Dr. Melissa Rose is trying to decide whether to be a Medicare-participating physician for the upcoming year. Here are the assumptions shell use for the calculations if she is Medicare-participating physician: * Assume that her average charge is $120 (before Medicares limiting charge is applied), and the average Medicare-approved amount is $100. (notice these two amts are different) * Medicare covers 80% of the payment and the patients co-payment is 20% of the payment.

Here are the assumptions shell use for the calculations if she is non-participating physician: * Assume that shell accept assignment 80% of the time. * For the unassigned patients, assume that she would set her charges at 110 percent of the Medicare-approved fee for a nonparticipating physician. * Assume that her Medicare patient volume will not change if she chooses not to participate nor if he does not accept assignment.

Questions to respond to: 1. What will be Roses average reimbursement per visit if she chooses not to be a Medicare- participating physician? (Average reimbursement includes payment from both Medicare (80%) and patients co-payment (20%))

2. Based strictly on the information presented here should she choose to be participating or non- participating if she wishes to maximize her total reimbursement for services?