prevailing charge


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prevailing charge

The typical fee that a health care provider bills for a service, e.g., an office visit or a surgical procedure.
See also: charge
References in periodicals archive ?
The 1988 increase in Medicare revenue reflects the net effect of a variety of factors: a decrease in the overpriced procedures' prevailing charges; an increase in primary care services' prevailing charges by 3.
To illustrate, the 75th percentile for PAR physicians indicates that 25 percent of the physicians had customary charges that were at least 20 percent greater than their prevailing charge.
Thus, estimates of such historic payment amounts, based on specialty-adjusted prevailing charge data, must include adjustments to account for services where allowed charges were determined by customary-charge pricing screens.
Finally, although prevailing charge screens have had the largest overall impact on price determinations under current physician payment rules, their historic, extensive use in physician payment studies only provide partial answers to the relationships and interactions between CPR pricing screens.
Legislative and regulatory initiatives have been concentrated on modifications to and limitations in the growth of prevailing charges.
Medicare Economic Index (MEI) limits on the growth of prevailing charges.
Computation of updated MAACs in each fee-screen year (FSY) are based on limited increased over the previous year and on certain relationships with current prevailing charges.
OBRA 1987 extended or continued both the customary and prevailing charges for physician services during the first 3 months of calendar year 1988 at 1987 pricing levels.
In the last step, prevailing charges were obtained.
This index (McMenamin and JIL Systems, 1988) is used to measure geographic differences in physician payment rates and was based on data from the 1984 Medicare Directory of Prevailing Charges.
The pricing source classified as "other" in the tables includes services for which the allowed charge was not equal to the customary, submitted, or prevailing charges contained in the available data files.