How Much Does Medicare Pay Doctors?

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   Ted Ratliff

   Owner, SFS Associates,

   It depends upon the procedure.  Medicare has a list of codes that they use to determine the payment to doctors.  The best way to find out how uch a doctor is paid is to look at the explanation of benefits that Medicare provides.  This will list the actual charge, the medicare approved amount, and the amount owed by the beneficiary.  Medicare pays a doctor 80% of the approved amount.  For example if your doctor charges $125 for an office visit, Medicare may approve $100.  They would pay $80 and you would be responsible for the other $20.  In most States doctors may charge up to 15% over the Medicare approved amount.  Some States like Ohio, do not allow this excess charge.

   Answered on October 9, 2013

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