Helping you to understand your fee codes and how we set our fees
How we set our fees
We set our fees through market research and regular benchmarking. We also take into consideration:
Sometimes our fees may not reflect exceptional circumstances. If you give us details, before you invoice us, we’ll review the amount we pay.
We may also challenge invoices. But in these cases, we’ll always work with you to find a rate that’s fair to you, and us.
Our billing standards
To protect our members, we only work with providers who show a total commitment to our values.
Part of this commitment is an agreement to our Billing Standards.
When you submit an invoice to use, your Invoices should include all relevant information. This includes:
 Follow the multiple procedure rules in these scenarios
 We need to agree these scenarios in writing at least 72 hours in advance
Multiple procedure billing
This allows you to carry out more than one procedure during an operating session
There are specific CCSD codes for procedures performed bilaterally.
If a code exists for a bilateral (e.g. Bilateral mastectomy) we’ll pay the highest fee for that code only.
Where there’s no bilateral procedure code, the multiple rules apply.
If you give us details of complications or unusual circumstances before invoicing, we’ll review the amount we pay.
Unbundling is the breaking down of a procedure and charging for each component individually.
Therefore, we won’t pay for procedures that are:
 We will not accept codes W9030, W9040, W9012, W9013, W9014, W9015, S5210, A7350 and AC100
Need some help?
If you need further guidance on fees, please submit a query form to get in touch with us.