If the standard fee for a Medicare covered service is $150 and the Medicare non-PAR fee schedule for the service is $80, what is the limiting charge for the services?

Question

Quizplus · Accepted Answer

The limiting charge for non-participating providers (non-PAR) who do not accept Medicare assignment is 115% of the Medicare non-PAR fee schedule. Therefore, the limiting charge is 115% of $80, which equals $92.

If the Standard Fee for a Medicare Covered Service Is