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Pectus Brace Billing Information

How much will each visit cost?


The estimate of prices and traditional charges for professional service are listed below. These prices are only valid for services through 6/30/2022. Every child is different and treatment plans may vary. In addition to each office visit or consultation, your child may also be evaluated by a physical or occupational therapist. The pricing list below does not provide an inclusive list of all services your child may need during their services for Pectus Brace. If you have questions regarding pricing, please call Financial Clearance at (816) 302-1650, option 4.

Procedure Code  Description of Treatment   Standard Price*   
99201-99205 New Patient Office Visit  $169.00 - $750.00
99211-99215 Established Patient Office Visit  $49.00 - $583.00
99241-99245 Office Consultation $118.00-$554.00
97161-97163 PT Eval $282.00 - $316.00
97165-97167 OT Eval $340.00
97760 Fit and Train $179.00

 

What happens after our consultation?


If your child has been identified as a pectus brace candidate, the clinical team will reach out to the Financial Clearance team to pursue a prior authorization and to determine if your insurance company will cover the brace.

How long should the prior authorization process take?


It can take up top 30 days to get the prior authorization approval. Once a determination has been made, a Financial Clearance Specialist will reach out to you. If you have not heard from a member of the Financial Clearance team 30-45 days after your consultation, please reach out to Financial Clearance at (816) 302-1650, option 4 for an update. Please note, if you have any concerns related to benefits or timeline concerns with your plan, please alert the clinic team and/or the Financial Clearance team immediately.

Important note: The brace is not billed at the time of the ordering of the brace. The brace is billed at the completion of the follow-up appointment for the fitting. Because it can take up to 8 weeks for the brace to arrive, the estimated patient balance that is provided by Financial Clearance prior to the brace being ordered may change based on where you are at in your benefit year. Please make sure you communicate to
the clinical team If you have any timeline concerns and how the approximate brace fitting appointment date may negatively affect your cost deductible/coinsurance amount. Examples: New insurance, deductible starting over for a new calendar year, employer changing, etc.

How much does a Pectus Brace cost?


Listed below is the average price for the Pectus Brace. These prices are only an estimate as every patient is different and requires a unique treatment plan. Price below is valid through 06/30/2022.

Procedure Code Description of Treatment Standard Price*
L1499 Pectus Brace $4,125.00


Financial assistance


These services may be eligible for Financial Assistance. Please call a Financial Counselor to see if you qualify at (816)234-3567 or go to our Financial Counseling page.