A non-participating physician provides services to a


Question: A non-participating physician provides services to a Medicare patient who has total charges of $100 (before Medicare's limiting charge is applied). The physician does not accept assignment, charges the maximum allowable, and submits the claim to Medicare. Assume Medicare's approved schedule for these services is $80.

A. What is the Medicare portion of the physician payment (that Medicare sends to the patient)?

B. What is the patient's portion of the payment to the physician (net of the reimbursement from Medicare in the information above?

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