What extra charge may a non-participating doctor impose?

• A. They can charge a flat fee for all services.
• B. They can impose an "Excess Charge" above what Medicare approves.
• C. They must remain within Medicare limits.
• D. They cannot charge anything beyond Medicare rates.

Answer: (B)

A non-participating doctor may impose an "Excess Charge" above what Medicare approves, which is a crucial aspect of their billing practices. Non-participating providers do not have a contract with Medicare to accept assignment for all services, which allows them to bill patients for the difference between their charges and the Medicare-approved amount. While they are required to accept Medicare's approved amount as a minimum charge, they can add an excess charge, typically up to 15% over that approved amount for Part B services. This is an important consideration for patients when selecting healthcare providers, as it can affect their out-of-pocket costs significantly. Understanding this aspect of non-participating providers helps beneficiaries plan better for healthcare expenses and make informed choices about their care.