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Rate of Payment Determination & Required Documentation*

April of 2014

Note: When available, price comparison among three vendors is always required

Cost of Service How to Determine Rate Supporting Documentation
Items Costing Under $500 Quick price check using internet search, ad search, calls to providers. Recommend case note supporting how rate determined but not required.Recommend case note supporting how rate determined but not required.
Items Costing Between $500 - $1,499 Quick price check using internet search, ad search, calls to providers. Case note supporting how rate determined.Case note supporting how rate determined.
Items Costing Over $1,500 Written Quotes. Written quotes attached to file.

* For items not listed on a fee schedule or listed on a fee schedule as an "up to" amount.