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In general, when a nonphysician provider treats a Medicare patient independently (not incident to), how is the MPFS amount adjusted?

a) Increased
b) Decreased
c) No adjustment
d) Fixed

User Bheeshmar
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1 Answer

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Final answer:

When nonphysician providers treat Medicare patients independently, the MPFS amount is decreased to 85% of the fee schedule amount. This decrease reflects differences in qualifications and costs associated with nonphysician providers.

Step-by-step explanation:

In general, when a nonphysician provider treats a Medicare patient independently, meaning the services are not billed as 'incident to' the services of a physician, the Medicare Physician Fee Schedule (MPFS) amount is typically adjusted by being decreased. Specifically, Medicare pays 85% of the fee schedule amount for services rendered by nonphysician providers such as nurse practitioners, clinical nurse specialists, physician assistants, certified registered nurse anesthetists, and clinical psychologists. This adjustment reflects the differences in provider qualifications and recognizes the lower costs associated with nonphysician providers.

User Gilad Foyer
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