A patient was seen by Dr. Zachary. The charge for the office visit was $125. The Medicare beneficiary had already met his deductible. The Medicare fee schedule amount is $100. Dr. Zachary does not accept assignment. The office manager will apply a practice termed as "balance billing," which means that the patient is

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When a provider does not accept assignment, they are allowed to charge up to 15% more than the Medicare fee schedule amount. This additional amount is known as "excess charges." In this scenario, Dr. Zachary charged $125, which is $25 more than the Medicare fee schedule amount of $100. The patient is responsible for paying the $25 excess charge, making them financially liable for charges in excess of the Medicare fee schedule.

A Patient Was Seen by Dr