This equation determines how patient responsibility is calculated from an explanation of benefits (EOB)

Charged amount - Payment amount - Adjustment amount = Patient responsibility

MPFS is the abbreviation for the

Medicare Physician Fee Schedule.

RBRVS is the abbreviation for

Resource-based relative value scale.

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Billing and coding

ABN Modifiers

Question	Answer
Provider believes a service will be denied as not medically necessary but does not have an ABN due to circumstances.	Modifier GZ
Waiver of liability statement issued as required by payer policy, mandatory ABN was issued for a service.	Modifier GA
Provider considers the service excluded and did not complete an ABN because none was required.	Modifier GY
“Notice of liability issued, voluntary under payer policy”	Modifier GX
This equation determines how patient responsibility is calculated from an explanation of benefits (EOB)	Charged amount - Payment amount - Adjustment amount = Patient responsibility
Another term for contractual adjustment	Write off
MPFS is the abbreviation for the	Medicare Physician Fee Schedule.
The Medicare Physician Fee Schedule is based on	RBRVS fees.
RBRVS is the abbreviation for	Resource-based relative value scale.
GPCI is the abbreviation for	Geographic practice cost index

Created by: InstructorWatson

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