MSP Calculator

Published 04/06/2023

The Medicare Secondary Payer tool can be used to determine the claim payment calculations when Medicare is the secondary payer for services. The calculations are done by detail line item. If the calculation does not provide a paid amount, it is because the provider has contracted with the primary insurance company and is obligated to accept their allowed amount for the service.

The calculated amount may not be exact due to rounding.

MSP Calculator

* OTAF stands for Obligated to Accept as payment in Full. The OTAF amount is equal to the amount of primary payer's payment plus any patient responsibility.

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