View the Expected Reimbursement Detail for CPT Bundling

Use the following procedure to view the CPT Bundling detail on the Expected Reimbursement Detail page. This section only displays if the contract profile uses the CPT Bundling reimbursement tool to bundle CPT or revenue codes for reimbursement. For more information about the bundling reimbursement tool, refer to CPT Bundling.

  1. Access the Expected Reimbursement Detail page for an account that includes code bundling. For more information, refer to View the Expected Reimbursement Details . 
  2. Review the reimbursement details.
  3. Optionally, you can perform the following actions:
    • Click Reimbursement to display the View Contract Profile page. For more information, refer to View a Contract Profile.
    • Click a link in the Service Type column to display the service type on the View Contract Profile page. For more information, refer to View a Contract Profile.

The following table describes each of the fields in the CPT Bundling section of the Expected Reimbursement Detail page. The fields are listed in alphabetical order.

Field

Description

Adjusted Charge

The discounted reimbursement after the reimbursement percentage specified in the CPT Bundling reimbursement tool is applied

Bundling Group

Name of the bundling group and associated reimbursement rules applied to the code. Codes that are bundled together display the same bundling group. The values in this column are a link that displays the details of the bundling rule in the Bundling Group Description window.

Charged Amount

Total billed charges for the selected CPT or revenue code

Code

CPT or revenue code included in the bundling logic. Codes that are bundled together display the same group in the Bundling Group column.

Expected Reimbursement

The calculated reimbursement based on the overall discount rate and the bundling rules selected in the CPT Bundling reimbursement tool

Multi-Procedure Bundle %

The bundle tiered percentages applied to each line item, typically 100, 50, 25, 0

RVU

The relative value unit (RVU) from the CMS RVU table. This value is used to rank each code that is bundled and determine the reimbursement percentage that is applied.

Note: This column does not display if a bundling percentage is applied to charges.

Service Date

Date the service is rendered.

Service Type

Service type name. Click this link to display the service types on the View Contract Profile page. For more information, refer to View a Contract Profile.

Term Type

A link that allows you to view the contract profile. For more information, refer to View a Contract Profile.