Question

Can I have more than one fee for a procedure?

Yes, as long as you consistently charge the same fee for each category of procedures. However, payers benefit one fee for each procedure code and the fact that the doctor has more than one fee will not affect what the insurance company reimburses. For example, you could have two fees to report fluoride varnish, a lower fee to report fluoride varnish for adult patients and a higher fee for pediatric patients. The practice may also have two fees for an occlusal guard. One fee is for a hard acrylic guard, and another fee for a soft suck-down guard. The practice management software may differentiate between the two fee levels by adding a letter at the end of all CDT codes, for example D9940A and D9940B.

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