When a participating physician accepts assignment, what is the patient's financial liability for a visit costing $200.00 under the PAR Medicare Fee Schedule?

When a participating physician accepts assignment under the Medicare Fee Schedule, they agree to accept the Medicare-approved amount as full payment for their services. For the scenario provided, where the visit costs $200.00, the physician must adhere to the fee schedule determined by Medicare.

Under Medicare, patients are typically responsible for certain costs that may include deductibles, copayments, or coinsurance. Depending on the specifics of the insurance plan and the Medicare structure in place, this often results in a set percentage of the Medicare-approved amount that the patient must pay.

In this case, the amount patients are liable for is calculated as a copayment. If the patient's financial liability is $40.00, this suggests that the approved Medicare rate for the service results in that copayment amount, which is typical for many outpatient physician services. Thus, if a patient is responsible for $40.00 after Medicare’s adjustments and payments, this reflects the standard patient cost-sharing responsibilities for a participating physician when assignment is accepted, confirming that the patient's portion of the financial liability for a $200.00 visit would indeed be $40.00.