Mr. Johnson came to the office today complaining of headache and upset stomach. He has the traditional Medicare fee-for-service plan. Your office's usual fee for an established patient visit is $125. Medicare's allowable charge is $100. If Mr. Johnson does not have Medigap insurance, how much will he have to pay for this visit?

Question

Quizplus · Accepted Answer

Under traditional Medicare fee-for-service, Medicare typically covers 80% of the allowable charge, leaving the patient responsible for the remaining 20%. In this case, with an allowable charge of $100, Mr. Johnson would be responsible for 20% of that amount, which is $20. The difference between the office's usual fee and Medicare's allowable charge does not affect the patient's cost in this scenario.

Mr Johnson Came to the Office Today Complaining of Headache