Medicarebob

If you are enrolled in Medicare, you may be familiar with Medicare Part B Excess Charges. Some doctors accept what is called the “assigned” rate for their work. Others charge a higher rate, but they cannot charge more than 15 percent more than the assigned rate. For example, Medicare might decide that the fair “assigned” rate for a specific procedure should be $400. A doctor who accepts the Medicare assignment would bill at or below that rate. However, your doctor may decide that $400 is not a sufficient reimbursement. Doctors are allowed to charge up to an additional 15% over and above what Medicare has approved. Therefore, in this case, your doctor could charge you $460 and you would be responsible for paying the additional $60 “excess” charge out-of-pocket ($400 X 15% = $60 excess charge) in addition to any deductible and co-pay.