Solutions Benchmark Data Products

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 and 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.

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 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 Outpatient Facility. Billed charges arrayed by CPT codes for services performed in a hospital outpatient setting, based on billed charges from the CMS Outpatient Standard Analytical File (OPSAF).
  • 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.

FH®
Allowed Benchmarks:

  • FH Allowed Medical. Fees allowed by plans for medical professional services; benchmarks available by CPT code, including E&M, medical, surgical, radiology and laboratory procedures.
  • FH Allowed Dental. Allowed amounts arrayed by CDT codes for all dental procedures.
  • FH Allowed Anesthesia. Allowed amounts arrayed by CPT Category I codes for anesthesia and surgical procedure codes, cross-walked to anesthesia codes.
  • FH Allowed HCPCS. Allowed amounts arrayed by Level II HCPCS codes for equipment, supplies and services not included in CPT codes, such as ambulance services, DME, specialty drugs, prosthetics, orthotics and supplies when used outside a physician’s office.
  • FH Allowed Outpatient Facility. Allowed amounts arrayed by CPT codes for services performed in a hospital outpatient setting, based on billed charge data from the CMS OPSAF.

CPT © 2017 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.