County-Based Rate Cards
How to configure billing rates that vary by patient county
Some payors (like Ohio DoDD) have billing rates that depend on the patient's county of residence. Cadence supports this with county-based rate cards — an opt-in feature you configure per binder.
How It Works
- An admin enables county-based rates on a binder and enters rates per billing code and county
- When adding a patient to that binder, a County dropdown appears
- The patient info panel shows the resolved rate next to each billing code (e.g., "APC - $7.51")
- Billing codes become a dropdown (instead of free text) limited to the codes in the rate card
Setting Up a Rate Card
- Go to /binders and click the edit icon on the binder
- Scroll to County-Based Rates at the bottom
- Check "Enable county-based billing rates"
- Add each billing code (e.g., APC, FPC, AOC, FOC) and enter the rate per county
- Click "Save Changes"
Only counties the agency serves are shown (currently Summit and Cuyahoga). Rates are stored as dollar amounts per unit.
Adding a Patient with County Rates
When a binder has county-based rates enabled, the Add Patient form changes:
- A County dropdown appears in the Basic Information section (required)
- The Billing Code field on schedules becomes a dropdown with only the codes from the rate card
Select the patient's county and choose their billing code. The rate is automatically determined from the rate card.
County is required for binders with rate cards. You cannot save a patient without selecting a county.
Viewing Rates
On the patient's calendar page, the patient info panel shows:
- The patient's County field
- Each billing code with its rate (e.g., "APC - $7.51")
This gives billers immediate visibility into what rate to enter in the payor portal.
Editing Rates
To update rates, edit the binder and modify the values in the rate card. Changes apply to all patients in the binder — rates are looked up from the binder configuration, not stored on individual patients.
If a new billing code needs to be added, use the Add Code button in the rate card editor. If a code is no longer needed, click the trash icon to remove it.
Which Binders Need This?
Most binders do not need county-based rates. This feature is only for payors where the reimbursement rate varies by the patient's county. If a binder's rates are the same regardless of county, leave this feature disabled.
For more on binder configuration, see: Managing Binders (Payors)