Fee Schedule Help Information


Medical Fee Schedule

Fee Schedules are available for participating providers. Fees are only available for the specialties credentialed for our Providers. Procedure codes and modifier combinations are available in the single code search and the most commonly billed code searches.

  • Single code search - Type any code and modifier combination to determine the fee. Autocomplete will assist with the data entry by narrowing the codes available to you. 
  • Most commonly billed search - Pulls the codes identified as the most commonly billed for the specialty.

Codes that are not available online can be requested via Fax.  To receive the most commonly billed procedure codes, fax a request on company letterhead to 410-872-4100 and include Provider ID, Tax ID, contact information and specific procedure codes if needed.

GHMSI rates are available for the HMO, RPN and PPN networks. The fees are based on the specific contract for the specific practitioner, based on the offices primary location.  The fees are based as of the beginning of the date of inquiry.CFMI rates are not available online available for PAR and PPN networks. (QUESTION: - keep this CFMI or lose it – this is a revised sentence)

Medical Fee Schedule results follow traditional rounding rules.

A print function feature allows you to print the fee schedule Click through each Result page to print each set of results.

If you have questions about the fee schedule information provided, please contact your Professional Provider Representative.

Dental Fee Schedules

Dental Fee Schedules are available for participating dental providers. Credentialed specialties Fee Schedules are available. Requests for Fee Schedules may be made using either Search by Procedure Code(s) or All Procedure Codes.

  • Procedure Code(s) - search allows user to perform a search by an individual procedure code, multiple procedure codes or a range of procedure codes. A maximum of 100 codes can be searched at a time. Search criteria formatting must be consistent within the search; codes must either begin with a D or not include the D across the search.

    Example: D0120, D0140, D0145-D0160, D0180.
  • All Procedure Codes - Search pulls all the active procedure codes for the group or practitioner by location.

Dental rates are available for Traditional, Preferred, DHMO. Fees are displayed for the specific contract, group and location requested. Fees may also be available for a specific practitioner when they are different from the group/location. Fees are as of the date of inquiry.

A print function feature allows you to print the entire fee schedule results regardless of which results page is being viewed.

Fee Schedules are not available for the GRID, NovaNet or FEP networks.

  • GRID - Contact your home plan for Fee Schedule information.
  • NovaNet - Contact Novanet for Fee Schedule information.
  • FEP – Contact FEP Customer Service at the number listed on the back of the member’s card.