Accepting assignment for Medicare Part B services is a binding agreement where the provider consents to accept the Medicare-approved amount as payment in full. This amount is determined by the Medicare Physician Fee Schedule (MPFS). Consequently, the provider is legally prohibited from "balance billing" the patient, which is the practice of charging the patient for the difference between the provider's usual charge and the Medicare-approved amount. The provider may only collect the annual deductible and the 20% coinsurance from the patient. This protects beneficiaries from excess charges for covered services.

A. Providers are not reimbursed at a premium for accepting assignment; this option incorrectly describes Medicare payment rules.

B. There is no standard 10% bonus added to the MPFS for providers who accept assignment.

D. Both participating (PAR) and non-participating (non-PAR) providers can accept assignment, so this is not a defining characteristic.

1. Centers for Medicare & Medicaid Services. (2023). Medicare Claims Processing Manual

Chapter 1 - General Billing Requirements. (Rev. 12385

11-22-23). Section 30.2.4

"Definition of Assignment

" states

"By accepting assignment

the physician or other supplier agrees to accept the Medicare-approved amount as payment in full for the covered services."

2. LaTour

K. M.

Eichenwald-Maki

S.

& Oachs

P. K. (2021). Health Information Management: Technology and Lifecycles (6th ed.). AHIMA Press. In Chapter 13

"Reimbursement Methodologies

" the text explains that when a provider accepts assignment

they are "banned from balance billing the patient" (p. 435).

3. Johns

M. L. (2020). Health Information Management Technology: An Applied Approach (6th ed.). AHIMA Press. Chapter 20

"Reimbursement

" clarifies that under the Medicare Physician Fee Schedule (MPFS)

providers who accept assignment agree to accept the Medicare-approved amount and cannot bill the patient for any remaining balance.