Question
Calculate the following amounts for a nurse practitioner who bills Medicare as incident to a supervising physician (billed under the physician's NPI). Submitted charge$75 Medicare
Calculate the following amounts for a nurse practitioner who bills Medicare as incident to a supervising physician (billed under the physician's NPI).
Submitted charge$75
Medicare allowed amount (MPFS)$60
Nurse practitioner allowed amount (100% of MPFS)$
Medicare payment (80 percent of the allowed amount)$
Coinsurance amount (20% allowed amount)$
Provider write-off$
Scenario 2
Calculate the following amounts for a nurse practitioner who bills Medicare under their own NPI.
Submitted charge$75
Medicare allowed amount (MPFS)$60
Nurse practitioner allowed amount$
(80% of office charge or 85% of MPFS whichever is lower)
Medicare payment (80% of the allowed amount)$
Coinsurance amount$
Provider write-off$
Step by Step Solution
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