Question: Why is my bill for an outpatient service now more than I paid before?
Answer: Before the outpatient prospective payment system was used, you paid 20%
of the amount your hospital charged for the service. People with Medicare who
got the same service at different hospitals paid different amounts because
hospitals charged different amounts for the same service.
Now, Medicare sets the amount you will pay for outpatient services. Medicare decides this amount by looking at how much all hospitals across the country have charged for a service (national median charge). You pay a percentage of this amount adjusted for wages in your area. This change means that people with Medicare will pay similar amounts for the same service no matter which hospital they go to.
If the amount you pay for your service is higher than in the past, your hospital may have charged less for this service than other hospitals in the country.
