The American Academy of Pediatrics (AAP) provides its members with several valuable tools that can be used by practices to negotiate for appropriate payments and to help determine fees for services they provide.

Located on the AAP Web site at www.aap.org/research/pedmedcostmodel.cfm, this tool allows practices to calculate state- and locale-specific costs for each medical service recommended in the AAP “Scope of Health Care Benefits for Children From Birth Through Age 21” policy statement (http://aappolicy.aappublications.org/cgi/content/full/pediatrics;117/3/979). It can determine unit cost and fees by calculating per-member, per-month (PMPM) payment rates for each type of service provided for Medicaid/State Children's Health Insurance Program or commercial plans. The model is based on 2008 actuarial data and can be used to estimate costs and use by benefit (eg, preventive medicine, immunization administration), case mix (eg, public vs private payer, patient age and gender mix), and locale (eg, state, urban vs rural). Previous...

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