Reasonable fee for FCE

I think there is a typo, or maybe I misread one of the statements, in an earlier post about fees. Here are a couple of independent thoughts to consider:

1. If at all possible, move away from CPT codes as soon as you can. The codes tend to lock you into a commodity-type response to the market. Once you develop your skill, start a parallel marketing effort aimed at those that do not see FCE as a commodity. Self-insured employers, long-term disability carriers, and many state employee systems will not restrict your work to CPT reimbursement.

2. Watch closely the response to your reports (your product is the report). Does the fee payer give you positive or negative feedback? Is there a lack of feedback? Discussing the report after it is submitted is a good barometer as to the strength of your relationship with the referrer. If there is no communication before or after the engagement, you need to move to a higher level of respect and Utility. (Remember the phrase "He's just not into you"?).

3. Be careful about accepting rederrals from FCE brokers. They have the potential to be the death of FCE in general and your practice in particular. You will most likely not receive the information you need to do a high Utility job and you will get payment around the time of my next birthday. (Not until next March!).

Develop a market for YOUR FCE product.

Hello

Our clinical advisor said that OT's usually make about $28 per hour in the states, but other than that we are not sure what to say...

My best suggestion is to ask your state's Board of Physical Therapy or Occupational Therapy. I think they would have a better idea, because it may vary from region to region.

Sorry couldn't be of further assistance,

Jenn

Thank you very much for the information, Jenn. It was very informative.
Would you also know, or have an idea of what an independent Certified Work Capacity Evaluator charges to perform an FCE in a facility?

Thank you again for your assistance,

Hello Bene,

Here is a mix of what our clinical advisor has posted recently in response to this very question:

My company calculates our billing on Physical Performance Test units (CPT Code) and we charge 4 hours for the FCE-that works out to be about $1,100. We keep our fee a "standard" of 4 hrs. for quoting consistency, and this time does not include documentation time.
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I would advise you to check your state's fee schedule for workman's comp cases-this will dictate what a workman's comp insurance company is "obligated'' to reimburse you for. Across the river in Kentucky, they reimburse ~$250, hence I see very few, specially negotiated KY cases.
"Private referrals", like attorneys and employers could reimburse you for whatever you agree upon. I suggest you calculate what you would make per hour if treating patients and go from there. Remember that what you bill for and what you get reimbursed are two different things. Hope this helps.
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As you are probably aware, the 97750 code is for Physical Performance Testing, in 15 minute increments. The 2008 CPT book continues the statement that this code is for musculoskeletal exams and evaluation of functional capacity (with written report). The 97750 code is what I use for FCE billing (x16 units). As you are probably aware, some insurance companies have all kinds of stipulations designed to help deny claims-like not accepting more than one unit per day or having caps on only a few per week/etc.
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Be wary of sacrificing your product for cost-you may end up with a report no more valuable than your competitor! Once you get more established in your area as a top notch evaluator-you can seek referrals from non-insurance referral sources like; vocational rehab offices, attorneys and long term disability carriers. Some of them pay 100% up front!

Hope that helps! Let me know if you have any other questions!

Jenn