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September 5, 2023

Medicare Part B Excess Charges refer to additional costs that some healthcare providers may charge for medical services. Specifically, excess charges are extra fees that can be up to 15% higher than the amount that Medicare typically allows [1][2].

Medicare Excess Charges

Medicare Part B Excess Charge is an additional fee that a healthcare provider may charge if they do not accept Medicare assignment.

These charges can occur when a healthcare provider does not accept Medicare assignment, which means they do not agree to accept the Medicare-approved amount as full payment for their services [2]. For example, if a healthcare provider bills Medicare $150 for a service that Medicare approves for only $100, they can charge the patient the remaining $50 as an excess charge if they do not accept Medicare assignment [3].

It is important to note that excess charges do not apply to all healthcare providers, and they may not happen frequently. As such, Medicare beneficiaries should confirm whether a provider has opted out of Medicare before seeking medical care or tests from them [1].

Sources:

  1. https://www.medicare.gov/coverage/what-are-part-b-excess-charges

  2. https://www.aarp.org/health/medicare-insurance/info-2021/what-are-excess-charges.html

  3. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/Downloads/Excess-Charge-QA.pdf

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