Counseling Locations and Appointments
Last Updated:
2/1/2012
In 2010, a Medicare beneficiary pays $155 annual deductible and a 20% co-payment for Medicare-approved charges and services. Medicare pays 80% of the Medicare-approved charge. A beneficiary is responsible for all costs above Medicare-approved charges ("excess charge"). Physicians who do not accept assignment of a Medicare claim are limited as to the amount they can charge Medicare beneficiaries for covered services.
The Limiting Charge is 115% of the fee schedule amount for non-participating physicians. NOTE: Medicare-covered services, such as mental health services, physical and occupational therapy, and certain services rendered by special practitioners have special payment rules.