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Where does Find-A-Code get UCR Data?Find-A-Code offers UCR fees gathered from the US Department of Veterans Administration (VA) using Geographically-adjusted charges and the 80th percentile conversion factors; this information can be found on the code information page (see example below) and is offered as a fee comparison with our UCR Pricing add-on. Reasonable charges are updated by the VA annually on January 01. We display the VA's data for our customers and have listed the VA's detailed information below from the VA; however, for additional questions on the VA's data and processes, please contact the Veterans Administration (listed below).

Understanding the 80th Percentile"80th percentile" charges are not the same as a fee multiplier.

When the VA did their survey of fee amounts, the fee amount they chose as the UCR amount is in the middle of at least 80% of the fee amounts reported. Like in a bell curve that covers X%, the middle or peak of the bell curve is the amount they chose.  The VA determines the amount of the national average administrative cost annually for the prior fiscal year (October through September) and then applies the charge at the start of the next calendar year. Below are links to the Federal Register and data sources from the VA Website.

VA Data SourcesThe VA uses multiple Reasonable Charges Data Sources and has them sorted by charge type on their website and where to obtain the data. Using the links below, the page will open up under "Payer Rates and Charges" from there, select the type of data, such as "Reasonable Charges Data Sources," and select the most current version of the Inpatient or Outpatient and Professional files. Rules and Notices such as the Federal Register are available and helpful in understanding where the Information used by the VA is coming from. Visit the "Payer Rates and Charges" page for information on Reasonable Charges Rules, Notices, & Federal Register.

Data Tables offer additional information on how the VA uses its UCR Data; please see the Reasonable Charges Data tables on the "Payer Rates and Charges" page.

Data Sources used by the VA when assigning UCR fees can be found on the "Payer Rates and Charges" page under Reasonable Charges Data Sources.

Charge adjustment factors are taken from the VA. See TABLE M. for Charge Adjustment Factors for Profesional services charge modifiers.

RVU Conversion Factors V4.235 Table L: Professional Services RVU Conversion Factor Geographic Area Adjustment Factors (GAAFs) by Zip Code  See data sources for information on where the VA gets RVU Data from see (Table 1. sample page).

After reviewing this information, if you have further questions, please contact the VA, Office of Community Care, Revenue Operations, Payer Relations and Services, Rates and Charges (10D1C1), Veterans Health Administration (VHA), Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202) 382– 2521. (This is not a toll-free number) or 800-698-2411.

Information From the VA The following information comes from the VA to give an understanding of accountability to the Federal Register, calculations and links to data sources used on our UCR pricing.

Reasonable charges, according to the VA, are described as follows; "Reasonable Charges are based on amounts that third parties pay for the same services furnished by private-sector health care providers in the same geographic area. In the past, VA used average cost-based, per diem rates for billing insurers. Reasonable charges are calculated for inpatient and outpatient facility charges, and for professional or clinician charges for inpatient and outpatient care".

Inpatient

Outpatient and Professional

Anesthesia

Third-Party Pharmacy Prescription Administrative Charge

Once you are on the code information page on a specific code, scroll down to the fees section and open the tab titled “UCR Fees” the fees will be displayed for UCR, Workers Comp, as well as Medicare, billed, and allowed amounts.

The percentage calculations can be used for adjusting your fees to obtain a range of Low, Medium, or High pricing; it can also be used to adjust for modifier usage. UCR for CPT/HCPCS Code:

UCR for DRG Codes:

UCR Fees for Outpatient Facility:

Pro Fee CalculatorThe Pro Fee Calculator is an easy-to-use tool when calculating UCR fees for CPT and HCPCS codes.  Need to apply modifiers? Additional units?  The Pro Fee calculator can do this and more. For example, when using modifier 50, "bilateral procedure," the charge factor will be adjusted by 1.50; modifier 22, Unusual procedure, uses a charge factor of 1.25. Meaning your fee will change from 100% to 150 for the bilateral Modifier 50 and from 100% to 125% when reporting the 22 modifiers.  See Find-A-Code for a list of all CPT Modifiers and descriptions.

Posted on October 2, 2012 By Mike Ross Culture, The Latest, TV and Radio

There is no longer any such thing as “too much information.”

Just listen to the radio for proof. Most of the popular announcers are expected to share EVERY LITTLE DETAIL of their fabulous lives, because making human, personal connections is so important these days. For marketing. So in Edmonton, we learn about Terry Evans’ luxurious house, Lesley Primeau’s dog, the misadventures of Paul Brown and daily bickering Bickersons banter from not one, but TWO married morning show couples. The only limit to what most of these folks reveal about themselves on the air – aside from the CRTC code of conduct – is that you can only hear what’s going on. For those not satisfied with leaving the rest to the imagination, there’s always Facebook.

Crash and Mars, the morning crew on Now! 102.3 FM, are an engaged couple whose impending marriage seems to be the topic in another of the station’s relentless billboard campaigns. Will they or won’t they? Do they or don’t they? Should they or shouldn’t they? It’s clear they’re gearing up for some reality show-style public matrimonial spectacle – and just watch their ratings go through the roof when that happens.

