Pricing associated with charges hard-coded with a 52 modifier
Can anyone provide insight into how they price their reduced services when the service is hard-coded with a 52 modifier? We are battling two schools of thought:
1. Less resource consumption=lower price and
2. The modifier is going to trigger a reduced payment so charge the same as you would for the full procedure
Since CMS has announcement facilities will have to make their CDMs public, and trying to be cognizant of market sensitive procedures, like mammograms, we are curious as to how others are approaching the charging of reduced procedures.
Thank you.
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We price them at 75% of the regular charge.