How Medicare's fee schedule shapes what practices get paid

When practice administrators talk about physician reimbursement, they often focus on what insurers pay without understanding the formula driving those numbers. The first episode of The Back Office, a new Physicians Practice video series, breaks down the mechanics behind Medicare’s fee schedule and what it means for practices trying to set competitive charges.

Lucien W. Roberts III, MHA, FACMPE, the show’s host and a longtime practice administrator, is joined in the debut episode by Bert Wilson, CMPA, who spent years on the payer side before transitioning to practice management. Together, they walk through how charges, allowables and reimbursement actually interact, and why the difference matters even when an insurer is footing most of the bill.

The Back Office is a monthly video series and podcast from Physicians Practice where host Lucien W. Roberts III, MHA, FACMPE, sits down with industry experts to dig into the real challenges of running a physician practice. Each episode covers a different facet of practice management, from revenue cycle to staffing to payer contracting, with the kind of candid, experience-driven conversation you would expect from colleagues who have seen it all.

Roberts brings decades of hands-on practice management experience and a network of industry contacts that opens doors to guests with genuine, real-world expertise. His easy, conversational style puts guests at ease and keeps complex topics accessible without talking down to the administrators who live with these issues every day.

New episodes of The Back Office drop monthly on Physicians Practice, YouTube and wherever you get your podcasts.