Fair Square Medicare Wordmark

What Are Medicare Part B Excess Charges?

Illustrated referential images of a hospital bill, coins, cash in a wallet, a calculator, and a magnifying glass
By Daniel Petkevich
Jan 6, 2023

Avoid excess charges and save money

In many instances, a doctor that accepts Medicare means that you won't have to worry about out-of-pocket costs. However, you might get nabbed with excess charges if your doctor accepts Medicare but doesn't accept assignment. What are excess charges? Let's find out.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Definition of Medicare Part B Excess Charges

Medicare Part B excess charges are fees a healthcare provider may charge beyond the Medicare-approved amount for a service or item. This additional fee is only applied to Medicare beneficiaries by outpatient providers who do not accept assignment.
Assignment means that the provider agrees to take the approved Medicare amount as payment in full for the item or service provided. But if your doctor doesn't accept assignment, they can charge you more than the Medicare-approved amount.
These extra charges will increase your out-of-pocket costs and can add up quickly if you receive multiple services from a provider who does not accept assignment.

How Do Healthcare Providers Apply Excess Charges to Medicare Beneficiaries?

When a provider applies excess charges to Medicare beneficiaries, they must provide a written notice informing you of their policy before providing services. This is called an Advance Beneficiary Notice (ABN), and it outlines the cost for the service or item that could be charged above the approved amount.
If you agree to receive the service with the additional charge, the provider must give you a copy of the ABN and have you sign it. The signature acknowledges that you understand what services will be provided and at what cost.
If you don't agree to pay for any excess charges, the provider cannot provide the service or item.

Tips for Finding Providers Who Accept Assignment and Avoiding Excess Charges

The best way to avoid excess charges is to find a healthcare provider who accepts assignment. Here are some tips to help you find one:
  • Check online directories of Medicare-approved providers, like Medicare's Physician Compare tool or your plan’s directory.
  • Ask your current doctor if they accept assignment and what fees they charge for services.
  • Find out if other healthcare providers in your area accept assignment and what fees they charge for services.
  • Ask your friends, family members or support network about their experiences with different healthcare providers in terms of accepting assignment and costs.
  • Check if the provider participates in Medicare's Shared Savings Program, which can help reduce costs for services.
It’s important to do your research and find a healthcare provider who accepts assignment whenever possible. This can help you avoid expensive excess charges and keep your out-of-pocket health care costs affordable.

Examples of Situations Where a Provider May Charge an Excess Fee Above the Medicare-Approved Amount

In most cases, providers who accept Medicare also accept assignment and charge the approved amount. However, there are some instances in which a provider may choose to charge an excess fee:
  • The service or item is not covered by Medicare.
  • The provider does not usually participate with Medicare but is willing to do so for the patient on a one-time basis.
  • The provider is not enrolled in Medicare but they are legally allowed to provide services to Medicare beneficiaries.
  • The service or item is provided multiple times within a certain period of time and Medicare does not reimburse providers at the same rate for every instance.
  • The provider is in a rural area and does not have any other options for providing the service or item.
Remember, you should try to find providers who accept assignment whenever possible to avoid excess charge fees.

Conclusion

When seeking healthcare services or items as a Medicare beneficiary, it's important to find providers who accept assignment. Doing so will help you avoid excess charges and keep your out-of-pocket costs affordable. Before committing to any service or item, read the Advance Beneficiary Notice (ABN) and understand exactly how much you may be charged for it. And remember, for any Medicare questions you have; we are here to help. Call our team of experts at Fair Square Medicare.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Nasal spray stock image
Can Medicare Help with the Cost of Tyrvaya?
Jan 12, 2023
Saving money against a stopwatch stock image
What is the 8-Minute Rule on Medicare?
Dec 21, 2022
Cover image
The Fair Square Bulletin: February 2024
Feb 15, 2024
An illustrated image of a cartoon man using giant scissors to cut the "T" in the word "Tax"
How to Deduct Medicare Expenses from Your Taxes
Dec 28, 2022
Doctor physician consulting with male patient in hospital exam room stock photo
Does Medicare Cover Penile Implant Surgery?
Dec 9, 2022
Fecal microbiota transplant from healthy in unhealthy intestine, FMT. Improvement intestinal microflora and normalization stool by introducing beneficial bacteria in bowel colon tract. Vector stock illustration
Does Medicare Cover an FMT?
Dec 2, 2022
elderly woman with glasses having difficulty reading her phone stock image
Is Vitrectomy Surgery Covered by Medicare?
Dec 2, 2022
Medigap stock image
What Is Medical Underwriting for Medigap?
Apr 14, 2023
Cover image
Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?
Nov 30, 2022
Medicare Enrollment Periods stock image
Explaining the Different Enrollment Periods for Medicare
Feb 3, 2023
Sinusitis. stock illustration
Is Balloon Sinuplasty Covered by Medicare?
Dec 1, 2022
Teenager Helping his Grandfather at Home stock photo
Does Medicare Cover Geri Chairs?
Dec 7, 2022
Male doctor with his arms crossed stock image
Can Doctors Choose Not to Accept Medicare?
Dec 8, 2022
Senior woman having vision problems stock photo
Does Medicare Cover Macular Degeneration?
Nov 30, 2022
Cover image
Does Medicare Cover Cold Laser Therapy (CLT)?
Jun 14, 2023
various cartoon scenarios showing long term care stock photo
Which Medigap Policies Provide Coverage for Long-Term Care?
Sep 16, 2022
A doctor with a clipboard consults a female patient with cancer
Does Medicare Cover Inqovi?
Jan 11, 2023
breast cancer awareness ribbon stock image
Does Medicare Cover Piqray?
Dec 2, 2022

