Instructions: Complete the following (fill in the blank). Calculating Medicare Payments, Write-Offs, Limiting Charges, and Allowed Amounts: Calculate the following amounts for a participating provider who bills Medicare:
Submitted charge (based on provider's regular fee for office visit) $ 75
Medicare physician fee schedule (MPFS) $ 60
Coinsurance amount (paid by patient or supplemental insurance) $ 12
Medicare payment (80 percent of the MPFS amount) $
Medicare write-off (not to be paid by Medicare or the beneficiary) $
Calculating Medicare Payments, Write-Offs, Limiting Charges, and Allowed Amounts: Calculate the following amounts for a nonPAR who bills Medicare and does not accept assignment:
Submitted charge (based on provider's regular fee) $650
NonPAR Medicare physician fee schedule limiting charge amount $450
Medicare payment (80 percent of the MPFS limiting charge amount) $
Beneficiary is billed the balance of the limiting charge $175.50
Write-off (not to be paid by Medicare or the beneficiary) $
Calculating Medicare Payments, Write-Offs, Limiting Charges, and Allowed Amounts: Calculate the following amounts for a nonphysician practitioner who bills Medicare:
Submitted charge (based on provider's regular fee for office visit) $ 75
Medicare allowed amount (according to the Medicare physician fee schedule) $ 60
Nonphysician practitioner allowed amount (100 percent of MPFS) $
Medicare payment (80 percent of the allowed amount) $