A fee may be considered excessive if a person knowledgeable of current fee structures has a firm and definite conviction that a fee is too much after review of all the factors in a particular case.
Factors that may impact a physician's fee:
(1) difficulty and/or uniqueness of the services performed
(2) time, skill, experience required for a procedure
(3) experience, reputation and ability of the physician
(4) customary fee for the service in the region
(5) quality of the service
where:
• I am tempted to add riskiness of procedure to cover the liability risk.
Practices considered illegal:
(1) double billings
(2) residual billing when inappropriate by prior agreement
(3) billing for services not performed
(4) billing for material cost in excess of those used
