If a provider's office fee is $100 and Medicare Part B allowed is $85, what amount should the patient be billed assuming the deductible has not been met?

In this scenario, understanding how charge amounts and allowed amounts work in conjunction with Medicare regulations is key. The provider’s office fee of $100 represents the amount that the provider charges for the service, while the Medicare Part B allowed amount of $85 reflects the maximum amount that Medicare agrees to pay for that specific service.

Since the deductible has not been met, the patient is responsible for the full amount of the allowed charge, which is $85. Therefore, the patient would be billed this amount, as it is what Medicare considers the reasonable charge for the service provided.

If the deductible had been met, the patient would not owe the full allowed amount and may only be responsible for a percentage of it, depending on the specifics of their coverage. However, in this case, since the deductible remains outstanding, the patient incurs the entire allowed amount of $85.