> Dermatologist accepts Medicare and Medicare Assignment but Medicare won't pay for cosmetic surgery. Sounds fair. That's not what I'm talking about at all. I

> Dermatologist accepts Medicare and Medicare Assignment but Medicare won't pay for cosmetic surgery. Sounds fair. That's not what I'm talking about at all. I don't know where you got "cosmetic surgery" out of that. A common pattern is that Medicare will only cover a certain service X times per week/month/year. Because their limits are inherently coarse by design, they're not going to be appropriate for all patients. A patient for whom (X+2)/(unit time) or even 2X/(unit time) would be more appropriate can only obtain the additional services from another provider altogether. Which, in plenty of circumstances, may not actually be literally possible. > First, non-participating providers can charge whatever they want; they're non-participating and not bound by Medicare rules. Incorrect. Non-participating providers can only charge the limiting charge (usually 15% more than the Medicare reimbursement rate, though some states cap it at a lower value).