Paying for Physician services

Subject: Healthcare

Mr. Smith is a 68-year-old Medicare beneficiary. He sought treatments from Dr. Johnson. Assume the following values for the services provided by Dr. Johnson:

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

How much will Medicare pay Dr. Johnson if Dr. Johnson is a Medicare participating physician? How much out-of-pocket payment will Mr. Smith be responsible for?
How much will Medicare pay Dr. Johnson if Dr. Johnson is a Medicare non-participating physician who elects assignment? How much out-of-pocket payment will Mr. Smith be responsible for?
How much will Medicare pay Dr. Johnson if Dr. Johnson is a Medicare non-participating physician who does not elect assignment? How much out-of-pocket payment will Mr. Smith be responsible for?
Categories

RVU 27.45 43.05 10.32

Geographic Cost Index 1.092 1.743 0.543

Product 29.98 75.04 5.60

Categories RVU Geographic C I 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
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