What does the medical abbreviation UCR mean?

Answer 1

Usual, customary, and reasonable.
Usual, Customary & Reasonable The fee that an insurance company establishes as a standard fee for a procedure. Check your insurance plan -- your insurance company will pay up to this amount for a particular procedure.
It can mean different things in medical terminology and, typically, the context is needed to be sure that the acronym is correctly decoded in the situation at hand. Since this question was placed in the medical billing and coding category, I'd suggest that you are looking for UCR meaning "Usual, Customary and Reasonable". This is a term from the health insurance industry that is used to explain how the insurer payment amount was determined that was given to a provider for fee-for-service claim billings.

The US insurance industry organization shares information among the carriers about the typical (usual, customary and reasonable) charges, payments, and final amounts providers accepted for their services, from reports of all claims paid nationally by member insurance companies. This is a huge amount of data that is then crunched to come up with the UCR for each particular service. Most insurer contracts with providers will specify UCR as the method of determining reimbursement amounts for many services, unless flat fees, capitation or other specified reimbursement methods or systems are negotiated. These UCR amounts for each provider service code (ICD-9-CM, CPT, HCPCS, etc.) are annually adjusted, based on the data of the prior year, and distributed among the insurers for use in renegotiating contracts with providers. The complex computations of the UCR in each contracting situation can, however, vary from insurer to insurer and contract to contract.

Other meanings of UCR you may be looking for might be:

Uniform Case Record (used in the medical information management fields to define documentation requirements, etc.)

Unit Carcinogenic Risk (probability, per dose unit of a chemical or compound, for producing cancer).