Does your provider accept Medicare as full payment?
You can get the lowest cost if your doctor or other health care provider accepts the Medicare-approved amount as full payment for a covered service. This is called “accepting assignment.” If a provider accepts assignment, it’s for all Medicare-covered Part A and Part B services.
Using a provider that accepts assignment
Most doctors, providers, and suppliers accept assignment, but always check to make sure that yours do.
If your doctor, provider, or supplier accepts assignment:
- Your out-of-pocket costs may be less.
- They agree to charge you only the Medicare deductible and coinsurance amount, and usually wait for Medicare to pay its share before asking you to pay your share.
- They have to submit your claim directly to Medicare and can't charge you for submitting the claim.
How does assignment impact my drug coverage?
Using a provider that doesn't accept Medicare as full payment
Some providers who don’t accept assignment still choose to accept the Medicare-approved amount for services on a case-by-case basis. These providers are called "non-participating."
If your doctor, provider, or supplier doesn't accept assignment:
- You might have to pay the full amount at the time of service.
- They should submit a claim to Medicare for any Medicare-covered services they give you, and they can’t charge you for submitting a claim. If they refuse to submit a Medicare claim, you can submit your own claim to Medicare. Get the Medicare claim form .
- They can charge up to 15% over the Medicare-approved amount for a service, but no more than that. This is called "the limiting charge."
Does the limiting charge apply to all Medicare-covered services?
Using a provider that "opts-out" of Medicare
- Doctors and other providers who don’t want to work with the Medicare program may "opt out" of Medicare.
- Medicare won’t pay for items or services you get from provider that opts out, except in emergencies.
- Providers opt out for a minimum of 2 years. Every 2 years, the provider can choose to keep their opt-out status, accept Medicare-approved amounts on a case-by-case basis ("non-participating"), or accept assignment.
Find providers that opted out of Medicare.
Private contracts with doctors or providers who opt out
- If you choose to get services from an opt-out doctor or provider you may need to pay upfront, or set up a payment plan with the provider through a private contract.
- Medicare won’t pay for any service you get from this doctor, even if it’s a Medicare-covered service.
What are the rules for private contracts?
You may want to contact your State Health Insurance Assistance Program (SHIP) for help before signing a private contract with any doctor or other health care provider.
What do you want to do next?
- Next step: Get help with costs
- Take action: Find a provider
- Get details: How to get Medicare services
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What is Medicare assignment and how does it work?
En español | Whether or not your doctors “accept assignment” determines how much you pay for their services.
Medicare decides how much to pay providers for covered services. Most doctors accept the Medicare-approved amount for services Medicare covers, even if it’s less than they usually charge. If the doctor agrees to the approved amount, he or she is accepting assignment.
A doctor who accepts assignment agrees to charge you no more than the amount Medicare has approved for that service. A doctor who participates in Medicare but doesn’t accept assignment can potentially charge you up to 15 percent more than the Medicare-approved amount.
When choosing new doctors, ask if they accept assignment before you receive care, even if they accept Medicare patients. If a doctor doesn’t accept assignment, you will pay more for that physician’s services compared with one who does.
How much do I pay if my doctor accepts assignment?
Because Medicare Part B covers doctor and outpatient services, your $226 deductible for Part B in 2023 applies before most coverage begins. If your doctor accepts assignment, then you generally pay 20 percent of the Medicare-approved amount for the service, called coinsurance, after you’ve paid the annual deductible.
All providers who accept assignment must submit claims directly to Medicare, which pays 80 percent of the approved cost for the service and will bill you the remaining 20 percent. You can get some preventive services and screenings, such as mammograms and colonoscopies, without paying a deductible or coinsurance if the provider accepts assignment.
What if my doctor doesn’t accept assignment?
A doctor who takes Medicare but doesn’t accept assignment can still treat Medicare patients but won’t always accept the Medicare-approved amount as payment in full. This means he or she can charge you up to a maximum of 15 percent more than Medicare pays for the service you receive. In this case, you’re responsible for the additional charge, plus the regular 20 percent coinsurance, as your share of the cost.
How to cover the extra cost? If you have a Medicare supplement policy , better known as Medigap, it may cover the extra 15 percent, called Medicare Part B excess charges.
All Medigap policies cover Part B’s 20 percent coinsurance in full or in part. The F and G policies cover the 15 percent excess charges from doctors who don’t accept assignment.
If you’re new to Medicare, you can’t buy Medicare supplement Plan F as of 2020. But if you turned 65 by the end of 2019, you may be able to even if you haven’t enrolled yet.
