The dollar amount Medicare finds reasonable for a covered medical service. Compare with Actual Charge.
The amount your health plan says is reasonable for a covered service. This amount may be less than the actual amount. For example, your health plan may cover $29.00 for a doctor's office visit, even though your doctor may charge you $32.00 for that visit. The $29.00 is the approved amount.
Entire payment Medicare will "approve" for collection. This includes the payment made by Medicare and the amount owed by the beneficiary, but does not necessarily reflect the balance of the bill (this is assuming the psychologist's actual charge is more than Medicare's approved amount).
The fee that Medicare sets as its rate for a medical service. Medicare will cover 80 percent of this amount (or 50 percent for mental health services) and you (or your supplemental insurance) are responsible for the remainder. All doctors and other providers who take assignment must accept this approved amount as full payment, even if they normally charge more for the service.
The fee Medicare sets as reasonable for a covered medical service. This is the amount a doctor or supplier is paid by you and Medicare for a service or supply. It may be less than the actual amount charged by a doctor or supplier. The approved amount is sometimes called the "Approved Charge."
The lesser amount between the billed charge and our maximum payment for the covered service. Any required copayments and deductibles are subtracted from this amount before payment is made.
The amount Medicare determines to be reasonable for a service that is covered under Part B of Medicare. It may be less than the actual charge. For many services, including physician services, the approved amount is taken from a fee schedule that assigns a dollar value to all Medicare-covered services that are paid under that fee schedule.