Questions: Insurance Plan: Mountville Health Plan; patient has met annual deductible of Services: CPT 99203, 90700 Payer Reimbursement: Patient Charge:

To determine the payer reimbursement and patient charge for the services provided under the Mountville Health Plan, we need to consider the following:

1. CPT Codes:

   • 99203: This is a code for an office or other outpatient visit for the evaluation and management of a new patient. The specifics of reimbursement for this code depend on the insurance plan's fee schedule.
   • 90700: This code is for the DTaP vaccine (Diphtheria, Tetanus, and Pertussis). Again, reimbursement will depend on the insurance plan's fee schedule.

2. Annual Deductible: The patient has met their annual deductible, which means that the insurance plan should cover the services according to its terms without requiring the patient to pay out-of-pocket for the deductible.

3. Payer Reimbursement and Patient Charge:

   • Payer Reimbursement: This is the amount the insurance company will pay for the services. It is typically determined by the insurance plan's fee schedule for the specific CPT codes.
   • Patient Charge: Since the deductible has been met, the patient charge will generally be limited to any applicable co-payments or co-insurance as specified by the insurance plan.

To provide specific numbers for the payer reimbursement and patient charge, we would need access to the Mountville Health Plan's fee schedule and details on co-payments or co-insurance. Without this information, we can only outline the process as described above.

In summary, the insurance plan will cover the services according to its fee schedule, and the patient will be responsible for any co-payments or co-insurance, as the deductible has already been met.