Medicare reimburses health care providers in the USA for services they provide to beneficiaries and Medicare refers to this reimbursement as the Medicare Physician Fee Schedule (MPFS). Medicare’s official website reveals that rates for health care providers vary, with clinical nurse specialists receiving 85 percent reimbursement for most services and clinical social workers receiving 75 percent. “The rate at which Medicare reimburses health care providers is generally less than the amount billed or the amount that a private insurance company might pay,” reads the website.
The Centers for Medicare & Medicaid Services (CMS) estimates that Medicare reimburses around 80 percent of total costs.
In 2023, the federal government is not expected to raise Medicare reimbursements despite objections from several physician groups
Download the 2018 Alpha-Numeric HCPCS File from the CMS website to see current Medicare reimbursement rates.
On the Medicare website, you can access the searchable Medicare Physician Fee Schedule (MPFS) as well as the HCPCS code of the service being reimbursed.