Everyone enrolled in original Medicare can apply for Plan G. Keep in mind that Medigap policies only cover excess charges for doctors who accept Medicare but don’t accept assignment and they won’t cover costs for doctors who opt out of Medicare entirely.
How do I find doctors who accept assignment?
Before you start working with a new doctor, ask whether he or she accepts assignment. About 97 percent of providers billing Medicare are participating providers, which means they accept assignment on all Medicare claims, according to the Kaiser Family Foundation.
You can get help finding doctors and other providers in your area who accept assignment by using Medicare’s Physician Compare tool . You can look up doctors and other clinicians near your zip code.
Those who accept assignment have this note under the name: “Charges the Medicare-approved amount (so you pay less out of pocket).” However, not all doctors who accept assignment are accepting new Medicare patients.
What does it mean if a doctor opts out of Medicare?
Doctors who opt out of Medicare can’t bill Medicare for services you receive. They also aren’t bound by Medicare’s limitations on charges.
In this case, you enter into a private contract with the provider and agree to pay the full bill. Be aware that neither Medicare nor your Medigap plan will reimburse you for these charges.
While most doctors participate in Medicare, others, such as some psychiatrists, opt out. A Kaiser Family Foundation study found that only 1 percent of physicians who weren’t pediatricians formally opted out of Medicare in 2022, but 7.5 percent of psychiatrists had opted out.
Differences in what you pay for doctors’ services
The three ways that physicians deal with Medicare can drastically affect what you spend on care.
Note: Doctors who don’t accept assignment receive a Medicare-approved amount that is 5 percent less than those who accept assignment.
Source: Medicare, California Health Advocates, AARP research
Keep in mind
These rules apply to original Medicare. Other factors determine costs if you choose to get coverage through a private Medicare Advantage plan . Most Medicare Advantage plans have provider networks, and they may charge more or not cover services from out-of-network providers.
Before choosing a Medicare Advantage plan, find out whether your chosen doctor or provider is covered and identify how much you’ll pay. You can use the Medicare Plan Finder to compare the Medicare Advantage plans and their out-of-pocket costs in your area.
Updated July 14, 2023
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Medicare Assignment: Everything You Need to Know
- Providers Accepting Assignment
- Providers Who Do Not
- Billing Options
- Assignment of Benefits
- How to Choose
Frequently Asked Questions
Medicare assignment is an agreement between Medicare and medical providers (doctors, hospitals, medical equipment suppliers, etc.) in which the provider agrees to accept Medicare’s fee schedule as payment in full when Medicare patients are treated.
This article will explain how Medicare assignment works, and what you need to know in order to ensure that you won’t receive unexpected bills.
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There are 35 million Americans who have Original Medicare. Medicare is a federal program and most medical providers throughout the country accept assignment with Medicare. As a result, these enrollees have a lot more options for medical providers than most of the rest of the population.
They can see any provider who accepts assignment, anywhere in the country. They can be assured that they will only have to pay their expected Medicare cost-sharing (deductible and coinsurance, some or all of which may be paid by a Medigap plan , Medicaid, or supplemental coverage provided by an employer or former employer).
It’s important to note here that the rules are different for the 29 million Americans who have Medicare Advantage plans. These beneficiaries cannot simply use any medical provider who accepts Medicare assignment.
Instead, each Medicare Advantage plan has its own network of providers —much like the health insurance plans that many Americans are accustomed to obtaining from employers or purchasing in the exchange/marketplace .
A provider who accepts assignment with Medicare may or may not be in-network with some or all of the Medicare Advantage plans that offer coverage in a given area. Some Medicare Advantage plans— health maintenance organizations (HMOs) , in particular—will only cover an enrollee’s claims if they use providers who are in the plan's network.
Other Medicare Advantage plans— preferred provider organizations (PPOs) , in particular—will cover out-of-network care but the enrollee will pay more than they would have paid had they seen an in-network provider.
The bottom line is that Medicare assignment only determines provider accessibility and costs for people who have Original Medicare. People with Medicare Advantage need to understand their own plan’s provider network and coverage rules.
When discussing Medicare assignment and access to providers in this article, keep in mind that it is referring to people who have Original Medicare.
How to Make Sure Your Provider Accepts Assignment
Most doctors, hospitals, and other medical providers in the United States do accept Medicare assignment.
Provider Participation Stats
According to the Centers for Medicare and Medicaid Services, 98% of providers participate in Medicare, which means they accept assignment.
You can ask the provider directly about their participation with Medicare. But Medicare also has a tool that you can use to find participating doctors, hospitals, home health care services, and other providers.
There’s a filter on that tool labeled “Medicare-approved payment.” If you turn on that filter, you will only see providers who accept Medicare assignment. Under each provider’s information, it will say “Charges the Medicare-approved amount (so you pay less out-of-pocket).”
