Fee schedule and contract analysis
Fee schedule and payer contract analysis services that uncover missed revenue
If your fees are set too low, you’re leaving money on the table on every claim, and payers won’t tell you. (Company Name) reviews your fee schedule and payer contracts against market benchmarks and actual payments, then shows you exactly where to adjust and what to negotiate.
Fee schedule review
Fees below Medicare
Found on some codes
Fees below payer allowed
Leaving money unpaid
Outdated codes
Removed
Payer rates compared
By top CPT codes
Low-paying contracts
Identified
Recommendations
Delivered
Example of findings from a fee schedule and contract review.
How outdated fees and contracts cost you money
Many practices haven’t reviewed their fee schedule or contracts in years. Meanwhile, payer rates change, new codes appear and costs keep rising.
Fees set below what payers allow
If your charge is lower than the payer's allowed amount, you're paid your lower charge, and the difference is lost.
Fee schedules not updated in years
Old fee schedules miss annual changes and new codes.
Contracts never reviewed
Contracts auto-renew at rates that no longer reflect your costs or value.
No idea how payers compare
Without data, you can't tell which payers pay well and which don't.
Negotiating without evidence
Payers are rarely persuaded without clear data on rates and volume.
Contract terms not enforced
Payments below contracted rates go unnoticed without a reference.
Our fee schedule and contract analysis
We compare your current fees with Medicare rates, payer allowed amounts and market benchmarks for the codes you bill most, and highlight where fees should change.
Then we review your payer contracts and actual payments to show which payers pay fairly, which don’t, and where negotiation is worth your time.
- Full fee schedule review by CPT and HCPCS code
- Comparison with current Medicare rates
- Comparison with payer allowed amounts
- Identification of fees set below allowed amounts
- Updates for new, deleted and revised codes
- Payer contract terms review
- Payer-by-payer reimbursement comparison
- Analysis of your highest-volume and highest-value codes
- Financial impact estimates for changes
- Contract renegotiation data and support
- Expected reimbursement loading for underpayment tracking
- Annual fee schedule update reviews
Our analysis process
A clear, data-driven review with practical recommendations.
Step 1
Gather data
We collect your fee schedule, payer contracts and recent payment data.
Step 2
Benchmark fees
Fees are compared with Medicare rates and payer allowed amounts.
Step 3
Review contracts
Contract terms and actual payments are analyzed payer by payer.
Step 4
Report findings
You receive clear recommendations with estimated financial impact.
Step 5
Support changes
We help update your fee schedule and prepare negotiation data.
What your practice gains
Better fees and stronger contracts increase revenue without seeing more patients.
Higher reimbursement
Fees set correctly so you're paid what payers allow.
Revenue leaks found
Spot codes and payers where money is being lost.
Stronger negotiations
Go to payers with real data, not guesses.
Contracts enforced
Expected rates loaded for underpayment tracking.
Up-to-date fee schedule
Codes and rates kept current each year.
Smarter decisions
Know which payers are worth keeping or renegotiating.
Why practices choose (Company Name) for fee schedule analysis
Fee and contract analysis needs billing data, payer knowledge and clear thinking. We turn your numbers into decisions you can act on.
- Analysis based on your actual billing and payment data
- Benchmarks against Medicare and payer allowed amounts
- Clear findings with estimated financial impact
- Practical support for contract negotiations
- Annual reviews to keep fees current
- HIPAA-focused processes and a signed BAA
What we analyze
Every review is tailored to your specialty and payer mix.
Fee schedule
Medicare rates
Payer allowed amounts
Top CPT codes
Contract terms
Payer mix
Reimbursement trends
Underpayment patterns
Related medical billing services
Fee schedule analysis connects to these services across your revenue cycle.
Underpayment recovery
Payments checked against contracts, short pays appealed.
Payment posting
Payments posted and reconciled accurately.
Revenue cycle reporting
Clear monthly reports on collections, denials and A/R.
Medical coding
Accurate ICD-10, CPT and HCPCS coding by certified coders.
Fee schedule analysis FAQs
Common questions about fee schedules and payer contract analysis.
What is a medical fee schedule?
A fee schedule is the list of charges a practice sets for each service it provides, usually by CPT or HCPCS code. Payers also have their own fee schedules that set what they will pay.
Why does my fee schedule matter if payers pay their own rates?
Payers typically pay the lower of your charge or their allowed amount. If your fee is lower than the allowed amount, you’re paid less than you could be.
How often should a fee schedule be reviewed?
At least once a year, and whenever codes change, new services are added or payer contracts are renegotiated.
What is payer contract analysis?
Payer contract analysis reviews the terms and rates in your insurance contracts and compares them with what payers actually pay and with other payers, to find problems and negotiation opportunities.
Can you negotiate contracts for us?
We provide the data, analysis and preparation needed for negotiations and support you through the process. Final contract decisions are always yours.
Is this a one-time project?
It can be a one-time review or an annual service to keep your fees and contracts current.
Find out if your fees and contracts are costing you
Start with a free review. We’ll show you where your fee schedule and contracts could be working harder.