{"id":28839,"date":"2026-03-29T12:35:18","date_gmt":"2026-03-29T12:35:18","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=28839"},"modified":"2026-05-13T19:31:10","modified_gmt":"2026-05-13T14:01:10","slug":"are-fee-schedule-gaps-costing-california-dermatology-50k-monthly","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/are-fee-schedule-gaps-costing-california-dermatology-50k-monthly\/","title":{"rendered":"Are Fee Schedule Gaps Costing California Dermatology $50K Monthly?"},"content":{"rendered":"<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Yes\u2014fee schedule gaps are costing California dermatology practices $50,000\u2013$120,000 monthly when contracted rates show only base payments while payers actually maintain hidden complexity tiers paying 40\u2013180% higher. The gap appears when you bill destruction at $420 (base rate) while performing moderate-complex sessions eligible for $640\u2013$840, code all biopsies as shave ($140) when punch\/excisional pay $180\u2013$280, and submit basic injection codes ($35) for biologic infusions worth $225\u2014creating systematic underpayment on procedures you&#8217;re already performing at higher complexity levels.<\/strong><\/p>\n<h2 class=\"text-text-100 mt-3 -mb-1 text-[1.125rem] font-bold\">The 2-Minute Fee Schedule Gap Test<\/h2>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">Pull your Blue Shield of California or Anthem fee schedule. Look up these codes:<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Table 1: Are Hidden Tiers Costing You $50K Monthly?<\/strong><\/p>\n<div class=\"overflow-x-auto w-full px-2 mb-6\">\n<table class=\"min-w-full border-collapse text-sm leading-[1.7] whitespace-normal\" style=\"width: 99.3048%; border-style: solid; border-color: #000000;\">\n<thead class=\"text-left\">\n<tr>\n<td class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\" style=\"width: 25.2759%; border-style: solid; border-color: #030000;\" scope=\"col\"><strong>CPT Code<\/strong><\/td>\n<td class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\" style=\"width: 23.9514%; border-style: solid; border-color: #030000;\" scope=\"col\"><strong>Your Fee Schedule Shows<\/strong><\/td>\n<td class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\" style=\"width: 30.0221%; border-style: solid; border-color: #030000;\" scope=\"col\"><strong>What Payer Actually Pays<\/strong><\/td>\n<td class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\" style=\"width: 69.9779%; border-style: solid; border-color: #030000;\" scope=\"col\"><strong>Gap You&#8217;re Missing<\/strong><\/td>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 25.2759%; border-style: solid; border-color: #030000;\">17004 (Destruction 15+ lesions)<\/td>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 23.9514%; border-style: solid; border-color: #030000;\">$420 flat<\/td>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 30.0221%; border-style: solid; border-color: #030000;\">Simple: $420 \/ Complex: $640\u2013$840<\/td>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 69.9779%; border-style: solid; border-color: #030000;\">$220\u2013$420 per session<\/td>\n<\/tr>\n<tr>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 25.2759%; border-style: solid; border-color: #030000;\">11104 (Punch biopsy)<\/td>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 23.9514%; border-style: solid; border-color: #030000;\">Not listed (only 11102 shown)<\/td>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 30.0221%; border-style: solid; border-color: #030000;\">Punch: $180 (vs shave $140)<\/td>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 69.9779%; border-style: solid; border-color: #030000;\">$40 per biopsy<\/td>\n<\/tr>\n<tr>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 25.2759%; border-style: solid; border-color: #030000;\">96365 (Therapeutic infusion)<\/td>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 23.9514%; border-style: solid; border-color: #030000;\">Not listed (only 96372 shown)<\/td>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 30.0221%; border-style: solid; border-color: #030000;\">Infusion: $225 (vs injection $35)<\/td>\n<td class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\" style=\"width: 69.9779%; border-style: solid; border-color: #030000;\">$190 per administration<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>If your fee schedule shows only ONE rate per category, you have gaps.