Private Fee-For-Service Plan (PFFS)
A private fee-for-service (PFFS) plan is a type of Medicare Advantage plan in which enrollees may use any Medicare-approved provider that accepts the plan's payment terms. The plan, rather than CMS, sets payment amounts and enrollee cost-sharing.
Definition
A private fee-for-service (PFFS) plan is a type of Medicare Advantage plan in which enrollees may use any Medicare-approved provider that accepts the plan's payment terms. The plan, rather than CMS, sets payment amounts and enrollee cost-sharing.
Why it matters
Because providers must agree to the plan's terms at the time of service, agencies should confirm PFFS payment acceptance before delivering care.
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