If a physician's standard fee is $120.00 and the PAR fee is $60.00, how much will the physician be reimbursed by Medicare after the patient’s deductible is met?

To determine the amount that Medicare will reimburse the physician, it is important to consider the physician's participating agreement and Medicare's reimbursement policies.

In this scenario, the physician's standard fee is $120.00, but as a participating physician, the physician has accepted the Medicare-approved rate, known as the PAR (Participating Physician Fee Schedule) fee, which is $60.00. Under Medicare's payment policy, for participating physicians, the reimbursement amount is usually a percentage of the PAR fee after the patient has met their deductible.

For outpatient services covered by Medicare, the reimbursement rate typically is around 80% of the approved amount after the deductible is met. Therefore, if the PAR fee is $60.00, 80% of that would be calculated as follows:

[

60.00 \times 0.80 = 48.00

]

Thus, the physician will be reimbursed $48.00 by Medicare after the patient's deductible is met, which aligns with the correct choice.

The other options do not take into account the percentage of the PAR fee that Medicare typically reimburses, leading to incorrect values. Understanding the distinction between the physician's standard fee and their accepted fees as a participating physician is crucial in navigating Medicare