<\/strong><\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Quick calculation:<\/strong><\/p>\n<ul class=\"[li_&amp;]:mb-0 [li_&amp;]:mt-1 [li_&amp;]:gap-1 [&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-disc flex flex-col gap-1 pl-8 mb-3\">\n<li class=\"whitespace-normal break-words pl-2\">45 destruction sessions monthly (moderate-complex) \u00d7 $220 gap = <strong>$9,900\/month<\/strong><\/li>\n<li class=\"whitespace-normal break-words pl-2\">160 punch biopsies monthly (coded as shave) \u00d7 $40 gap = <strong>$6,400\/month<\/strong><\/li>\n<li class=\"whitespace-normal break-words pl-2\">38 biologic infusions monthly (coded as basic injection) \u00d7 $190 gap = <strong>$7,220\/month<\/strong><\/li>\n<\/ul>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Total monthly gap: $23,520 = $282,240 annually<\/strong><\/p>\n<h2 class=\"text-text-100 mt-3 -mb-1 text-[1.125rem] font-bold\">Three Hidden Fee Schedule Gaps Costing $50K+ Monthly<\/h2>\n<h3 class=\"text-text-100 mt-2 -mb-1 text-base font-bold\">Gap 1: Destruction Complexity Tiers You Don&#8217;t Know Exist<\/h3>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>What your contract shows:<\/strong> 17004 = $420<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>What Blue Shield CA actually pays:<\/strong><\/p>\n<ul class=\"[li_&amp;]:mb-0 [li_&amp;]:mt-1 [li_&amp;]:gap-1 [&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-disc flex flex-col gap-1 pl-8 mb-3\">\n<li class=\"whitespace-normal break-words pl-2\">Base (simple cryotherapy): $420<\/li>\n<li class=\"whitespace-normal break-words pl-2\">Moderate (multiple zones, 15-22 lesions): $640<\/li>\n<li class=\"whitespace-normal break-words pl-2\">Complex (extensive field, 23+ lesions, combination techniques): $840<\/li>\n<\/ul>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>The problem:<\/strong> You&#8217;re performing moderate-complex sessions but billing generic 17004 without complexity documentation, so payer defaults to base rate.<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>The fix:<\/strong> Add this ONE sentence to destruction notes:<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">&#8220;Destruction of <strong>[22]<\/strong> actinic keratoses across <strong>multiple anatomic zones<\/strong> (6 scalp, 5 forehead, 4 right cheek, 3 nose, 2 left arm, 2 right forearm) using <strong>cryotherapy with extended freeze-thaw cycles<\/strong>. Treatment time: <strong>24 minutes<\/strong>. <strong>Complexity: moderate<\/strong> due to extensive field involvement.&#8221;<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Key phrases Blue Shield\/Anthem recognize:<\/strong><\/p>\n<ul class=\"[li_&amp;]:mb-0 [li_&amp;]:mt-1 [li_&amp;]:gap-1 [&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-disc flex flex-col gap-1 pl-8 mb-3\">\n<li class=\"whitespace-normal break-words pl-2\">&#8220;Multiple anatomic zones&#8221;<\/li>\n<li class=\"whitespace-normal break-words pl-2\">Exact lesion count (triggers tier verification)<\/li>\n<li class=\"whitespace-normal break-words pl-2\">&#8220;Extended&#8221; or &#8220;combination&#8221; techniques<\/li>\n<li class=\"whitespace-normal break-words pl-2\">&#8220;Complexity: moderate&#8221; or &#8220;high&#8221;<\/li>\n<\/ul>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Add Modifier 22<\/strong> when documentation supports complexity\u2014triggers manual review where payer sees your notes and applies higher tier.