We have seen UR fees run anywhere from $98 to upwards of $9,500 per treatment.
- Routine treatment such as PT, diagnostics and consults are usually approved with an average UR fee up to $500 per review.
- The UR cost drivers are surgeries and opioids/narcotics - whether approved, modified or denied.
- We recently saw a TPA charge $9,500 in UR fees for a request for spine surgery because of the unbundling of the Utilization Review and fees.