

View or Edit Fee Schedules for an Individual CPT code

  1. Navigate to the Procedure (CPT) Code table using the path provided above.
  2. Enter all or part of the CPT Code (if known) or a Description of the code.
  3. Click the Search button. Results for your code search are displayed. If your CPT code window is not enlarged, it may be necessary to scroll to the right to see more details of the CPT code or enlarge the window. In the image below, you can see the charge amount for Fee Schedule 1 for CPT code 99213 is highlighted.

  1. If edits are necessary, select the Code you would like to edit. 
  2. Click Edit.
  3. Enter the desired Value  into the appropriate fee field.
  4. Click the Save button.   

View or Edit Fee Schedules for CPT Codes by Category

  1. Navigate to the Procedure (CPT) Code table using the path provided above.
  2. Select the Category radio button.
  3. From the Category drop-down menu, select the Category of codes you would like to view. The codes assigned to the selected category are displayed in the grid. For example, many practices have codes 99201 through 99205 and codes 99211 through 99215 assigned to the Encounter category. If your CPT code window is not enlarged, it may be necessary to scroll to the right to see more details of the CPT code or enlarge the window. 
  4. If edits are necessary, click in the appropriate Fee field and make your edits. 
  5. Click the Save button.

Note: Practices often utilize Fee Schedule 19 and Fee Schedule 20 for internal or reporting purposes. Fee Schedule 19 is commonly used to house costs for items such as vaccines, medications, and other supplies.  Fee Schedule 20 is commonly used to add RVUs.  Reports for both fee schedules can be accessed using the Reimbursement Analysis Report.

Version 14.10
Utilities > Manage Codes > Procedure (CPT) Codes

Overview

The Fee Schedule is a complete listing of fees charged for service.  Fee schedules may be viewed and/or edited for an individual CPT code or by CPT code category. If it is necessary to edit an entire fee schedule, use the Modify Fee Schedules button rather than editing an individual CPT code or CPT Code category. Once fee schedules are configured, assign them to the specific insurance payer by going to Utilities > Manage Practice > Insurance Payer.  Edit the payer, and place the applicable fee schedule in the "Fee Schedule" field.

Note: Only users who have permissions to access the CPT Code table may make edits to Fee Schedules. If access to this code table is not given, the staff member needing access should contact their practice administrator.

View or Edit Fee Schedules for an Individual CPT code

  1. Navigate to the Procedure (CPT) Code table using the path provided above.
  2. Enter all or part of the CPT Code (if known) or a Description of the code.
  3. Click the Search button. Results for your code search will appear. If your CPT code window is not enlarged, it may be necessary to scroll to the right to see more details of the CPT code or enlarge the window. In the image below, you can see the charge amount for Fee Schedule 1 for CPT code 99213 is highlighted.

  1. If edits are necessary, select the Code you would like to edit. 
  2. Click the Edit Record button .
  3. Enter the desired Value directly into the appropriate fee field.
  4. Click the Post Edit button    

View or Edit Fee Schedules for CPT Codes by Category

  1. Navigate to the Procedure (CPT) Code table using the path provided above.
  2. Select the Category radio button.
  3. From the Category drop-down menu, select the Category of codes you would like to view. The codes assigned to the selected category will appear in the grid. For example, many practices have codes 99201 through 99205 and codes 99211 through 99215 assigned to the 'Encounter' Category. If your CPT code window is not enlarged, it may be necessary to scroll to the right to see more details of the CPT code or enlarge the window. 
  4. If edits are necessary, click in the appropriate Fee field and make your edits. 
  5. Click the Post Edit button.
Practices often utilize Fee Schedule 19 and Fee Schedule 20 for internal or reporting purposes. Fee Schedule 19 is commonly used to house costs for items such as vaccines, medications, and other supplies.  Fee Schedule 20 is commonly used to add RVUs.  Reports for both fee schedules can be accessed using the Reimbursement Analysis Report.