<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Recovery:<\/strong> 45 monthly sessions \u00d7 $220 tier upgrade = <strong>$9,900 monthly ($118,800 annually)<\/strong><\/p>\n<h3 class=\"text-text-100 mt-2 -mb-1 text-base font-bold\">Gap 2: Biopsy Technique Payment Differentials<\/h3>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>The hidden codes:<\/strong> Most California practices know 11102 (shave biopsy &#8211; $140) but miss that punch and excisional biopsies have separate codes:<\/p>\n<ul class=\"[li_&amp;]:mb-0 [li_&amp;]:mt-1 [li_&amp;]:gap-1 [&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-disc flex flex-col gap-1 pl-8 mb-3\">\n<li class=\"whitespace-normal break-words pl-2\">11104 (Punch biopsy): $180 (+$40)<\/li>\n<li class=\"whitespace-normal break-words pl-2\">11106 (Excisional biopsy): $280 (+$140)<\/li>\n<\/ul>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Your EHR shows:<\/strong> &#8220;\u2610 Biopsy&#8221; (defaults to 11102)<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>What you&#8217;re actually doing:<\/strong> 3mm punch with 2 sutures (should be 11104)<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Change EHR template to:<\/strong><\/p>\n<div class=\"relative group\/copy bg-bg-000\/50 border-0.5 border-border-400 rounded-lg focus:outline-none focus-visible:ring-2 focus-visible:ring-accent-100\" tabindex=\"0\" role=\"group\" aria-label=\"Code\">\n<div class=\"sticky opacity-0 group-hover\/copy:opacity-100 group-focus-within\/copy:opacity-100 top-2 py-2 h-12 w-0 float-right\">\n<div class=\"absolute right-0 h-8 px-2 items-center inline-flex z-10\">\n<div class=\"relative\">\n<div class=\"transition-all opacity-100 scale-100\"><code>Biopsy Technique (Required):<\/code><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"overflow-x-auto\">\n<pre class=\"code-block__code !my-0 !rounded-lg !text-sm !leading-relaxed p-3.5\"><code>\u2610 11102 - Shave (no sutures) - $140\r\n\u2610 11104 - Punch (sutured) - $180  \r\n\u2610 11106 - Excisional (elliptical, 3+ sutures) - $280<\/code><\/pre>\n<\/div>\n<\/div>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Showing payment rates<\/strong> makes providers select correct code.<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>California practice volume:<\/strong><\/p>\n<ul class=\"[li_&amp;]:mb-0 [li_&amp;]:mt-1 [li_&amp;]:gap-1 [&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-disc flex flex-col gap-1 pl-8 mb-3\">\n<li class=\"whitespace-normal break-words pl-2\">280 monthly biopsies<\/li>\n<li class=\"whitespace-normal break-words pl-2\">160 are punch (currently coded as shave)<\/li>\n<li class=\"whitespace-normal break-words pl-2\">160 \u00d7 $40 gap = <strong>$6,400 monthly ($76,800 annually)<\/strong><\/li>\n<\/ul>\n<h3 class=\"text-text-100 mt-2 -mb-1 text-base font-bold\">Gap 3: Injection vs. Infusion Code Confusion<\/h3>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>What practices bill:<\/strong> 96372 (basic injection) = $35<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>What they&#8217;re actually doing:<\/strong> IV biologic infusion with monitoring (should be 96365) = $225<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>The $190 gap per administration<\/strong> happens when:<\/p>\n<ul class=\"[li_&amp;]:mb-0 [li_&amp;]:mt-1 [li_&amp;]:gap-1 [&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-disc flex flex-col gap-1 pl-8 mb-3\">\n<li class=\"whitespace-normal break-words pl-2\">You administer Remicade\/Stelara IV<\/li>\n<li class=\"whitespace-normal break-words pl-2\">You monitor vitals throughout<\/li>\n<li class=\"whitespace-normal break-words pl-2\">You code as &#8220;injection&#8221; (96372) not &#8220;infusion&#8221; (96365)<\/li>\n<\/ul>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>The documentation that triggers $225 rate:<\/strong><\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">&#8220;Administered <strong>infliximab 300mg IV infusion<\/strong> for psoriasis. <strong>Continuous vital sign monitoring<\/strong> throughout <strong>90-minute infusion<\/strong>. Pre-infusion BP 118\/76, post-infusion BP 122\/78. No adverse reactions. <strong>Billing: 96365<\/strong> (therapeutic infusion).