FH Fee Estimator is a tool provided by FAIR Health to allow licensed healthcare providers in solo or small medical and dental practices (fewer than 5 licensed professionals) to purchase a license for FAIR Health data products for specified uses, including the development of fee schedules for use in their practices. FH Fee Estimator is not intended for use by bill review or revenue cycle management companies, consultants, insurers, payors, or others. If you are not a solo or small medical or dental practice, please call (855) 301-FAIR (3247) or email service@fairhealth.org and a member of the FAIR Health team will be pleased to discuss license options.
If you are a licensed medical or dental professional in a small or solo practice (fewer than 5 licensed professionals), or an employee of a small or solo medical or dental practice, you may purchase up to 2 products (dentistry or medical specialty and geozip combinations) through FH Fee Estimator by choosing the applicable specialties and locations for your practice, agreeing to the User Agreement terms and paying the license fee for your products.
The data available through FH Fee Estimator represent professional charges only. If you are interested in licensing facility charge data, please call (855) 301-FAIR (3247) or email service@fairhealth.org and a member of the FAIR Health team will be pleased to discuss license options.
Up to 2 products, consisting of a medical specialty or dentistry and a geozip, can be ordered online through FH Fee Estimator. If you wish to order more than this, please call (855) 301-FAIR (3247) or email service@fairhealth.org. A member of the FAIR Health team will be pleased to discuss product options that include broader sets of data.
Yes, evaluation and management procedure codes are included with each medical specialty.
Data in FH Fee Estimator products are based on claims with dates of service for a recent 12-month period. Updated products based on more recent data are released twice during the year; the dates of service vary by product but generally coincide with the 12-month period ending 3 to 4 months prior to the product release date.
FH Fee Estimator data are updated twice a year.
FH Fee Estimator provides data from FH Benchmarks, reflecting the non-discounted fees-for-service that healthcare professionals report to insurers through the claims process. Data include:
In addition, FH Fee Estimator separately presents the applicable Medicare fee for the service, where applicable. Medicare fees are taken from the Medicare fee schedule established by the Centers for Medicare & Medicaid Services (CMS), for the procedure code in the Medicare Geographic Practice Cost Index (GPCI) area that maps most closely to the corresponding FAIR Health geozip. When a FAIR Health geozip overlaps 2 or more GPCIs, the fee from the GPCI with the highest population is displayed.
Solo and small medical and dental practices (fewer than 5 licensed professionals) may license FAIR Health charge data through FH Fee Estimator for the uses specifically described in the User Agreement. Data can be used to inform:
Any other use is prohibited. Prohibited uses include, but are not limited to: (1) use of the Data to consult outside your own individual healthcare practice; (2) use of the Data in litigation; (3) use of the Data in performing medical diagnostic functions or setting treatment procedures; or (4) otherwise using the Data as a substitute for the medical judgment of a physician or qualified healthcare provider.
FH Fee Estimator licensees use the data in their small or solo medical and dental practices to:
In the FAIR Health database, healthcare practitioners' non-discounted fees-for-service (charges) are arrayed from lowest to highest and organized into percentiles. A percentile is a position in a distribution of values below which a specified percentage of the values fall. For example, in a distribution of 100 values, 70 percent of the values are equal to or below the value in the 70th position—the 70th percentile.
FH Fee Estimator displays charge benchmarks based on actual data for each procedure code/geozip combination. When there are not enough occurrences for a given procedure code/geozip combination in the database, a relative value methodology is used to derive a benchmark charge. More information about FAIR Health data methodologies is available here. In rare instances where the FAIR Health database does not contain enough occurrences to derive a benchmark charge, the benchmark displayed will be zero.
Products available through FH Fee Estimator are drawn from the FAIR Health database, which contains over 44 billion billed medical and dental procedures from 2002 to the present. More than 2 billion new claim records are added each year; products are updated twice per year, and each release is based on a recent 12 months of available data. Data are contributed by over 75 commercial health insurance payors and third-party administrators.
The charge benchmarks presented in FH Fee Estimator products are based on the range of charges for each procedure in each geozip, a location generally defined by the first 3 digits of a zip code. The charges reported for a code/geozip combination are arrayed from lowest to highest and organized into “percentiles.” A percentile represents the value below which a certain specified percentage of observations fall.
If there are not enough occurrences of a given procedure code/geozip combination in the FAIR Health database, a relative value methodology is used to derive benchmark charge amounts.
FH Fee Estimator indicates which benchmarks have been developed with a relative value methodology. For more information about statistical methodologies used to develop FAIR Health products, please visit fairhealth.org/methodologies.
If you need assistance with FH Fee Estimator Online products or navigating the website, please call FAIR Health Customer Support at (855) 301-FAIR (3247) or email service@fairhealth.org. Representatives are available from 9 am to 6 pm ET, Monday through Friday. Outside of business hours, please leave a message and your call or email will be returned the next business day.
Yes. Select “Pay by Check” during the checkout process. You can print an invoice and send it with your check to FAIR Health at the address provided. When your check is received, FAIR Health will email you instructions to access your data.
FAIR Health collects sales tax in the states where we are required to do so. If your organization has tax-exempt status and is in a state where sales tax is applied to your order, you have two options.
During the checkout process please select the box that says, “My organization has tax-exempt status,” and:
1. If paying by credit card—complete the checkout process. You will be billed for the full amount plus sales tax. When your transaction is complete, we will contact you to request a copy of your tax-exempt certificate or other proof of tax-exempt status. Once we have received this supporting documentation, we will credit your card for the amount of the sales tax.
2. If paying by check—please send a copy of your tax-exempt certificate or other proof of tax-exempt status with your invoice and a check for the amount of the data product license agreement. Your invoice will be adjusted accordingly.
FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal tax code. It is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. As an independent nonprofit not affiliated with any governmental agency, insurer or other organization in the healthcare sector, FAIR Health is widely regarded as a trusted and neutral provider of robust data and data tools by diverse stakeholders throughout the healthcare sector. Evident throughout our business practices, FAIR Health’s independence starts with our corporate structure. FAIR Health is governed by a conflict-free, uncompensated Board of Directors comprising leaders with experience in all segments of healthcare, including providers, hospitals, insurers, consumers, researchers, educators and policy makers. For more information about FAIR Health, visit our corporate website, fairhealth.org.
In addition to FH Fee Estimator for solo and small medical and dental practices, FAIR Health licenses a range of data products to meet the needs of multiple stakeholders in the healthcare system. To learn more, visit fairhealth.org/who-we-serve.
