What Does Medicare Approved Mean? 
Any time you have a claim , Medicare must approve the medical necessity of that claim and the amount they will pay . If a claim is not approved Medicare will not pay . Medicare when paying claims has a set payment they will approve for a specific procedure based on how that procedure is billed . Medicare will only pay 80 % of that approved amount for Part B covered charges . A doctor can not bill for more than 15 % of the Medicare approved charges . Some states like Ohio do not allow the 15 % excess charges . A doctor who accepts Medicare can not balance bill for more than the approved amount . 