What If Your Provider Doesn’t Accept Assignment?
If your medical provider or equipment supplier doesn’t accept assignment, it means they haven’t agreed to accept Medicare’s approved amounts as payment in full for all of the services.
These providers can still choose to accept assignment on a case-by-case basis. But because they haven’t agreed to accept Medicare assignment for all services, they are considered nonparticipating providers.
Note that "nonparticipating" does not mean that a provider has opted out of Medicare altogether. Medicare will still pay claims for services received from a nonparticipating provider (i.e., one who does not accept Medicare assignment), whereas Medicare does not cover any of the cost of services obtained from a provider who has officially opted out of Medicare.
If a Medicare beneficiary uses a provider who has opted out of Medicare, that person will pay the provider directly and Medicare will not be involved in any way.
Physicians Who Have Opted Out
Only about 1% of all non-pediatric physicians have opted out of Medicare.
For providers who have not opted out of Medicare but who also don’t accept assignment, Medicare will still pay nearly as much as it would have paid if you had used a provider who accepts assignment. Here’s how it works:
- Medicare will pay the provider 95% of the amount they would pay if the provider accepted assignment.
- The provider can charge the person receiving care more than the Medicare-approved amount, but only up to 15% more (some states limit this further). This extra amount, which the patient has to pay out-of-pocket, is known as the limiting charge . But the 15% cap does not apply to medical equipment suppliers; if they do not accept assignment with Medicare, there is no limit on how much they can charge the person receiving care. This is why it’s particularly important to make sure that the supplier accepts Medicare assignment if you need medical equipment.
- The nonparticipating provider may require the person receiving care to pay the entire bill up front and seek reimbursement from Medicare (using Form CMS 1490-S ). Alternatively, they may submit a claim to Medicare on behalf of the person receiving care (using Form CMS-1500 ).
- A nonparticipating provider can choose to accept assignment on a case-by-case basis. They can indicate this on Form CMS-1500 in box 27. The vast majority of nonparticipating providers who bill Medicare choose to accept assignment for the claim being billed.
- Nonparticipating providers do not have to bill your Medigap plan on your behalf.
Billing Options for Providers Who Accept Medicare
When a medical provider accepts assignment with Medicare, part of the agreement is that they will submit bills to Medicare on behalf of the person receiving care. So if you only see providers who accept assignment, you will never need to submit your own bills to Medicare for reimbursement.
If you have a Medigap plan that supplements your Original Medicare coverage, you should present the Medigap coverage information to the provider at the time of service. Medicare will forward the claim information to your Medigap insurer, reducing administrative work on your part.
Depending on the Medigap plan you have, the services that you receive, and the amount you’ve already spent in out-of-pocket costs, the Medigap plan may pay some or all of the out-of-pocket costs that you would otherwise have after Medicare pays its share.
(Note that if you have a type of Medigap plan called Medicare SELECT, you will have to stay within the plan’s network of providers in order to receive benefits. But this is not the case with other Medigap plans.)
After the claim is processed, you’ll be able to see details in your MyMedicare.gov account . Medicare will also send you a Medicare Summary Notice. This is Medicare’s version of an explanation of benefits (EOB) , which is sent out every three months.
If you have a Medigap plan, it should also send you an EOB or something similar, explaining the claim and whether the policy paid any part of it.
What Is Medicare Assignment of Benefits?
For Medicare beneficiaries, assignment of benefits means that the person receiving care agrees to allow a nonparticipating provider to bill Medicare directly (as opposed to having the person receiving care pay the bill up front and seek reimbursement from Medicare). Assignment of benefits is authorized by the person receiving care in Box 13 of Form CMS-1500 .
If the person receiving care refuses to assign benefits, Medicare can only reimburse the person receiving care instead of paying the nonparticipating provider directly.
Things to Consider Before Choosing a Provider
If you’re enrolled in Original Medicare, you have a wide range of options in terms of the providers you can use—far more than most other Americans. In most cases, your preferred doctor and other medical providers will accept assignment with Medicare, keeping your out-of-pocket costs lower than they would otherwise be, and reducing administrative hassle.
There may be circumstances, however, when the best option is a nonparticipating provider or even a provider who has opted out of Medicare altogether. If you choose one of these options, be sure you discuss the details with the provider before proceeding with the treatment.
You’ll want to understand how much is going to be billed and whether the provider will bill Medicare on your behalf if you agree to assign benefits (note that this is not possible if the provider has opted out of Medicare).
