Fee Schedule at Institute
The Institute will verify your current information at each visit to keep our records as updated as possible in order to serve you better.
There is an 80% deposit required on all evaluations and procedures. Payment is expected at the time of the visit. The balance will be due no later than 30 days after the service. Payments can be made by cash or credit card. We accept VISA and MASTER CARD. The Institute is under no obligation to pursue reimbursement on the patient’s behalf other than to provide the patient an insurance claim form. See footnote*. The codes used by most insurance companies for reimbursing patients are published below. Effective October 17, 2007, health providers at the Institute were no longer under the University of South Florida (USF) contractual rates with insurance companies. A link to the document verifying this change in status is available. Physicians and staff at the Institute are non-participating health professionals with regard to contracts with all insurance companies. Workers Compensation, insurance companies and IME cases will be prepaid as per individual agreement. Our staff can provide you with the form to submit to your attorney / workers compensation adjuster / insurance company. The Institute’s Treatment Center provides free care to research subjects. See item # 2 under FAQs below. Our staff will assist you in financially planning for your care with us. |
Policies and Procedures for Claims
1. Stellate Ganglia Nerve Block per block: $1,300 Deposit: $1040 USA CPT Code 64510 2. Lumbar Sympathetic Nerve Block per block: $1,470 Deposit: $1176 USA CPT Code 64520 3. Trigger Point Injections (for 1-2 injections):$200 Deposit: $160 USA CPT Code 20551 4. Trigger Point Injections ( for 3 or more injections):$250 Deposit: $200 USA CPT Code 20552 5. Four-hour ketamine infusion by anesthesiologist: $2,500 Deposit: $2,000
Reimbursement for Ketamine Treatment .... Learn more
EVALUATIONS: 1. Initial Evaluation: $500 Deposit: $400 USA CPT Code 99245 2. Follow-up evaluation: $360 Deposit: $288 USA CPT Code 99213 3. Independent Medical Evaluation (IME): $1,500
ADDITIONAL USA INSURANCE CODES: 1. USA DIAGNOSTIC CODES: ICD-9 codes: 337.21 - Reflex sympathetic dystrophy of the upper limb 337.22 - Reflex sympathetic dystrophy of the lower limb 2. USA "PLACE OF SERVICE" CODE: Ambulatory Surgery Center = Code 24 3. The Institute’s Tax ID # = 80 - 0168082 4. Dr. Anthony Kirkpatrick's medical license #: 40765
FAQs ~ Frequently Asked Questions:
1. Will the Center bill insurance or is money paid up front? The Center is a private research institute that provides care to patients worldwide. Unlike medical practice in hospitals and universities in the USA, the Center receives no financial support from state or federal agencies. The Institute does not have an Accounts Receivable Department. Therefore, the Center requires money up front from the insurance company, the patient or another third party. The fee schedule is based on usual and customary charges in the Tampa Bay Area of Florida. Our staff will assist you in financially planning for your care with us. We will make it as easy as possible for patients to receive, if appropriate, reimbursement from their insurance companies. The Center has created a two step process to facilitate financial planning and reimbursement.
STEP 1 ~ Prior to Evaluation / Treatment:
The Center will provide the patient the service(s) to be performed, CPT Code(s) and the fee. This information is reported on the "Fee Agreement" document shown at the following site: It is the patient’s responsibility to submit the document to their insurance company to determine if their company will, if appropriate, reimburse them for the money they pay the Institute.
This process will help the patient get PRIOR approval from their insurance for the Center's fee so that they can, if possible, obtain reimbursement for the money they pay the Institute: Please note that the Fee Agreement document provides a link to our fee schedule on this web page.
STEP II ~ After Evaluation / Treatment:
After the patient is provided an evaluation and/or treatment, the patient will be provided with the following Health Insurance Claim (HIC) form linked below. This form will facilitate the reimbursement, if appropriate, from their insurance company. In addition, the patient will receive a copy of our evaluation or procedure notes.
Health Insurance Claim Form PDF Please find below a link to a form letter that will be provided to all patients for services at the Institute. The document will facilitate the reimbursement process for patients with PPO contracts with their health insurance company.
2. Does the Center provide free care? Yes -- The Center provides free follow-up evaluations for research subjects engaged in its research studies. 3. Will Medicare reimburse you for your medical expenses at the Institute? The Center has opted out of Medicare. Any bills you pay for services at the Center will not be reimbursed to you by Medicare. 4. Why does the Research Institute not contract with insurance companies in the USA? The purpose of this policy is to create a fiscal environment for the Research Institute which will help to assure its survival without relying upon the vagaries of health care insurers..
The Institute's contract is strictly with the patient. The patient's contract, on the other hand, is with their insurance company to provide services / reimbursements under the terms of the patient’s health care policy. We will furnish you the information you may require in order to apply for reimbursement from your applicable insurance.
5. What is the nature / status of our outpatient surgical facility with the State of Florida? Please note the formal written statement / attestation made by the Research Institute at the bottom of its web pages at the www.rsdhealthcare.org
On May 20, 2008, the RSD / CRPS Treatment Center and Research Institute underwent its first annual onsite inspection by the Florida Board of Medicine. The review included inspection of the operating room, patient charts and office space.
Conclusion:
“You and your new institute were top notch”. If the patient would like the Institute to follow-up with their insurance company with this information, it would be happy to do so. Please provide the name of a contact person and phone #. Alternatively, feel free to forward this information to your insurance company.
6. Do you need to bring any documents to your initial evaluation at the Institute? Yes -- Please bring your medical records and New Patient Information Form. The New Patient Information Form can be downloaded from the following site:
7. Do hotels give discount rates for RSD Institute patients? Recently, the Institute negotiated $55 / night with a nice La Quinta Hotel across the street from Busch Gardens and 7 blocks from the Institute. The details can be found at the following site:
http://rsdhealthcare.org/PatientInfo/Kirkpatrick_Hotels.htm
Families can stay at The Ronald McDonald House for free. This housing is reserved for families of children 18 years and younger. Hotels & The Ronald McDonald House Many types living accommodations are available ... Learn More
8. What are the instructions to patients for procedures?
RSD / CRPS Treatment Center and Research Institute 1900 East Busch Blvd. Tampa, Florida 33612 (813) 995-5511
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The RSD / CRPS Treatment Center and Research Institute is a licensed Ambulatory Surgical Center that is approved by the Florida Board of Medicine for Level II surgery. The facility is regulated pursuant to the rules of the Board of Medicine as set forth in Rule Chapter 64B8, F.A.C. |