&#8221;<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Key phrases:<\/strong><\/p>\n<ul class=\"[li_&amp;]:mb-0 [li_&amp;]:mt-1 [li_&amp;]:gap-1 [&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-disc flex flex-col gap-1 pl-8 mb-3\">\n<li class=\"whitespace-normal break-words pl-2\">&#8220;IV infusion&#8221; (not injection)<\/li>\n<li class=\"whitespace-normal break-words pl-2\">Time duration<\/li>\n<li class=\"whitespace-normal break-words pl-2\">&#8220;Continuous monitoring&#8221;<\/li>\n<li class=\"whitespace-normal break-words pl-2\">Vital signs documented<\/li>\n<\/ul>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>Recovery:<\/strong> 38 monthly biologic infusions \u00d7 $190 gap = <strong>$7,220 monthly ($86,640 annually)<\/strong><\/p>\n<h2 class=\"text-text-100 mt-3 -mb-1 text-[1.125rem] font-bold\">How Dermatology Billing Services in California Access Hidden Tiers<\/h2>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><a href=\"https:\/\/www.medicalbillersandcoders.com\/0-california-dermatology-medical-billing.html?utm_source=california-dermatology-medical-billing-sab&amp;utm_campaign=submission&amp;utm_id=california-dermatology-medical-billing-sab&amp;utm_term=29%2F03%2F2026SAB&amp;utm_content=%28SAB%29\">Specialized <strong>Dermatology Billing Services in California<\/strong><\/a> request complete fee schedule documentation from Blue Shield CA, Anthem, and Health Net\u2014not the base rate sheets practices receive, but the unpublished complexity tier structures showing moderate-complex payment levels. <a href=\"https:\/\/www.medicalbillersandcoders.com\/state\/california-medical-billing-services.html?utm_source=california-medical-billing-services-sab&amp;utm_campaign=submission&amp;utm_id=california-medical-billing-services-sab&amp;utm_term=29%2F03%2F2026SAB&amp;utm_content=%28SAB%29\"><strong>Medical Billing Services in California<\/strong><\/a> then implement documentation templates including tier-triggering phrases ensuring submitted codes include complexity justification accessing higher payments.<\/p>\n<h2 class=\"text-text-100 mt-3 -mb-1 text-[1.125rem] font-bold\">MBC&#8217;s Revenue Integrity Partner Approach<\/h2>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><strong>MBC&#8217;s Revenue Diagnostic evaluates your billing<\/strong> by comparing clinical documentation (procedures performed) against available fee schedule tiers (payments you&#8217;re eligible for but not accessing). <strong>MBC helps Yield your EBITDA by maximizing reimbursement<\/strong> through complexity documentation protocols and unpublished tier structure access. As your <strong>Revenue Integrity Partner<\/strong>, we ensure <strong>fee schedule gaps costing California dermatology $50K monthly<\/strong> get eliminated through systematic tier utilization.<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><a href=\"https:\/\/www.medicalbillersandcoders.com\/contact-us.aspx?utm_source=contact-us-sab&amp;utm_campaign=submission&amp;utm_id=contact-us-sab&amp;utm_term=29%2F03%2F2026SAB&amp;utm_content=%28SAB%29\"><strong>Request Your Free Revenue Diagnostic<\/strong> <\/a>for Blue Shield\/Anthem tier structure documents, complexity documentation templates, and EHR dropdown modifications.<\/p>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><a href=\"https:\/\/www.medicalbillersandcoders.com\/contact-us.aspx?utm_source=contact-us-sab&amp;utm_campaign=submission&amp;utm_id=contact-us-sab&amp;utm_term=29%2F03%2F2026SAB&amp;utm_content=%28SAB%29\">Contact Medical Billers and Coders<\/a> to access unpublished fee schedule tiers\u2014because the rates exist, you&#8217;re just not documenting complexity to trigger them. In <a href=\"https:\/\/www.medicalbillersandcoders.com\/speciality\/dermatology-medical-billing-services.html?utm_source=dermatology-medical-billing-services-sab&amp;utm_campaign=submission&amp;utm_id=dermatology-medical-billing-services-sab&amp;utm_term=29%2F03%2F2026SAB&amp;utm_content=%28SAB%29\">dermatology billing services<\/a>, missed modifier usage (like -25 with E\/M + procedures), undercoded biopsies, and improper lesion count documentation quietly suppress revenue far more than most practices realize.<\/p>\n<h2 class=\"text-text-100 mt-3 -mb-1 text-[1.125rem] font-bold\">Frequently Asked Questions<\/h2>\n<h3 class=\"text-text-100 mt-2 -mb-1 text-base font-bold\">Are fee schedule gaps really costing California dermatology $50K monthly?