Fee Schedule

The Fee Schedule is a list of codes and fees. Almost all information in the Charge window can be defaulted within the Fee Schedule.

The Fee Schedule field will list the Fee Schedule selected in the Patient tab, if applicable. Otherwise, it will pull the first Fee Schedule alphabetically. You will want to be sure that the correct Fee Schedule is selected before entering the desired procedure.

For more information on creating and configuring Fee Schedules, please click Here.

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Procedure Date

This is the date in which the procedure was performed (or started, if it spanned multiple days). By default, it will list the current date, but this can be manually overridden.

To Date
*Not present in MacPractice DDS*

If a procedure spans multiple days, an end date for the procedure may be entered here.

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Code

A Code is a series of letters, numbers, or symbols assigned to something for the purposes of classification or identification. Codes in MacPractice are usually used to indicate a specific procedure, product or diagnosis.

A user can enter the Procedure Code or Alias in this field.

If a code entered does not match the selected Fee Schedule, a prompt will appear asking if the user would like to add the Code to the Fee Schedule.

Search Button
Click the magnifying glass to bring up a search window to search the selected fee schedule by code, Supercode, short description, or alias.

The search field is a smart search, so if a user begins to type something, any relevant or matching fields will appear in the window. Clicking on an item in the results will highlight that item. It is possible to select multiple items by holding down shift and clicking (if they are all in a row) or by holding down command and clicking multiple items.

Selecting items and clicking OK populates selected charges into the Code field. If multiple codes are selected, then each code will appear as a line item in the Procedure Table.

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Modifiers

If the code has any modifiers, they can be entered here. A modifier is a two digit code added to the end of a procedure code to give more specific information for the processing of a claim. There can be up to 4 two digit modifiers per charge on a claim.

A user can also enter modifiers in the code itself (for example, 12345.67), and when they press Tab, if the code with the modifier exists in the Fee Schedule, the modifiers will apply appropriately to the Modifiers field.

The user may get a prompt asking to add the code if it does not exist. Click the Add Code button if this is the case.

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Procedure Description

This is the procedure's short description, as entered in the Fee Schedule Reference.

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Tooth & Surface

*Not present in MacPractice DC or 20/20*

These fields allows you to enter the number of the tooth/surface, the numbers reflected here should also be reflected on the Restorative Chartgraphic under the Dental tab.

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Alias

An Alias is a unique office designated code that can be input in place of the official Code. Once entered, the proper Code will appear in the Code field and the Alias will appear in the Alias field.

Aliases may be set in the Fee Schedule Reference.

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Fee Calculations

The Fee Calculations menu determines how the fee for the procedure is calculated.

• Fixed: The Total Fee will equal the Unit Fee. The Unit field cannot be edited.

• Units: When you select Unit, a Unit Type window will appear, and the Unit field will become editable. The Total Fee will be the Unit Fee multiplied by the number of units.

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Unit Type

The Unit Type classifies how the charge associated to the Code is going to be calculated. This can be based off hours, minutes, sessions or other.

Minutes should ONLY be used with anesthesia billing.

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Area of Oral Cavity

*Not present in MacPractice DC or 20/20*

This allows a user to select the area of the mouth affected by the procedure. This is necessary for some ADA claims.

It is in a different location in MacPractice MD. It is possible to make any code as requiring an Area of Oral Cavity in the Fee Schedule Reference.

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Units

The Units field is directly related to what has been selected in the Fee Schedule Calculation menu.

• If the Fee Calculations menu is set to 'Fixed', this field will be dimmed.

• If the Fee Calculation menu is set to 'Units', a user can enter the number of units used in conjunction with the procedure.

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Unit Fee

The Unit Fee is the cost of a procedure depending on what is selected in the Fee Calculations area.

• If Fee Calculation is set to 'Fixed', the Unit Fee will equal the Total Fee.

• If Fee Calculation is set to 'Units', the Total Fee will equal units multiplied by the Unit Fee.

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Total Fee

The Total Fee is the overall cost a user will charge the patient for a Procedure. It takes into account both the Unit Fee field as well as the Units field in the New Charge window.

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Schedule Units

This field displays the Schedule Units associated with the procedure. Any number here will appear in the Time column in the Ledger.

The Schedule Units numbers are for reference only, and have no bearing on scheduling.

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Taxable Checkbox

When the Taxable box is checked, the Tax will display in the Charge window to the right of the "Emergency" checkbox, right above the "Items" tab.

With the Taxable box checked, you can also select a Tax Rate as defined in References - Tax Rate & Tax Type. You can also configure Fee Schedule Codes to automatically assign a tax to them.

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Tax Rate

If the Taxable checkbox is checked, a Tax Rate pop-up menu will appear. A user can select the tax rate they wish to use for this procedure.

Information on setting up the Tax Rate can be found Here.

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Emergency Checkbox

When enabled, this checkbox makes it so the procedure will be marked as an Emergency Procedure on an insurance claim.

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Patient Responsible Checkbox

When checked, Patient Responsible ensures that the procedure will be omitted from all insurance claims.

If Insurance Estimating is used, the entire fee will go to the Patient Portion.

If this option is grayed out, this would indicate that there is a closed claim attached to the charge. 

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Charge Copay Checkbox

When checked, the copay amount will be allocated to the patient portion, and a copay field will appear in the Procedure Table below.

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Charge via Contract

Always select the Charge via Contract checkbox when posting a procedure to the contract so that the negative adjustment is automatically applied. If Charge via Contract is not selected when charges are entered, or if the negative adjustment on the procedure is deleted, the patient will be charged twice for the same procedure.

For more information on this, visit our Contract Billing article. 

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