What Is a Medicare Part B Excess Charge?

If you’re enrolled in Original Medicare, or planning to be, you may have come across the term Medicare Part B excess charge. It sounds technical, but the idea is actually pretty simple once you break it down.

Understanding excess charges can help you avoid unexpected medical bills and make a more informed decision about your coverage in 2026 and beyond.

First, A Quick Refresher on Medicare Part B

Medicare Part B covers outpatient medical services like:

• Doctor visits
• Specialist appointments
• Lab work
• Preventive services
• Durable medical equipment

Under Original Medicare, Part B generally pays 80 percent of approved medical costs. You are responsible for the remaining 20 percent.

But in some cases, you could owe more than that. That is where excess charges come in.

What Is a Medicare Part B Excess Charge?

A Medicare Part B excess charge happens when a doctor does not accept Medicare assignment and charges more than the Medicare-approved amount for a service.

Here is how it works:

• Medicare sets an approved amount for a service.
• A doctor who accepts assignment agrees to take that approved amount as full payment (aside from your 20 percent share).
• A doctor who does not accept assignment can charge up to 15 percent more than the Medicare-approved amount.

That additional amount above the Medicare-approved rate is called the Part B excess charge.

Not every provider does this, but it is allowed in most states.

How Much Could an Excess Charge Cost You?

Let’s say Medicare approves $100 for a service.

• Medicare pays $80.
• You pay $20 (your 20 percent share).
• If the doctor does not accept assignment, they could charge up to $115.

That extra $15 would be your responsibility.

It may not seem like much for one visit. But if you see specialists regularly or need ongoing treatment, those excess charges can add up over time.

Do All Doctors Charge Excess Fees?

No.

Many doctors accept Medicare assignment, which means they agree to the Medicare-approved amount.

However, some specialists do not. Before scheduling services, you can always ask the provider’s office whether they accept Medicare assignment.

Still, not everyone wants to worry about asking that question each time they see a doctor.

What about Medicare Advantage Plans?

Medicare Advantage plans work differently. They replace Original Medicare and operate with their own provider networks and cost structure.

Because they use network rules and contracted rates, excess charges under Original Medicare do not apply in the same way. However, you must follow the plan’s network and coverage guidelines.

If you are comparing your options, you may find this helpful:

Is Medicare Advantage Right for Me?

Why This Matters in 2026

As healthcare costs continue to rise, understanding where extra charges can occur is important.

If you prefer the flexibility of seeing any doctor who accepts Medicare nationwide, and you do not want to worry about excess billing, reviewing your Medicare Supplement options in 2026 may be worth your time.

You can also explore:

How to get Started with Medigap

or a breakdown of Medigap Plan Benefits

At FindMedicareCoverage.com we offer one on one consultations to help you understand your options clearly without pressure.

Schedule a one on one consultation with our team and make sure your coverage actually protects you when it matters.