Medicare Part B Excess Charges
Last updated May 2026
The limiting charge rule
Non-participating Part B providers can charge up to 115% of the Medicare-approved amount on assigned and unassigned claims. The 15% over-Medicare amount is the 'excess charge.'
What it means for SNFs
Most SNFs accept assignment as participating providers, eliminating excess charges entirely. When a non-par arrangement exists, residents and supplemental insurers may be billed the limiting charge difference.
Participating vs non-participating
Participating providers accept the Medicare-approved amount as full payment and cannot bill excess charges. Non-par providers can bill the limiting charge but must still file the claim and accept the Medicare reimbursement directly when the claim is assigned. Most SNFs operate as participating providers for Part B supplies.
Resident balance-billing rules
When excess charges do apply, the resident or their Medigap policy is responsible for the difference. Some Medigap plans (Plan F and Plan G) cover the limiting charge; others do not. Facilities should disclose any potential balance-bill exposure in writing before dispensing.
How Burst handles it
Burst Billing files all SNF Part B supply claims as assigned under your facility's NPI as a participating provider. There are no excess charges in our claim flow, residents are never balance-billed beyond the standard Part B 20% coinsurance, which Medigap typically covers.
Talk to Burst about your SNF's supply reimbursement process
Schedule a reimbursement review with our team, no obligation, no upfront cost.
Related
Frequently asked questions
- U.S. skilled nursing facilities (SNFs). We specialize in Medicare Part B supply reimbursement billed under your facility's NPI and tied to your clinical record.
Turn Missed Opportunities Into Real Profit.
Request a Part B reimbursement review for your skilled nursing facility. No added work for your staff. No upfront cost. No obligation.
"*" indicates required fields
Risk-free. If you don't get paid, neither do we.