Medicare Glossary

Limiting Charge

The highest amount a non-participating provider who does not accept assignment is allowed to charge for a Medicare-covered service — capped at 15% above the Medicare-approved amount.

Non-participating Provider

A doctor or supplier who does not accept Medicare assignment but is still enrolled in Medicare. They may charge up to 15% more than the Medicare-approved amount (the limiting charge). Medicare will still pay its share, but you may pay more.

Also known as: Non-par provider

Participating Provider

A doctor, hospital, or other health care provider who accepts Medicare assignment — meaning they agree to accept the Medicare-approved amount as full payment for covered services.

Also known as: Par provider