UCR Pricing, What is it?

UCR (Usual, Customary, and Reasonable) pricing is a method of generating healthcare pricing based on the average pricing in a particular geographic location.  Gathering information on pricing based on what other providers in that area is charging is commonly used for a fee or payment reference, as it gives a basis on what is considered customary and reasonable.

If a provider is not contracted or in the absence of a contract, providers can set their fees and are entitled to a reasonable value for the service provided.  It is important to get your UCR data from a reliable source to arrive at a reasonable value. Find-A-Code offers UCR fees gathered from the VA or US Department of Veterans Administration; this information can be found on the code information page and is offered as a fee comparison with a fee analysis or the with Compare-A-Fee.

More Items in January 2018

• Jan 23, 2018
  MAC Operations Continue During Shutdown
• Jan 22, 2018
  $4.6 million in Claims Paid Incorrectly by CMS when Using KX Modifier
• Jan 22, 2018
  New Payment Model launched by CMS- Bundled Payments for Care Improvement Advanced (BPCI Advanced).
• Jan 22, 2018
  Should ROM Testing be Reported with Evaluation and Management Services?
• Jan 22, 2018
  NEW on Find-A-Code: National Coverage Determinations (NCDs)

To view more items select a month from our "Items by Month" list.

Or view documentation, coding and billing articles.