If you have supplemental coverage, you’ll also want to check with that plan to see whether it will still pick up some of the cost and, if so, how much you should expect to pay out of your own pocket.
A medical provider who accepts Medicare assignment is considered a participating provider. These providers have agreed to accept Medicare’s fee schedule as payment in full for services they provide to Medicare beneficiaries. Most doctors, hospitals, and other medical providers do accept Medicare assignment.
Nonparticipating providers are those who have not signed an agreement with Medicare to accept Medicare’s rates as payment in full. However, they can agree to accept assignment on a case-by-case basis, as long as they haven’t opted out of Medicare altogether. If they do not accept assignment, they can bill the patient up to 15% more than the Medicare-approved rate.
Providers who opt out of Medicare cannot bill Medicare and Medicare will not pay them or reimburse beneficiaries for their services. But there is no limit on how much they can bill for their services.
A Word From Verywell
It’s in your best interest to choose a provider who accepts Medicare assignment. This will keep your costs as low as possible, streamline the billing and claims process, and ensure that your Medigap plan picks up its share of the costs.
If you feel like you need help navigating the provider options or seeking care from a provider who doesn’t accept assignment, the Medicare State Health Insurance Assistance Program (SHIP) in your state may be able to help.
A doctor who does not accept Medicare assignment has not agreed to accept Medicare’s fee schedule as payment in full for their services. These doctors are considered nonparticipating with Medicare and can bill Medicare beneficiaries up to 15% more than the Medicare-approved amount.
They also have the option to accept assignment (i.e., accept Medicare’s rate as payment in full) on a case-by-case basis.
There are certain circumstances in which a provider is required by law to accept assignment. This includes situations in which the person receiving care has both Medicare and Medicaid. And it also applies to certain medical services, including lab tests, ambulance services, and drugs that are covered under Medicare Part B (as opposed to Part D).
In 2021, 98% of American physicians had participation agreements with Medicare, leaving only about 2% who did not accept assignment (either as a nonparticipating provider, or a provider who had opted out of Medicare altogether).
Accepting assignment is something that the medical provider does, whereas assignment of benefits is something that the patient (the Medicare beneficiary) does. To accept assignment means that the medical provider has agreed to accept Medicare’s approved fee as payment in full for services they provide.
Assignment of benefits means that the person receiving care agrees to allow a medical provider to bill Medicare directly, as opposed to having the person receiving care pay the provider and then seek reimbursement from Medicare.
Centers for Medicare and Medicaid Services. Medicare monthly enrollment .
Centers for Medicare and Medicaid Services. Annual Medicare participation announcement .
Centers for Medicare and Medicaid Services. Lower costs with assignment .
Centers for Medicare and Medicaid Services. Find providers who have opted out of Medicare .
Kaiser Family Foundation. How many physicians have opted-out of the Medicare program ?
Center for Medicare Advocacy. Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) updates .
Centers for Medicare and Medicaid Services. Check the status of a claim .
Centers for Medicare and Medicaid Services. Medicare claims processing manual. Chapter 26 - completing and processing form CMS-1500 data set .
Centers for Medicare and Medicaid Services. Ambulance fee schedule .
Centers for Medicare and Medicaid Services. Prescription drugs (outpatient) .
By Louise Norris Louise Norris has been a licensed health insurance agent since 2003 after graduating magna cum laude from Colorado State with a BS in psychology.
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What is Medicare Assignment?
Written by: Rachael Zimlich, RN, BSN
Reviewed by: Eboni Onayo, Licensed Insurance Agent
Medicare assignment describes the fee structure that your doctor and Medicare have agreed to use.
If your doctor agrees to accept Medicare assignment, they agree to be paid whatever amount Medicare has approved for a service.
You may still see doctors who don’t accept Medicare assignment, but you may have to pay for your visit up front and submit a claim to Medicare for reimbursement.
You may have to pay more to see doctors who don’t accept Medicare assignment.
How Does Medicare Assignment Work?
What is Medicare assignment ?
Medicare assignment simply means that your provider has agreed to stick to a Medicare fee schedule when it comes to what they charge for tests and services. Medicare regularly updates fee schedules, setting specific limits for what it will cover for things like office visits and lab testing.
When a provider agrees to accept Medicare assignment, they cannot charge more than the Medicare-approved amount. For you, this means your out-of-pocket costs may be lower than if you saw a provider who did not accept Medicare assignment. The provider acknowledges that the amount Medicare set for a particular service is the maximum amount that will be paid.
You may still have to pay a Medicare deductible and coinsurance, but your provider will have to submit a claim to Medicare directly and wait for payment before passing any share of the costs onto you. Doctors who accept Medicare assignment cannot charge you to submit these claims.
