What are the payment arrangements for Medicare PAR providers?

Medicare Participating Providers, commonly referred to as PAR providers, agree to accept Medicare’s approved payment rates, known as the Medicare Physician Fee Schedule (MPFS), as total payment for their services. This means that they cannot bill patients for amounts exceeding the MPFS rates. By accepting these established amounts, PAR providers benefit from higher patient volumes, as beneficiaries have financial incentives to seek care from participating providers due to lower out-of-pocket costs.

This agreement helps streamline billing and reimbursement processes, ensuring that patients are not faced with unexpected balance billing on top of their standard coinsurance and deductibles. Thus, the choice highlighting that PAR providers must accept the MPFS amounts as total payment reflects the nature of their participation agreement with Medicare and emphasizes the commitment to maintain affordability for beneficiaries.