Multiple price lists can be created and assigned to facilities and payers. Contract rates are also added as price lists and assigned as contract rates for each payer and facility. Enter the price for Each Service Code and add a modifier if a CPT and modifier combination needs to be priced and click save or enter prices for all Service Codes and select the Check box above the ribbon to select all the services and then click Save Selected.

Medicare Pricing

Medicare prices are added and updated each year. Prices can be set as a ratio increase or decrease from the Medicare prices. This will update a price list with the name selected that can then be assigned to payers.

Filter Prices

To filter the pricing, select a Category and Subcategory after clicking on Click Here to Filter.  Then click on search. I will show the pricing for the CPTs that match the selected category and subcategory. To view the full list or filter again, click the Clear Filter button.

Another way to filter is to enter Service Name or enter a CPT Code in the respective search box and click outside the box. To view the full list or filter again, remove the search query from the search box and click again outside the box.

Entering Prices

1. Create a Price List first by click on Manage Price List.
2. Now a new window opens. Click on the New button to create a new price list
3. Enter the name, select the provider if applicable, and choose the effective date.
4. Check the applicable options for the price list, such as Member Pricing, Insurance Pricing, or Discounted Membership.
5. Select the Active checkbox if you want to make this price list accessible.
6. Select the Default checkbox if you want to make this the default price list.
7. Click Add. A pop-up message will appear stating, “Price List Saved Successfully.”
8. Close the window by clicking the X at the top-right corner of the window.
9. The newly added Price List will now appear in the table. Close this window as well by clicking the X at the top-right corner.
10. You will return to the Pricing Management screen. Select the newly created Price List from the drop-down menu next to Price List at the top of the screen.
11. On the left side, you will see a list of available services for which pricing can be added. Filter the services as explained earlier.
12. Enter the price for the required service. If needed, add a modifier to create pricing for a Service-Modifier combination.
13. Repeat this process for all the services you want to add pricing for. You can either add pricing for multiple services at once or add and save them one by one.
14. After entering the pricing details, check the box next to Save for each CPT and click the Save Selected link at the top.
15. All the selected CPTs with their pricing details will now appear on the right side.

Link Payer to Price List

1. Click Administration > Payer Management.
2. Click the Pen icon  to the right of the payer you want to link with a specific Price List. By default, every newly added payer is linked to the default Price List.
3. Once the Manage Payer screen opens, select the Price List you want to link with the payer from the Price List drop-down menu.
4. Click Update to save the changes.