MHI – Q: Are some providers required to “accept Medicare assignment”?

Posted by MedEd at MHI
A: A provider, such as a doctor or a hospital, who accepts Medicare assignment agrees not to charge more for a service than the Medicare approved amount (typically 20 percent once the Part B annual deductible is paid). Approximately 97 percent of all Medicare providers accept assignment.

Providers who participate in Medicare but do not accept assignment are allowed to charge fifteen percent more than the Medicare approved amount. This amount, known as Part B excess charges, is yours to pay unless you have a Medicare Supplement that pays for “excess charges” (only the F and G supplements).

The following provider services are required to accept assignment - clinical diagnostic and physician labs, services provided to people on both Medicare and Medicaid (dual eligibles) and ambulance services. In addition, the following medical personnel must accept assignment as well - physician assistants, nurse practitioners, clinical nurse specialists, nurse midwives, certified registered nurse anesthetists , clinical psychologists and clinical social workers.

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