Managing prior approval for site-of-service referrals: an algorithmic approach

Table 2 Procedure codes with savings per episode of care exceeding $50,000

Procedure Code	Payment in HOPD ($)	Fee in Alternate Location ($)	EOCs per HOPD	Aggregate Savings ($)
58,558	425,786	220,978	204	204,808
20,680	306,058	126,353	90	179,705
49,650	245,954	108,930	57	137,024
29,881	174,563	81,137	66	93,426
49,505	182,003	100,772	47	81,232
45,385	191,937	112,086	137	79,851
29,888	212,960	133,367	41	79,593
57,522	141,604	70,871	86	70,733
49,585	118,102	50,764	36	67,338
43,235	116,914	51,122	114	65,792
19,120	115,428	58,517	49	56,912
29,827	139,199	84,874	37	54,325
29,880	91,161	37,178	29	53,983
67,113	104,213	51,201	30	53,012
42,420	57,863	5,684	5	52,179
52,356	148,502	96,545	52	51,957
20,610	57,065	5,600	102	51,466

ISSN: 1472-6963