Excess charge

An excess charge refers to the additional amount that a healthcare provider may bill a patient beyond the Medicare-approved reimbursement rate for a covered service. This charge can occur when a provider does not accept assignment for Medicare patients, allowing them to bill up to 15% more than the Medicare-approved amount. Excess charges can result in higher out-of-pocket costs for Medicare beneficiaries who receive services from providers that do not accept assignment. It’s essential for Medicare beneficiaries to inquire about excess charges before receiving care to understand potential additional costs and explore options for minimizing expenses.