Medicare Set-Aside Fee Schedule
* Volume discounts available; please contact Henry Kohnlein at 303.825.0305 for details.

 
Service

Fee

Description

Complex Medicare Set-aside / Standard Medical Cost Projection

$2,500

(1)  Detailed medical narrative and cost projections;
(2)  ICD-9 reporting and classification;
(3)  detailed medication usage reports;
(4)  All telephone calls;
(5)  Standard settlement language;
(6)  Coordination of settlement parties;
(7)  Guaranteed 12 business day turnaround from the receipt of all information;
(8)  Preferred update pricing;
(9)  Pre-settlement conference; and
(10) Customized reports

Express Medicare Set-aside / Express Medical Cost Projection

$1,750

(1)  Medical summary and cost projections;
(2)  ICD-9 reporting and classification;
(3)  All telephone calls;
(4)  Standard settlement language;
(5)  Preferred update pricing;
(6)  Pre-settlement conference; and
(7)  5–7 business day turnaround from the receipt of all information

Preferred Update Services

(1)  Free if requested 0 to 6 months from date of the MSA
(2)  $750 if requested 6 to 12 months from date of the MSA
(3)  $1,500 if requested 12 to 24 months from date of the MSA
(4)  After two years, the request is treated as a new case referral
(5)  Plus $250 for document management fee

Drug Utilization Review

$750

A drug utilization review provides recommendations regarding the appropriateness of a drug utilization by a claimant. Service includes pharmacy management to coordinate the implementation of the
recommendations.

Conditional Payment Search (Medicare Liens)

$250

A full report of diagnoses code to Medicare Conditional Payment Coordinator with a request for determination of conditional
payments related to the claimant’s case. This includes negotiations regarding the lien ammount.

MSA Custodial Account Agreement

$1,000

Expert preparation of a professionally
administered Medicare Set-aside Custodial Agreement. This also includes any needed revisions of the agreement as well as coordination of the execution and required funding, but does not include administration fees.

Self-Administration Consultation

$1,000

One year consultation with the injured person to ensure proper self-administration of the MSA.

CMS Submission

$750

Submission of MSA and required
documentation to CMS for approval,
including negotiation to resolve final MSA amount, if necessary.

Rush

$375

A rush order involves the completion
of the MCP or MSA within a non-standard timeframe. No rush fee will be charged if we are unable to meet the established rush timeframe.

Regular Hourly Rates

$250/hr
$185/hr
$100/hr

Senior Analyst
Nurse / MSA Analyst
Case Manager

Reduced Hourly Rates

$100

Rates pertain to all staff

Other Service Rate Schedule

Service

Rate

Traditional Life Care Planning

$185/hr.

Medical Cost Projections / Medical Reserving

Professional Services $185/hr, Support Services $185/hr.

Medical Case Management

$80/hr.

Medical-Legal File Review

$125/hr.

Legal Nurse Consulting Services

$185/hr.