Limiting Charge

The maximum amount that a non-participating physician is permitted to charge a Medicare beneficiary for a particularly defined procedure or bundled service. These limits are published by the individual state intermediaries for Medicare and HCFA and are usually combined in reports with the allowed charges and regional payment schedules. In 1993,  the limiting charge was set at 115 percent of the Medicare-allowed charge. However, this does not reflect what the physician will be paid.