No one at Rawlco Radio (operating Now! and Up! radio stations) is talking about the nature of the big “reveal,” or when it’s coming. They spend a lot of money on those billboards, and it works. Now! is the No. 1 station in town. Program director Mark Hunter didn’t return calls to talk about this story, though perhaps that has to do with an article we published last fall called Up! Yours! that was somewhat critical of the two stations’ programming direction.

It doesn’t matter. What’s clear is that these lovely couples are selling portions of their personal lives to their listeners, in exchange for popularity, in exchange for ratings, in much the same way as reality TV stars like Kim Kardashian sell themselves because they have nothing else to sell, no creative work apart from themselves, nothing to offer the public beyond their own fabulous lives that are continually made more fabulous in the sale, and let us marvel at the great circle of life.

Old people used to keep a few things to themselves, you may remember: their sex lives, their income, that time dad didn’t come home one night; it was a matter of decorum that one didn’t air dirty family laundry. Times have changed. We live in an age of brutal honesty and transparency. The Internet hasn’t made human interaction more impersonal. Quite the opposite. It’s made people eager to share every little detail of their lives with friends and strangers alike, the more the better – and that’s the new reality of radio.

Jamie and Dan, hosts of Lite 95.7’s morning show, are for the moment Edmonton’s only on-air married couple. They’ve branded themselves as such for most of their married-broadcasting career, having met as teenagers when they were working at a radio station in High River.

They’ve since shared quite a bit of their personal lives on air.

“That’s what radio is these days,” says Dan. “You’re bringing your life, your stories, to people. If you’re not sharing your own personal stories, you’re not really doing your job.”

During a recent in person interview, Jamie and Dan are eerily EXACTLY like they are on the air. People apparently say that about them all the time. There’s no façade here, no secrets, no characters. They say one of their most popular segments that listeners still talk about was at a station in North Bay, Ontario, when Jamie was coming off six weeks maternity leave and doing the show from home. Her husband Dan, meanwhile, was on location in Antigua. So while Dan was sipping Margaritas by the pool, his better half was making breakfast, tending to the baby and trying to get the older kid off to school while trying to do the morning news all at the same time. Tears were shed. Jamie says, “I would joke and say, moms aren’t multi taskers, they’re hyper taskers – and the moms related. That’s what we do on a day to day basis.”

It made for good radio, anyway. That’s as close as Jamie and Dan have come to actually installing cameras in their home and taping a reality show, which they both agree would be “10 times funnier” and “10 times more tragic” than the radio show – with lots of careful editing, of course. They admit they do have arguments from time to time that don’t make it on the air.

Asked if there’s anything they won’t share with their listeners, Jamie replies, “What do you want to know?”

Dan says, “My vasectomy was fair game.”

Jamie laughs, “That was fun.”

They’ve always been this candid, they say, come from families that talked about everything. Moreover, both Jamie and Dan are in their mid-30s, and so were impressionable children when Donahue first appeared on TV, and he was the guy who started this whole “no secrets among strangers” trend. Thanks a bunch, Donahue.

Not all local radio announcers are open books. Sonic’s morning man Garner Andrews talks about how he liked the “mystery” of radio. Back in the day, for instance, the only thing you knew about a DJ like Wolfman Jack was his voice.

Andrews says, “I don’t share a lot of my personal life on air. I might talk about eating at a certain restaurant, going to folk fest or seeing a certain movie, but the personal stuff doesn’t come up very often. The listeners likely know that I’m married, and they may know that I have kids; but as far as the stuff that’s really important to them goes, their spouses, their kids, their friends, my stories can’t compete.”

He’s hit on something here. Jamie and Dan aren’t out just to talk about themselves. They’re sharing with the goal to encourage listeners to share, too, and to help people with their troubles. One recent topic was about the idea that a lot of people who want to get divorced don’t do it because it’s too expensive, prompting a female caller to tell her story of splitting up to become a broke single mom, “and her telling her real story can change someone’s life,” Jamie says.

She says she takes inspiration from her cousin, noted aboriginal film director Georgina Lightning, who came from tough times.

“She decided to change her life, to break the cycle of violence, and she made a difference,” Jamie says. “But it was only through people she could talk with, sharing their experiences that she could feel strong enough to do that. It’s all through talking! Talking can change people’s lives.”

Jamie and Dan do have some boundaries. “We’re radio people,” for one thing. They won’t be doing a TV reality show in their home any time soon, not unless an “astronomical” amount of money is involved. And they won’t say anything on the air that they wouldn’t say in front of their kids – the general guidelines for what’s appropriate for five- and nine-year-olds being roughly the same as Lite 95.7’s core listenership. It’s not Terry, Bill and Steve, in other words.

“Just remember my kids are in the back seat,” Jamie says. “I don’t want my kid blurting out something they heard on a radio show.”

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