Based on the information provided for this Medicare PAR situation, what is the patient’s out-of-pocket responsibility for this service?

Question

a. $ 5.00
b. $20.00
c. $15.00 RATIONALE: $15.00 is the coinsurance amount, which is the only amount the patient is responsible for, since the physician is PAR and accepts assignment.

Standard fee: $80.00
Medicare Approved: $75.00
Medicare pays (80%): $60.00
Coinsurance (20%): $15.00

Answer 1

c. $15.00 RATIONALE: $15.00 is the coinsurance amount, which is the only amount the patient is responsible for, since the physician is PAR and accepts assignment.