RSD / CRPS Treatment Center and Research InstituteFee Schedule & Billing InformationThe 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 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 follow-up evaluations to research subjects. Our staff will assist you in financially planning for your care with us. You will need to bring documents to your initial evaluation at the Institute. Please bring your medical records and New Patient Information Form. The New Patient Information Form can be downloaded from the following site:
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Fee SchedulePolicies and Procedures for ClaimsThe following fee schedule is based on usual and customary charges in the Tampa Bay Area. The fee schedule is global which means the fees include all the physician fees and facility fees. The Treatment Center does not accept assignment from any insurance company. The following fees are subject to change without notice.
Policies and Procedures for Claims
Procedures:All listed fees are global (Includes all fees)
1. Stellate Ganglia Nerve Block per block: $1,300 2. Lumbar Sympathetic Nerve Block per block: $1,470 3. Trigger Point Injections (for 1-2 injections):$200 4. Trigger Point Injections ( for 3 or more injections):$250 5.Bilateral Occipital Nerve Blocks: $600 Deposit: $480 USA CPT Code 64405 50 6. Four-hour ketamine infusion by anesthesiologist: $3,000
The 2009 Coders' Desk Reference lists the following CPT codes for "Therapeutic Intravenous Infusions"
The total fee for the 4-day treatment with Escalating Dose Ketamine Constant Rate Infusion is $12,000. The treatment includes a free follow-up evaluation approximately one month after the treatment to determine long-term outcome. The $12,000 includes all fees. Due to the scheduling structure of our infusions, a deposit fee of $750 is required at the time the infusion is scheduled. This fee will be refunded at the time of the scheduled infusion. Otherwise, if the ketamine infusion is not performed as scheduled, this fee is non-refundable. Reimbursement for Ketamine Treatment .... Learn more
Evaluations:1. Initial Evaluation: $750 2. Follow-up evaluation: $360 3. Independent Medical Evaluation (IME): $1,500 (Failure to appear will result in a $500 no-show fee) Additional USA Insurance Codes1. USA DIAGNOSTIC CODES: ICD-9 codes: 2. USA "PLACE OF SERVICE" CODE: Surgery Facility = Code 24 3. The Institute’s Tax ID # = 03 - 0467829 4. Dr. Anthony Kirkpatrick's medical license #: 40765
* Recent publications report how the New York Attorney General and the AMA are going after "crooks" employed in the health insurance industry .... learn more
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