Visit Cost

cptOne of the most common questions we are asked is: how much will the visit cost?   Many people are under the impression that the doctor randomly assigns a cost for each visit or service.

However, coding today is a very complicated science.  The physician no longer assigns a dollar amount cost.  The job of the physician today is to perform the service and then describe it with the appropriate code.  The cost can’t be known until after the condition has been assessed and the coding can be determined.

Every service and procedure is defined by a five-digit CPT code, published in a book by the American Medical Association.  Dr. Hoy is certified in billing and collections compliance.  If the patient has any known responsibilities, the codes are submitted to the Medical Administrative Assistant, who will look then up to see the cost value of the codes, and depending on how your insurance works, what is owed at the time of service.

We use the Medicare fee schedule for our zip code as the basis of the amount collected.  The average value of codes for a patient visit is around $200.  Again this varies on the value of the codes for services performed.  If more services are performed, the fee is increased, and less if fewer services are performed.  Patients should be ready to pay at the time of service if they have a deductible, no referral or uninsured.

Billing codes are submitted to our Billing Department, who then submits them to the insurance company.   After the insurance company decides, the Billing Department will send out any applicable invoices.

Our office will be happy to provide the code(s) for any procedure performed or planned so that the patient can verify patient responsibility with the insurance company.  Thank you.