More of our articles

13 Best Ways for Seniors to Stay Active in Columbus

13 Best Ways for Seniors to Stay Active in Indianapolis

13 Best Ways for Seniors to Stay Active in Jacksonville

13 Best Ways for Seniors to Stay Active in Phoenix

14 Best Ways for Seniors to Stay Active in Seattle

2024 Medicare Price Changes

Are Medicare Advantage Plans Bad?

Can Medicare Advantage Plans be Used Out of State?

Comparing All Medigap Plans | Chart Updated for 2023

Costco Pharmacy Partners with Fair Square

Does Medicare Cover Bariatric Surgery?

Does Medicare Cover Bladder Sling Surgery?

Does Medicare Cover Breast Implant Removal?

Does Medicare cover Deviated Septum Surgery?

Does Medicare Cover Diabetic Eye Exams?

Does Medicare Cover Driving Evaluations?

Does Medicare Cover Exercise Physiology?

Does Medicare Cover Fosamax?

Does Medicare Cover Hepatitis C Treatment?

Does Medicare cover Hyoscyamine?

Does Medicare Cover Hypnotherapy?

Does Medicare Cover Iovera Treatment?

Does Medicare Cover Jakafi?

Does Medicare Cover Ketamine Infusion for Depression?

Does Medicare Cover LVAD Surgery?

Does Medicare Cover Medical Marijuana?

Does Medicare Cover Mental Health?

Does Medicare Cover Nuedexta?

Does Medicare Cover Physicals & Blood Work?

Does Medicare Cover Qutenza?

Does Medicare Cover RSV Vaccines?

Does Medicare Cover Stair Lifts?

Does Medicare Cover Urodynamic Testing?

Does Medicare Cover Xiafaxan?

Does Medicare Cover Zilretta?

Does Medicare Have Limitations on Hospital Stays?

Does Medicare Pay for Allergy Shots?

Does Medicare Pay for Bunion Surgery?

Does Medicare Pay for Funeral Expenses?

Does Medicare Pay for Varicose Vein Treatment?

Does Retiring at Age 62 Make Me Eligible for Medicare?

Does Your Plan Include A Free Gym Membership?

Explaining IRMAA on Medicare

Fair Square Bulletin: We're Revolutionizing Medicare

Health Savings Accounts (HSAs) and Medicare

How Are Medicare Star Ratings Determined?

How Do I Sign up for Medicare? A Simple How-To Guide For You

How Does Medicare Cover Colonoscopies?

How Does the End of the COVID-19 Public Health Emergency Affect Your Medicare?

How Medicare Costs Can Pile Up

How Much Does a Pacemaker Cost with Medicare?

How Much Does Medicare Part A Cost in 2023?

How Much Does Medicare Part B Cost in 2023?

How to Become a Medicare Agent

Is Displacement Affecting Your Medicare Coverage?

Medicare Advantage MSA Plans

Medicare Advantage Plans for Disabled People Under 65

Medicare Savings Programs in Kansas

Medicare Supplement Plans for Low-Income Seniors

Plan G vs. Plan N

Seeing the Value in Fair Square

Should You Work With A Remote Medicare Agent?

The Easiest Call You'll Ever Make

The Fair Square Bulletin: October 2023

The Fair Square Bulletin: September 2023

Welcome to Fair Square's First Newsletter

What Is a Medicare Advantage POS Plan?

What is a Medicare Beneficiary Ombudsman?

What To Do If Your Medicare Advantage Plan Is Discontinued

What's the Difference Between HMO and PPO Plans?

When to Choose Medicare Advantage over Medicare Supplement

Will Medicare Cover Dental Implants?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M