Nationally (USA/Medicare) recognized billing codes are from these code sets:
Both Medicare and Veterans Administration (VA) fees are shown when established. "n/e" means "not established" - which means either Medicare or the VA has not set a fee for the code.
Typically the Medicare fee will be lower than the VA fee. The VA fee amounts are generally closer to "real-world" fees charged by public and private medical organizations.
Fees are calculated based on the date of service and the location where the service was performed. Fee amounts vary based on the economy of the location.
format($format) == $date; } function local_get_fees($date, $zipcode, $facility, $codes) { // build key $key = md5('innoviHealth - Find-A-Code, get-fees, ' . date('Y-m-d')); // build URL: $codesForURL = urlencode($codes); $url = "https://www.findacode.com/tools/get-fees.php?key=$key&date=$date&zipcode=$zipcode&facility=$facility&codes=$codesForURL"; //$url = "https://www.findacode.com/sandbox/test.php?key=$key&date=$date&zipcode=$zipcode&facility=$facility&codes=$codesForURL"; // get fees $ch = curl_init(); curl_setopt($ch, CURLOPT_RETURNTRANSFER, 1); curl_setopt($ch, CURLOPT_URL, $url); curl_setopt($ch, CURLOPT_FAILONERROR, true); // Required for HTTP error codes to be reported via our call to curl_error($ch) $result = curl_exec($ch); if (curl_errno($ch)) { $error_msg = curl_error($ch); //echo $error_msg . '$result
"; // process valid results $resultsArray = json_decode($result, true); $resultsHTML = '| code set | '; $resultsHTML .= 'code-mod | '; $resultsHTML .= 'description/fees | ||||
|---|---|---|---|---|---|---|
| ' . $codeInfo['code_set'] . ' | '; $resultsHTML .= '' . $code . ' | '; $resultsHTML .= '' . $codeInfo['description'];
if ($codeInfo['status'] && $codeInfo['status'] != 'active')
$resultsHTML .= ' Status: ' . $codeInfo['status'] . ''; $resultsHTML .= ' | ';
$resultsHTML .= '||||
| '; if ($modifier == 'none') { if (count($codeInfo['fees']) > 1) $resultsHTML .= ' | (none) | '; else $resultsHTML .= ' | '; } else { $resultsHTML .= ' | -' . $modifier . ' | '; $resultsHTML .= '' . $modifierInfo['description'] . ' '; } $resultsHTML .= 'Medicare fee: ' . ($modifierInfo['medicare'] != 'n/e' ? '$' : '') . $modifierInfo['medicare'] . ' '; $resultsHTML .= 'VA fee: ' . ($modifierInfo['va'] != 'n/e' ? '$' : '') . $modifierInfo['va'] . ' '; $resultsHTML .= ' | ';
$resultsHTML .= '