We are listed as a "non-participating" Medicare Provider. 

 This means that non-participating providers have signed up to accept Medicare Insurance but do not accept Medicare's approved fee amount as full payment. 

Non-Participating Providers charge up to a 15% co-insurance from the patient above Medicare's approved amount for the cost of services you receive. (known as the limiting charge). This means you are responsible for up to 35% (20% coinsurance + 15% limiting charge) of Medicare's approved amount for covered services. Limiting charges are not billable to secondary insurance like AARP, Aetna, etc.

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Example: If a new patient visit on Medicare is $140, you would be responsible for 15% additional charge which would be $21 and this is not billable to Medicare or any secondary insurance plans.  If you are also responsible for 20% coinsurance you would pay $28 (20% coinsurance) PLUS $21 for a total of $49.

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* This fee does not apply to Medicare Advantage Plans. 

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