Originally Posted by Exam grader
If doctors are reimbursed on "80% of UCR" basis, does this mean that first the fee is compared to UCR and if higher than it is reduced to the UCR, AND THEN multiplied by 80%? Or, does it mean that the fee is multiplied by 80%, and then if that's still geater than UCR then we reduce it to UCR?
the fee itself is U (usual)
The doctor gets reimbursed the lowest of U, C(ustomary) and R(easonable) for 100% UCR.
Thus the lowest of UCR is determined first and then, for 80% of UCR, the reimbursement would be 80% of that amount.