Wednesday, May 19, 2010

Medicare part A service

Part A (Hospital Insurance)

Helps Pay For:


Care in hospitals as an inpatient, critical access hospitals (small facilities that give limited outpatient and inpatient services to people in rural areas), skilled nursing facilities (not custodial or long-term care), hospice care, and some home health care. Information about your coverage under Medicare Part A can be found in the Your Medicare Coverage database.

If you aren’t sure if you have Part A, look on your red, white, and blue Medicare card. If you have Part A, “HOSPITAL (PART A)” is printed on your card.


Cost:

Most people get Part A automatically when they turn age 65. They don't have to pay a monthly payment called a premium for Part A because they or a spouse paid Medicare taxes while they were working.

If you don’t automatically get premium-free Part A, you may be able to buy it if


  • You (or your spouse) aren’t entitled to Social Security because you didn’t work or didn’t pay enough Medicare taxes while you worked and you are age 65 or older, or
  • You are disabled but no longer get premium-free Part A because you returned to work.
  • If you have limited income and resources, your state may help you pay for Part A and/or Part B.
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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download