Contracts-Negotiations and Fee Schedules

The College of American Pathologist (CAP) offers resources to assist you in navigating the complexities of payer negotiations, contracting and understanding the impact these contracts may have on your practice.

The CAP offers guidance on the preparation, evaluation and creation of pathology contracts with various payers and hospitals.

• Sample Pathology Services Agreement: Hospital Payment for Commercial Bundled Payments
  • Includes 9 critical steps in preparing for your contract negotiation and a sample agreement with annotations and contracting options.
• Contracting with Hospitals for Technical component Services; Resources and Recommendations for Pathology Practices

The following files provide information regarding Part-A contracts and services.

• Part-A Information Package
• Part-A Compensation
• CAP Webinar: "Meeting the Challenges of Part-A Contracts"
• Reasonable Compensation Equivalent (RCE)
• Part-A Time Study Log
• PC Billing Information Package
• Fraud and Abuse - Sidley Austin

• 2020 Physician Fee Schedule Impact Table
• 2019 Physician Fee Schedule Impact Table

Utilize this resource to assess the financial impact of a proposed fee schedule changes from Medicare or commercial payers. This can also be utilized to evaluate new payer contracts.

• Fee Impact Assessment Calculator

Good negotiation skills help ensure that you are fairly compensated for the expertise that you provide. CAP offers several resources to help you develop your these important skills.

• Negotiation Strategies for Pathologists
• Planning for a Negotiation