Benchmark Data Products

FH®
Benchmarks

FH® Charge Benchmarks Presenting up-to-date, actionable data based on recent claims from 493 distinct geographic regions nationwide, our charge benchmark offerings include medical/surgical, dental, anesthesia, HCPCS, HCPCS facility, inpatient facility, outpatient facility, ambulatory surgery center (ASC) facility, telehealth, urgent care and Category III modules.

FH® Allowed Benchmarks Based on the maximum amounts payors allow for reimbursement of provider charges, FH Allowed Benchmarks enable clients to understand in-network payment trends by regional area. FH Allowed Benchmarks include FH® Allowed Medical, FH® Allowed Dental, FH® Allowed Anesthesia, FH® Allowed HCPCS, FH® Allowed HCPCS Facility, FH® Allowed Telehealth, FH® Allowed Inpatient Facility DRG, FH® Allowed Outpatient Facility and FH® Allowed ASC Facility.

Actionable, Trusted Claims Data Packaged for Ease of Use

Key decisions made by healthcare-related businesses depend on trust—the confidence that the data behind those decisions are independent, reliable and representative of today’s market. The data supporting FH Benchmarks meet and surpass those criteria. That’s why states have adopted FH Benchmarks as a reference point for consumer protection laws and as the basis for workers’ compensation fee schedules, among other uses. It’s also the reason stakeholders rely on FH Benchmarks when adjudicating out-of-network claims, developing fee schedules, facilitating network negotiations, studying trends in cost and utilization, shaping strategic initiatives and more.

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FH
Charge Benchmarks:

  • FH® Charge Medical. Billed charges for professional fees arrayed by Current Procedural Terminology (CPT®) codes for evaluation and management (E&M), medical, surgical, radiology, laboratory and pathology procedures.
  • FH® Charge Dental. Billed charges arrayed by Current Dental Terminology (CDT®) codes for all dental procedures.
  • FH® Charge Anesthesia. Billed charges arrayed by CPT Category I codes for anesthesia. In certain formats, surgical procedure codes are cross-walked to anesthesia codes.
  • FH® Charge HCPCS. Billed charges arrayed by Level II HCPCS codes for equipment, supplies and services not included in CPT codes, such as ambulance services, durable medical equipment (DME), specialty drugs, prosthetics, orthotics and supplies when used outside a physician’s office.
  • FH® Charge Inpatient Facility DRG. Billed charges arrayed by diagnosis-related group (DRG) for services performed in a hospital inpatient setting.
  • FH® Charge Inpatient Facility ICD Proc/Rev. Billed charges arrayed by ICD-10 procedure codes and associated revenue codes for services performed in a hospital inpatient setting. Click here for sample data.
  • FH® Charge Outpatient Facility. Billed charges arrayed by CPT codes for services performed in a hospital outpatient setting.
  • FH® Charge ASC Facility. Billed charges at the state, regional and national level arrayed by CPT codes for services performed in an ASC.
  • FH® Charge Medical GapFill. Includes Category III CPT codes (temporary codes for emerging technologies, services, procedures and service paradigms), Proprietary Laboratory Analyses (PLA) codes and Multianalyte Assays with Algorithmic Analyses (MAAA) administrative codes.
  • FH® Charge Urgent Care. Billed charges arrayed by CPT and HCPCS codes for services performed in an urgent care setting.
  • FH® Charge HCPCS Facility. Billed charges arrayed by Level II HCPCS for products, supplies and services performed in a facility and generally not included in CPT codes.
  • FH® Charge Telehealth. Billed charges arrayed by CPT and HCPCS codes for professional services performed in a telehealth setting.

FH
Allowed Benchmarks:

  • FH® Allowed Medical. Benchmarks based on amounts allowed by plans for medical professional services and arrayed by CPT code, including E&M, medical, surgical, radiology and laboratory procedures.
  • FH® Allowed Dental. Benchmarks based on amounts allowed by plans for dental procedures and arrayed by CDT codes.
  • FH® Allowed Anesthesia. Benchmarks based on amounts allowed by plans for anesthesia and surgical procedure codes, cross-walked to anesthesia codes, and arrayed by CPT Category I codes.
  • FH® Allowed HCPCS. Benchmarks based on amounts allowed by plans for equipment, supplies and services not included in CPT codes and arrayed by Level II HCPCS codes; examples include ambulance services, DME, specialty drugs, prosthetics, orthotics and supplies when used outside a physician’s office.
  • FH® Allowed HCPCS Facility. Benchmarks based on amounts allowed by plans and arrayed by Level II HCPCS codes for products, supplies and services billed by a facility and generally not included in CPT codes.
  • FH® Allowed Telehealth. Benchmarks based on amounts allowed by plans for services performed in a telehealth setting and arrayed by CPT and HCPCS codes.
  • FH® Allowed Outpatient Facility. Benchmarks based on amounts allowed by plans for services performed in a hospital outpatient setting and arrayed by CPT codes.
  • FH® Allowed ASC Facility. Benchmarks based on amounts allowed by plans for services performed in an ASC and arrayed by CPT codes.
  • FH® Allowed Inpatient Facility DRG. Benchmarks based on amounts allowed by plans for services performed in a hospital inpatient setting and arrayed by diagnosis-related group (DRG).

CPT © 2023 American Medical Association (AMA). All rights reserved

Current Dental Terminology (CDT), American Dental Association (ADA). All rights reserved.

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