Insurance and billing
UCR fee
Also called usual customary and reasonable, reasonable and customary
A benchmark fee level that some plans use to decide what they will pay, based on typical fees in an area.
UCR stands for usual, customary and reasonable. Some insurers decide how much to pay by comparing an office's fee with what is typical for the area. If the office charges more than the plan's benchmark, the plan pays based on the lower amount, and an out-of-network office can usually bill the patient the difference. How each plan sets its level varies and is often not published.
Example at the front desk
The plan pays on its customary fee level, so the patient owes the gap above it.