Registered Health Information Administrator (RHIA) — Question 84
If the physician’s standard fee for a service is $210.00 and the Medicare PAR fee is $115.00, what is the limiting charge for a nonparticipating (nonPAR) provider?
Answer options
- A. $241.50
- B. $109.25
- C. $132.25
- D. $125.63
Correct answer: D
Explanation
The limiting charge for a nonparticipating provider is set at 115% of the Medicare PAR fee. In this case, 115% of $115.00 equals $132.25, which is the maximum they can charge, but they cannot exceed the physician's standard fee. Thus, the limiting charge is $125.63, which is the correct choice D. Options A, B, and C do not reflect the correct calculation for the limiting charge.