Paying for Physician Services – Overview
Mr. Roberts is a 66-year-old Medicare beneficiary. He sought treatments from Dr. Robinson. Assume the following values for the services provided by Dr. Robinson:
Categories RVU Geographic Cost Index Product
Work 27.45 1.092 29.98
Practice Expense 43.05 1.743 75.04
Malpractice 10.32 0.543 5.60
Conversion Factor: 64.43
Part II – Assignment
Please answer in about 3 pages the following questions:
- How much will Medicare pay Dr. Robinson if Dr. Robinson is a Medicare participating physician? How much out-of-pocket payment will Mr. Roberts be responsible for?
- How much will Medicare pay Dr. Robinson if Dr. Robinson is a Medicare non-participating physician who elects assignment? How much out-of-pocket payment will Mr. Roberts be responsible for?
- How much will Medicare pay Dr. Robinson if Dr. Robinson is a Medicare non-participating physician who does not elect assignment? How much out-of-pocket payment will Mr. Roberts be responsible for?
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