Practices struggle a lot with determining how to set prices for their practice. I have read lots of articles and blogs about different methods and ways to do this, but most are really complicated.
It’s actually pretty simple to set your best pricing – start by checking check your insurance contracts. Many say they will pay their rate OR 80% of your rate, whichever is LOWER.
Based on this alone, it is pretty easy to look at the company that pays the highest amount for each CPT code and add 25%. This will ensure you maximize your collection because everyone’s price will be their standard price so you don’t end up getting paid something less than their usual rate just because you aren't charging enough.
Revisit this every twelve months to make sure you are getting the maximum reimbursement and make sure the billing staff or service is on the lookout – when a payer pays 80% of what you charge, it is time to increase your charge.