Private Fee-for-Service (PFFS) plans are one of four main types of Medicare Advantage policies that private insurance companies administer. The plans have specific rules relating to costs paid to ...

A Medicare Private-Fee-for Service Plan (PFS) is a plan purchased from a private insurance company. An individual who purchases a PFS Plan is still within the Medicare Program and will receive all of ...

Medicare primarily operates a fee-for-service (FFS) payment system. This means that healthcare professionals and facilities bill Medicare for each service they provide, with itemized costs appearing ...

With new prior authorization rules for Original Medicare and a lower OOP max for MA plans, the choice is tougher in 2026.

This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for ...

As enrollment in Medicare Advantage (MA) has grown, critics have been pointing to studies showing the government overpays for these private offerings relative to traditional fee-for-service (FFS).

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The Medicare Physician Fee Schedule (MPFS) is the system through which the Centers for Medicare & Medicaid Services determines payment rates for services provided by physicians and other healthcare ...

A CMS pilot program will require providers in six states to submit select Medicare services for AI-enabled prior authorization or post-service medical review.

How surgeons are paid may meaningfully influence how often patients receive low-value outpatient surgery, with fee-for-service environments linked to higher rates of potentially unnecessary procedures ...