go to google search engine type highmark medicare select either part a for facilities or part b for physicians and their website will give you a link to the 2011 fee schedule.
Yes
Medicare covers 80% of what they feel the service should cost. If your doctor accepts Medicare, he is aware of Medicare's policies and what his reimbursement will be. You will be responsible for 20% of what Medicare did not cover.
"Medicare Allowable" charges: Providers who participate with Medicare agree to accept the Medicare allowable charge as full payment. Bear in mind that because Medicare is an 80/20 plan, the patient is still responsible for the 20 percent of the allowable charges not paid by Medicare. * For example: You have chemotherapy in your physician's office and Medicare is billed $500.00 for the service. The Medicare allowable or assignment for your chemotherapy treatment is $300.00. Your physician is paid 80 percent of $300.00 or $240.00. You are responsible for only the $60.00 not paid by Medicare but considered allowable under Medicare UCR fee schedule. This is because participating Medicare providers may not bill the patient for the balance amounts above the Medicare allowable fee schedule (known as "balance billing"). It is important to verify that your provider "Accepts Medicare Assignment" or is a "Medicare Provider" to avoid unexpected and potentially large out-of-pocket expenses.
97140 Medicare pays $25.55 per unit per MC fee schedule 2008
global
MPFS payment is determined by the fee associated with a specific Current Procedural Terminology (CPT) code and is adjusted by geographic location. This fee schedule is updated annually by the Centers for Medicare and Medicaid Services (CMS) with new rates going into effect January 1 of each year.
97140 Medicare pays $25.55 per unit per MC fee schedule 2008
Most physicians and clinics accept Medicare patients, and will continue to do so. The fee schedule (amount doctors get paid) surrounding visits has been tweaked, so that doctors are not making as much money as they were a few years ago for the same visit or procedure. A lot of physicians could help themselves by having a certified biller in their office that would immediately look for ways to bill so that the physician does not loose money.... but in the end most doctors settle for someone who has less training... because expert billers require a larger pay! Some doctors that I know... and I won't mention any names..... do not have a function in place to bill the 20% that Medicare doesn't pay. This adds up to a huge loss in revenue. I believe that most physicians and clinics will add more patients onto their practice rather than not accept any more Medicare patients. Of course, this adds to the time you will wait to see the doctor, and he will spend less time with you.
Medicare Fee Schedule (MFS)
There are basically four ways that fees are collected for service in the healthcare industry. Fee for service is when physicians are paid for every single service and/or test they give based on the fees of other physicians charge in their local area. There is also the Discount fee for service in which physicians are paid for every test or service they provide based on a fee schedule or a pre-set discount off the usual price of doctor's in that area. Capitation is also a way to be paid per enrollee, not per service, and salary is when the doctors are paid on a weekly or monthly and not based on services or enrollees.
There are basically four ways that fees are collected for service in the healthcare industry. Fee for service is when physicians are paid for every single service and/or test they give based on the fees of other physicians charge in their local area. There is also the Discount fee for service in which physicians are paid for every test or service they provide based on a fee schedule or a pre-set discount off the usual price of doctor's in that area. Capitation is also a way to be paid per enrollee, not per service, and salary is when the doctors are paid on a weekly or monthly and not based on services or enrollees.