Table used by the Centers for Medicare and Medicaid Services (CMS) to update the annual physician fee schedule to set limits for payment. This index considers annual changes in the economy taking into account inflation, productivity, and changes in health care expense factors such as malpractice insurance, personnel salaries, rent, and other expenses.
Insurance Encyclopedia
Medicare fee schedule (MFS)
List of Medicare payment fees based on resource-based relative value scale (RBRVS) factors. These factors are based on the physician’s work, medical practice expense, and malpractice insurance costs. The fee schedule is based on relative value units (RVUs). A formula is used to obtain the RVU consisting of three components: relative value unit (RVU) for the service, a geographical adjustment factor (GAF), and a monetary conversion factor (CF). Synonymous with and also see resource-based relative value scale (RBRVS) . Also called Medicare physician’s fee schedule (MPFS) .
Medicare for USA
The United States Federal Government Plan for paying certain hospital and medical expenses for persons qualifying under the plan, usually those over 65. The hospital benefits are Part A and the medical expenses portion is Part B. Part A is compulsory social insurance; Part B is voluntary government subsidized, government operated insurance.
Medicare Handbook
Publication that is given to all Medicare beneficiaries when first enrolled in the program. It provides information about how to file an insurance claim and what type of care is covered under the program.
Medicare health plan
Medicare advantage plan (e.g., HMO, PPO, or private fee-for-service plan) or other plan such as a Medicare cost plan. Everyone who has Medicare Part A and Part B is eligible for a plan in their area, except those who have end-stage renal disease (unless certain exceptions apply).
Medicare identification card
Insurance card issued to the beneficiary of the Medicare government program (see Figure M-1 ). It includes the patient’s name, insurance claim number, type of hospital and medical coverage (Part A and/or B), and effective date. The insurance claim number is the Social Security number of the wage earner with an alpha suffix. Medicare health insurance identification card.
Medicare Integrity Program (MIP)
Plan that permits Medicare to contract with other entities to examine the activities of providers, audit cost reports, educate providers, and maintain a list of authorized durable medical equipment.
Medicare Intermediary Manual
See: Medicare Benefit Policy Manual (BP) .
Medicare managed care plan
Type of Medicare Advan- tage Plan that is available in some areas of the United States. In most of these plans, the member can only go to doctors, specialists, or hospitals on the plan’s list. Plans must cover all Medicare Part A and Part B health care. Costs to the member may be lower than in the Original Medicare Plan.
Medicare Medical Savings Account (MSA) Plan
Type of Medicare health plan that is made up of two parts. One part is a Medicare MSA health insurance policy with a high deductible, and the other part is a special savings account where Medicare deposits money to help the insured pay the medical bills.