Ari Lamstein profile image 76

Why are Medicare and Medicaid reimbursement rates so low?

A doctor friend of mine recently told me that when he bills a private insurer for a procedure, he normally gets between 40% and 90% of the cost reimbursed. But when he bills medicare he gets 20% of the billed amount, and when he bills medicaid he gets about 10% of the billed amount back. So my question is: why do Medicare and Medicaid reimburse at such low rates?

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LandmarkWealth profile image87

Best Answer LandmarkWealth says

4 years ago
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  • Ari Lamstein profile image

    Ari Lamstein 4 years ago

    This is a good answer, and in line with what I've read elsewhere. Someone else pointed to Lasik and cosmetic surgery as a model for the whole industry. Insurance won't cover those procedures, and costs have gone down.

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