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.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

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.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

Recommended Articles

Fair Square

Do I Need to Renew My Medicare?

Nov 29, 2022

various people wearing masks due to the COVID-19 pandemic stock photo

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

Mar 3, 2023

Senior person holding tissue roll near a toilet bowl, using walker to walk to the bathroom stock photo

Does Medicare Cover Oxybutynin?

Dec 2, 2022

doctor consulting their patient stock image

Does Medicare Cover the Urolift Procedure?

Dec 6, 2022

Cover image

Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?

Nov 30, 2022

Cover image

Can I Choose Marketplace Coverage Instead of Medicare?

May 2, 2023

Illustrated representation of medical marijuana, using a prescription bottle with a marijuana leaf on the front.

Does Medicare Cover Medical Marijuana?

Jan 6, 2023

Medicare research stock image

Medicare Consulting Services

Apr 3, 2023

breast cancer awareness ribbon stock image

Does Medicare Cover Piqray?

Dec 2, 2022

Cover image

Why You Should Keep Your Medigap Plan

Sep 21, 2023

Senior person holding tissue roll near a toilet bowl, using walker to walk to the bathroom stock photo

Is Emsella Covered by Medicare?

Nov 21, 2022

air purifier stock image

Does Medicare Cover Air Purifiers?

Nov 18, 2022

Cover image

What To Do If Your Medicare Advantage Plan Is Discontinued

Feb 26, 2024

Cover image

Saving Money with Alternative Pharmacies & Discount Programs

Feb 1, 2024

heart surgery stock image

How Much Does Open Heart Surgery Cost with Medicare?

Jan 27, 2023

Cover image

The Easiest Call You'll Ever Make

Jun 28, 2023

Cover image

What People Don't Realize About Medicare

Mar 27, 2023

Medicare at 62 stock image

Does Retiring at Age 62 Make Me Eligible for Medicare?

Jun 16, 2022

More of our articles

13 Best Ways for Seniors to Stay Active in Columbus

13 Best Ways for Seniors to Stay Active in Jacksonville

14 Best Ways for Seniors to Stay Active in Washington, D.C.

14 Best Ways to Stay Active in Charlotte

15 Best Ways for Seniors to Stay Active in Denver

2024 Fair Square Client Retention and Satisfaction Report

2024 Fair Square NPS Report

2025 Medicare Price Changes

Are Medicare Advantage Plans Bad?

Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?

Do I Need Medicare If My Spouse Has Insurance?

Do You Need Books on Medicare?

Does Medicare Cover an FMT?

Does Medicare Cover Bladder Sling Surgery?

Does Medicare Cover Boniva?

Does Medicare Cover Cardiac Ablation?

Does Medicare Cover Cartiva Implants?

Does Medicare Cover Cataract Surgery?

Does Medicare Cover Cervical Disc Replacement?

Does Medicare cover Deviated Septum Surgery?

Does Medicare Cover Disposable Underwear?

Does Medicare Cover Fosamax?

Does Medicare Cover Geri Chairs?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Hepatitis C Treatment?

Does Medicare Cover Jakafi?

Does Medicare Cover Kyphoplasty?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Mental Health?

Does Medicare Cover PTNS?

Does Medicare Cover Qutenza?

Does Medicare Cover Service Animals?

Does Medicare Cover SI Joint Fusion?

Does Medicare Cover Stair Lifts?

Does Medicare Cover TENS Units?

Does Medicare Cover Vitamins?

Does Medicare Have Limitations on Hospital Stays?

Does Medicare Pay for Allergy Shots?

Does Your Plan Include A Free Gym Membership?

Estimating Prescription Drug Costs

Everything About Your Medicare Card + Medicare Number

Fair Square Bulletin: We're Revolutionizing Medicare

Finding the Best Dental Plans for Seniors

Health Savings Accounts (HSAs) and Medicare

How Does Medicare Pay for Emergency Room Visits?

How is Medicare Changing in 2025?

How Medicare Costs Can Pile Up

How Much Does a Medicare Coach Cost?

How Much Does a Pacemaker Cost with Medicare?

How Much Does Medicare Part B Cost in 2025?

How Much Does Rexulti Cost with Medicare?

How to Apply for Medicare?

How Your Employer Insurance and Medicare Work Together

Is Balloon Sinuplasty Covered by Medicare?

Is Displacement Affecting Your Medicare Coverage?

Is HIFU Covered by Medicare?

Medicare 101

Medicare Advantage MSA Plans

Medicare Savings Programs in Kansas

Medigap Plan N vs. Plan G — Which One Fits You in 2025?

Medigap vs. Medicare Advantage

Plan G vs. Plan N

Should You Work With A Remote Medicare Agent?

Top 10 Physical Therapy Clinics in San Diego

Turning 65 and Thinking of Keeping COBRA? Here’s Why It Usually Backfires

What Is a Medicare Advantage POS Plan?

What is Plan J?

What to Do When Your Doctor Doesn't Take Medicare

What You Need to Know About Creditable Coverage

When Can You Change Medicare Supplement Plans?

Will Medicare Cover Dental Implants?

Will Medicare Cover it?

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

Fair Square Medicare

FSM symbol - 50