What are Medicare Excess charges?

A: If you go to a non-participating provider who doesn’t accept assignment for Medicare covered
services, they can charge you more than the Medicare-approved amount, but there’s a
limit called “the limiting charge” or “excess charge.” The provider can only charge you up to 15
percent over the amount that non-participating providers are paid. Non-participating providers
are paid 95 percent of the fee schedule amount. The excess charge applies only to certain
Medicare-covered services and doesn’t apply to some supplies and durable medical equipment.
Non-participating providers who charge excess charges are relatively rare, but it is still worth
checking whether your healthcare provider accepts assignment or participates in Medicare.
You can do this by visiting www.medicare.gov/physician.

Note: / If this is the case, it makes sense to visit the www.medicare.gov website.