Medicare Set-Aside Allocations Cost

Typical range

Allocation fees depend on the number of injury-related conditions, the volume of medical and pharmacy records, whether a rated age is obtained, and whether submission support is requested. KW Life Care Planning provides a written fee schedule and a cost estimate before work begins.

What drives cost

• Number of accepted or claimed injury-related conditions to be allocated
• Volume of medical, pharmacy, and payment records to review
• Whether a rated age is obtained to adjust the projection period
• Whether the allocation uses the workers' compensation fee schedule, usual and customary pricing, or both
• Whether counsel requests submission support and response to review correspondence
• Coordination with an existing life care plan so the two documents reconcile

Billing structure

Medicare set-aside allocations are billed at an hourly rate for Medicare entitlement review, records review, allocation preparation, rated-age coordination, and submission support. Many allocations are completed within a fixed initial retainer because the scope is defined at engagement. The current rate schedule and retainer terms are provided on request and confirmed in a written engagement agreement.

Also for this service

• Medicare Set-Aside Allocations
• Engagement process for Medicare Set-Aside
• Typical timeline for Medicare Set-Aside