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Variation in Patient Charges for Vaccines and Well-Child Care

Spencer J. Brody, MD
Arch Pediatr Adolesc Med. 1996;150(11):1221. doi:10.1001/archpedi.1996.02170360111026.
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The current article by Freed et al in the April 1996 issue of the Archives1 serves to emphasize the standard pediatric practice of undercharging for our services. Well-child visit charges (excluding immunization charges) by pediatricians ranged from an average of $49.94 in Massachusetts down to $38.14 in North Carolina.

On December 8, 1995, relative value units (RVUs) were published in the Federal Register2 for preventive health visits. For established patients, the total RVUs for infants from birth to age 1 year are 2.15 and from ages 1 through 4 and from ages 5 through 11 years are 2.5. For comparison, the total RVU for the most commonly used illness code, 99213 (office visit, expanded problem, established patient), is only 0.96. Assuming a charge of $36 for a code 99213 office call (probably well below the national average), 1 RVU would be valued at $37.50, and therefore the charge


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