AAPC CPB - Chapter 11 Review | Questions
and Verified Solutions Latest Update 2024
Medicare's payment amount for services are determined by which of the following formulas?
a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment
b. Total RVU X Conversion factor = Medicare payment
c. Total Practice Expense (PE) X Conversion factor = Medicare payment
d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - Answer - b. Total RVU
X Conversion factor = Medicare payment
The total RVU is composed of which of the following components:
a. Conversion factor (CF), practice expense (PE), and malpractice insurance (MP)
b. Physician work, practice expense (PE), and malpractice insurance (MP)
c. Sustainable growth rate (SGR), conversion factor (CF), and malpractice insurance (MP)
d. Sustainable growth rate (SGR), practice expense (PE), and physician work. - Answer - b. Physician work,
practice expense (PE), and malpractice insurance (MP)
Response Feedback:
Total RVU is based on three components of physician services: physician work, practice expense (PE) and
malpractice insurance (MP).
Medicare Supplement Insurance policies or Medigap is sold by:
a. Medicare
b. Medicaid
, c. Private insurance companies
d. Healthcare providers - Answer - c. Private insurance companies
Medicare statutorily excluded services are:
a. Non-covered items and services
b. Not reimbursed by Medicare
c. Reimbursed on a case-by-case basis.
d. Both A & B - Answer - d. Both A & B
Response Feedback:
Non-covered items and services are statutorily excluded and are not reimbursed by Medicare. Examples
of statutorily excluded services are routine foot care, cosmetic surgery, and acupuncture.
Albert has purchased a Medigap policy to supplement his Medicare benefits. To which entity will Albert
pay his monthly premium for this policy?
a. Medicare
b. MAC
c. Medicaid
d. Medigap insurance company - Answer - d. Medigap insurance company
Response Feedback:
Premiums for Medigap policies are paid directly to the Medigap insurance company, not to CMS, MAC's
or Medicaid.
and Verified Solutions Latest Update 2024
Medicare's payment amount for services are determined by which of the following formulas?
a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment
b. Total RVU X Conversion factor = Medicare payment
c. Total Practice Expense (PE) X Conversion factor = Medicare payment
d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - Answer - b. Total RVU
X Conversion factor = Medicare payment
The total RVU is composed of which of the following components:
a. Conversion factor (CF), practice expense (PE), and malpractice insurance (MP)
b. Physician work, practice expense (PE), and malpractice insurance (MP)
c. Sustainable growth rate (SGR), conversion factor (CF), and malpractice insurance (MP)
d. Sustainable growth rate (SGR), practice expense (PE), and physician work. - Answer - b. Physician work,
practice expense (PE), and malpractice insurance (MP)
Response Feedback:
Total RVU is based on three components of physician services: physician work, practice expense (PE) and
malpractice insurance (MP).
Medicare Supplement Insurance policies or Medigap is sold by:
a. Medicare
b. Medicaid
, c. Private insurance companies
d. Healthcare providers - Answer - c. Private insurance companies
Medicare statutorily excluded services are:
a. Non-covered items and services
b. Not reimbursed by Medicare
c. Reimbursed on a case-by-case basis.
d. Both A & B - Answer - d. Both A & B
Response Feedback:
Non-covered items and services are statutorily excluded and are not reimbursed by Medicare. Examples
of statutorily excluded services are routine foot care, cosmetic surgery, and acupuncture.
Albert has purchased a Medigap policy to supplement his Medicare benefits. To which entity will Albert
pay his monthly premium for this policy?
a. Medicare
b. MAC
c. Medicaid
d. Medigap insurance company - Answer - d. Medigap insurance company
Response Feedback:
Premiums for Medigap policies are paid directly to the Medigap insurance company, not to CMS, MAC's
or Medicaid.
