Froedtert Health OCRICC is responsible for providing pricing for any Froedtert Health affiliate service, space, or resource needed for research when the service is not billable (i.e. “research-only” or deemed not medically necessary). Follow the instruction below on how to obtain pricing for Froedtert Health services for financial feasibility, developing a study budget, or when submitting a grant award application.

Pricing Request Process

All Froedtert Health patient care services/resources will continue to be priced at the Medicare rate. Beginning July 1, 2019, research staff can look to the Froedtert Health Research Chargemaster for estimate pricing.

If the service is not listed there, research staff will need to request pricing for these services from Froedtert Health OCRICC using the Request for Froedtert Health Pricing Application.

  • For most efficient service, research staff should identify CPT codes for the services needing to be priced. If there is no CPT code, research staff should identify a CPT code for a comparable procedure, making note of this detail on the request form. If the correct CPT code or comparable CPT code/procedure is not known, research staff should ask the sponsor or PI. If the sponsor cannot provide, or PI does not know, the research team should contact their MCW Department resource that manages professional billing/coding
  • In FY20, for services without a Medicare rate, Froedtert Health OCRICC will work with the PI and the Froedtert Health clinical service line to identify a comparable service with a Medicare rate in order to provide pricing.

Upon receipt of your completed Request for Froedtert Health Pricing Application, an OCRICC Billing Specialist will be assigned and review the request. If the information provided is not sufficient, the Primary Contact listed on the application will be contacted to provide more information.

Research staff can expect that, if they provide CPT codes for each service when requesting pricing, OCRICC will be able to complete these requests within 5 business days. Researchers submitting pricing requests without corresponding CPT codes may experience a delayed turnaround.

When the OCRICC Billing Specialist provides the pricing, the study team will receive an OCRICC Project Number (for example, 19-0395). Research staff must retain this number and identify it on the Request for Froedtert Health OCRICC Administrative Approval Application when returning to request Froedtert Health administrative approval for the project.

When the research staff requests Froedtert Health administrative approval, they can expect that OCRICC will validate pricing, whether issued by OCRICC, or obtained by the research staff off the Froedtert Health Research Chargemaster. We do understand that there may be add-on pricing or services/items identified as not billable during the Medicare Coverage Analysis. For such instances, pricing will be provided at that time.

REMINDER — MCW Professional Services: Froedtert Health OCRICC does not provide pricing for professional services, such as the time/effort of the individual performing the professional service (example: the MRI radiologist read fee). Pricing for MCW Professional services needs to come from the respective MCW department(s).

More information about Froedtert Health OCRICC’s pricing request process is available in our Research Pricing Guidance document.

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