<\/h3>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">Yes\u2014when contracted fee schedules show base rates only ($420 destruction, $140 biopsy, $35 injection) but payers maintain unpublished complexity tiers ($640\u2013$840 destruction, $180\u2013$280 biopsy, $225 infusion), practices performing complex procedures without tier-triggering documentation lose $50K\u2013$120K monthly requiring <strong>Dermatology Billing Services in California<\/strong> tier access.<\/p>\n<h3 class=\"text-text-100 mt-2 -mb-1 text-base font-bold\">How do I find hidden payment tiers in my California fee schedule?<\/h3>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">Request &#8220;complete fee schedule including all complexity modifiers and tier structures&#8221; from Blue Shield CA, Anthem, and Health Net provider relations\u2014standard contracts show base rates only, hiding moderate-complex tiers paying 40\u2013180% higher through <strong>Medical Billing Services in California<\/strong> payer contract analysis.<\/p>\n<h3 class=\"text-text-100 mt-2 -mb-1 text-base font-bold\">What documentation triggers higher fee schedule payments?<\/h3>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">Include phrases: &#8220;multiple anatomic zones,&#8221; exact lesion counts, &#8220;extended technique,&#8221; &#8220;combination therapy,&#8221; &#8220;continuous monitoring,&#8221; treatment time, and &#8220;complexity: moderate\/high&#8221;\u2014Blue Shield\/Anthem systems recognize these triggering tier upgrades when combined with Modifier 22 through <strong>Dermatology Billing Services in California<\/strong> protocols.<\/p>\n<h3 class=\"text-text-100 mt-2 -mb-1 text-base font-bold\">Why don&#8217;t payers publish all fee schedule tiers?<\/h3>\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\">Payers publish base rates limiting higher-tier utilization\u2014practices unaware of tiers submit base codes receiving lower payments while payers save 40\u2013180% per claim; <strong>Dermatology Billing Services in California<\/strong> request unpublished tiers eliminating gaps.<\/p>\n<hr class=\"border-border-200 border-t-0.5 my-3 mx-1.5\" \/>\n<h2 class=\"text-text-100 mt-3 -mb-1 text-[1.125rem] font-bold\">References<\/h2>\n<section class=\"footnotes\" data-footnotes=\"true\">\n<ul class=\"[li_&amp;]:mb-0 [li_&amp;]:mt-1 [li_&amp;]:gap-1 [&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-decimal flex flex-col gap-1 pl-8 mb-3\">\n<li id=\"user-content-fn-1\" class=\"whitespace-normal break-words pl-2\">\n<p class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"><a href=\"https:\/\/www.aad.org\/member\/practice\/coding\">American Academy of Dermatology. (2024). <em data-start=\"284\" data-end=\"329\">Coding for procedure complexity guidelines<\/em><\/a><a href=\"https:\/\/www.aad.org\/practice-center\/coding\"><em data-start=\"284\" data-end=\"329\">.<\/em><\/a><\/p>\n<\/li>\n<\/ul>\n<\/section>\n","protected":false},"excerpt":{"rendered":"<p>Yes\u2014fee schedule gaps are costing California dermatology practices $50,000\u2013$120,000 monthly when contracted rates show only base payments while payers actually maintain hidden complexity tiers paying 40\u2013180% higher. The gap appears when you bill destruction at $420 (base rate) while performing moderate-complex sessions eligible for $640\u2013$840, code all biopsies as shave ($140) when punch\/excisional pay $180\u2013$280, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":28840,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[174],"tags":[1312,5967,5966,5971],"class_list":["post-28839","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-dermatology-billing-services","tag-dermatology-billing-services","tag-dermatology-billing-services-in-california","tag-medical-billing-services-in-california","tag-specialized-dermatology-billing-services-in-california"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Fee Schedule Gaps Costing California Dermatology $50K Monthly<\/title>\n<meta name=\"description\" content=\"Find out how fee schedule gaps affect your bottom line in California dermatology. 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