What happens if a non-participating doctor accepts Medicare assignment?

• A. They must charge the maximum allowable fee.
• B. They are completely free from any billing regulations.
• C. They may charge excess fees instead of Medicare rates.
• D. They follow all participating doctor guidelines.

Answer: (A)

When a non-participating doctor accepts Medicare assignment, they are agreeing to accept the Medicare-approved amount for their services as full payment, which is why charging the maximum allowable fee is the correct understanding. By accepting this assignment, the doctor is required to bill Medicare directly for services rendered, rather than billing the patient.

This means the physician cannot charge the patient more than the Medicare-approved amount, thus ensuring that patients are not billed excessive fees. Therefore, when a non-participating doctor accepts assignment, they must adhere to the same rate restrictions applied to participating providers, which includes only charging the maximum allowable fee set by Medicare.

The other options reflect misconceptions about billing practices. Non-participating providers do not have the freedom to charge whatever they wish (as implied in one choice). Additionally, there are specific guidelines and regulations they must still follow, such as those relating to billing and reimbursement, which distinguishes them from participating doctors who may have different obligations and a different set of guidelines to follow.