Solutions Benchmark Data Products

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FH®
Benchmarks

FH® Charge Benchmarks Presenting up-to-date, actionable data based on recent claims from 493 distinct geographic regions nationwide, our charge benchmark offerings include medical/surgical, dental, anesthesia, HCPCS, inpatient facility, outpatient facility, ambulatory surgery center (ASC) and Category III modules.

FH® Allowed Benchmarks Based on the maximum amounts payors allow for reimbursement of provider charges, FH Allowed Benchmarks enable clients to understand in-network payment trends by regional area. FH Allowed Benchmarks include FH® Allowed Medical, FH® Allowed Dental, FH® Allowed Anesthesia, FH® Allowed HCPCS and FH® Allowed Outpatient Facility.

Actionable, Trusted Claims Data Packaged for Ease of Use

Key decisions made by healthcare-related businesses depend on trust—the confidence that the data behind those decisions are independent, reliable and representative of today’s market. The data supporting FH Benchmarks meet and surpass those criteria. That’s why states have adopted FH Benchmarks as a reference point for consumer protection laws and as the basis for workers’ compensation fee schedules, among other uses. It’s also the reason stakeholders rely on FH Benchmarks when adjudicating out-of-network claims, developing fee schedules, facilitating network negotiations, studying trends in cost and utilization, shaping strategic initiatives and more.

Learn more and speak to a FAIR Health representative today.

FH
Charge Benchmarks:

  • FH® Medical. Billed charges for professional fees arrayed by Current Procedural Terminology (CPT®) codes for evaluation and management (E&M), medical, surgical, radiology, laboratory and pathology procedures.
  • FH® Dental. Billed charges arrayed by Current Dental Terminology (CDT®) codes for all dental procedures.
  • FH® Anesthesia. Billed charges arrayed by CPT Category I codes for anesthesia. In certain formats, surgical procedure codes are cross-walked to anesthesia codes.
  • FH® HCPCS. Billed charges arrayed by Level II HCPCS codes for equipment, supplies and services not included in CPT codes, such as ambulance services, durable medical equipment (DME), specialty drugs, prosthetics, orthotics and supplies when used outside a physician’s office.
  • FH® Inpatient Facility DRG Billed charges arrayed by diagnosis-related group (DRG) for services performed in a hospital inpatient setting, based on billed charges from the CMS MEDPAR file.
  • FH® Inpatient Facility ICD Proc/Rev Billed charges arrayed by ICD-10 procedure codes and associated revenue codes for services performed in a hospital inpatient setting. Click here for sample data.
  • FH® Outpatient Facility. Billed charges arrayed by CPT codes for services performed in a hospital outpatient setting.
  • FH® ASC Facility. Billed charges at the state, regional and national level arrayed by CPT codes for services performed in an ASC.
  • FH® Category III. Billed charges arrayed by Category III CPT codes, temporary codes for emerging technologies, services, procedures and service paradigms.
  • Coming Soon! FH® Urgent Care. Billed charges arrayed by CPT and HCPCS codes for services performed in an urgent care setting.

FH
Allowed Benchmarks:

  • FH® Allowed Medical. Benchmarks based on imputed amounts allowed by plans for medical professional services and arrayed by CPT code, including E&M, medical, surgical, radiology and laboratory procedures.
  • FH® Allowed Dental. Benchmarks based on imputed amounts allowed by plans for dental procedures and arrayed by CDT codes.
  • FH® Allowed Anesthesia. Benchmarks based on imputed amounts allowed by plans for anesthesia and surgical procedure codes, cross-walked to anesthesia codes, and arrayed by CPT Category I codes.
  • FH® Allowed HCPCS. Benchmarks based on imputed amounts allowed by plans for equipment, supplies and services not included in CPT codes and arrayed by Level II HCPCS codes; examples include ambulance services, DME, specialty drugs, prosthetics, orthotics and supplies when used outside a physician’s office.
  • FH® Allowed Outpatient Facility. Benchmarks based on imputed amounts allowed by plans for services performed in a hospital outpatient setting and arrayed by CPT codes.

CPT © 2018 American Medical Association (AMA). All rights reserved

The Code on Dental Procedures and Nomenclature is published in Current Dental Terminology (CDT), American Dental Association (ADA). All rights reserved.