Find a local Medicare plan that fits your needs
How do I know if a Provider Accepts Medicare Assignments?
There are a few levels of commitment when it comes to Medicare assignment.
- Providers who have agreed to accept Medicare assignment sign a contract with Medicare.
- Those who have not signed a contract with Medicare can still accept assignment amounts for services of their choice. They do not have to accept assignment for every service provided. These are called non-participating providers.
- Some providers opt out of Medicare altogether. Doctors who have opted out of Medicare completely or who use private contracts will not be paid anything by Medicare, even if it’s for a covered service within the fee limits. You will have to pay the full cost of any services provided by these doctors yourself.
How do I find a Medicare doctor? You can check to see if your provider accepts Medicare assignment on Medicare’s website .
Billing arrangement options for providers who accept Medicare
Doctors that take Medicare can sign a contract to accept assignment for all Medicare services, or be a non-participating provider that accepts assignment for some services but not all.
A medical provider that accepts Medicare assignment must submit claims directly to Medicare on your behalf. They will be paid the agreed upon amount by Medicare, and you will pay any copayments or deductibles dictated by your plan.
If your doctor is non-participating, they may accept Medicare assignment for some services but not others. Even if they do agree to accept Medicare’s fee for some services, Medicare will only pay then 95% of the set assignment cost for a particular service.
If your provider does plan to work with Medicare, either the provider or you can submit a claim to Medicare, but you may have to pay the entire cost of the visit up front and wait for reimbursement. They can’t charge you for more than the amount approved by Medicare, but they can charge you above the Medicare-approved amount. This is called the limiting charge, and can be up to 15% more than Medicare-approved amount for non-participating providers.
What Does it Mean when a Provider Does Not Accept Medicare Assignment?
Providers who refuse Medicare assignment can still choose to accept Medicare’s set fees for certain services. These are called non-participating providers.
There are a number of providers who opt out of participating in Medicare altogether; they are referred to as “opt-out doctors”. This means they have signed an opt-out agreement with Medicare and can’t be paid by Medicare at all — even for services normally covered by Medicare. Opt-out contracts last for at least two years. Some of these providers may only offer services to patients who sign contracts.
You do not need to sign a contract with a private provider or use an opt-out provider. There are many options for alternative providers who accept Medicare. If you do choose an opt-out or private contract provider, you will have to pay the full cost of services on your own.
Are you eligible for cost-saving Medicare subsidies?
Do providers have to accept Medicare assignment?
No. Providers can choose to accept a full Medicare assignment, or accept assignment rates for some services as a non-participating provider. Doctors can also opt out of participating in Medicare altogether.
How much will I have to pay if my provider doesn't accept Medicare assignment?
Some providers that don’t accept assignment as a whole will accept assignment for some services. These are called non-participating providers. For these providers and providers who have completely opted out of Medicare, you will pay the majority of or the full amount for your care.
How do I submit a claim?
If you need to submit your own claim to Medicare, you can call 1-800-MEDICARE or use Form CMS-1490S .
Can my provider charge to submit a claim?
No. Providers are not allowed to charge to submit a claim to Medicare on your behalf.
Lower Costs with Assignment. Medicare.gov.
Fee Schedules. CMS.gov.
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How can I find out if my doctor accepts Medicare?
Most doctors in the United States accept Medicare. To find a list of doctors in your area who accept Medicare and agree not to bill you for more than the approved Medicare amount for your visit or procedure, go to Medicare’s Care Compare website , select “Doctors & clinicians” under the Provider Type dropdown menu, and look for providers noted as charging the Medicare-approved amount. If you do not have access to a computer, you can also call 1-800-MEDICARE (1-800-633-4227), or call your doctor’s office and ask before you schedule an appointment.
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Where can I find a doctor that accepts Medicare and Medicaid?
Find a Medicare doctor
To find a provider that accepts Medicare payments, use the Care Compare tool on Medicare.gov. This tool gives you a list of professionals or group practices in the specialty and geographic area you specify, along with detailed profiles, maps and driving directions.
Find and compare doctors and other providers near you .
If you have trouble accessing the website or the search tool, please call 1-800-MEDICARE (1-800-633-4227) and a representative will be able to help you. TTY users can call 1-877-486-2048.
Find a Medicaid doctor
Medicaid programs vary by state and each state Medicaid agency maintains their own list of professionals that accept Medicaid. For further assistance, please contact your health plan or your state’s Medicaid agency. For more information about Medicaid, visit the Medicaid & CHIP page on Healthcare.gov.
There are other directories on MedlinePlus that will help you find health professionals, services, and facilities, some of which may accept Medicare or Medicaid payments.