How to read your parent's Medicare Summary Notice (MSN)
The MSN is not a bill. It is Medicare's record of what was billed, what Medicare paid, and the most a provider may bill your parent. Here is how to read one and line it up with a provider's bill.
Last checked against the sources below: October 23, 2026.
What is a Medicare Summary Notice?
It is a notice for people with Original Medicare, covering Part A and Part B services. Medicare.gov says it shows what was billed to Medicare in the period, what Medicare paid, and the maximum your parent may owe the provider. It comes every 6 months if your parent got services in that period, and electronic MSNs are available [1]. Part A, Part B and medical equipment (DME) each have their own MSN [1].
What is on each page of the MSN?
| Page | What it shows |
|---|---|
| 1: Dashboard | Name, last 4 digits of the Medicare number, the date the MSN was printed, deductible status, the total your parent may be billed, and the providers seen [3] |
| 2: Tips | How to check the notice, report fraud and get help [3] |
| 3: Claims | Each visit, line by line [3] |
| Last page | Denied claims and how to appeal, with the date the appeal must be received [2][3] |
Reading the claims page, column by column
On CMS's sample Part B MSN, each visit shows the date, the provider and these columns [2]:
| Column | What the MSN says it means |
|---|---|
| Service Provided & Billing Code | A plain-language description of the service, with its billing code |
| Service Approved? | Whether Medicare covered the service |
| Amount Provider Charged | The provider's fee |
| Medicare-Approved Amount | What a provider can be paid for the service; it may be less than the charge |
| Amount Medicare Paid | Usually 80% of the approved amount |
| Maximum You May Be Billed | The most the provider is allowed to bill your parent |
| See Notes Below | Letters pointing to notes, such as why a service was denied or that the claim went to a Medigap policy |
Claim numbers. Each claim ends with a "Total for Claim #" line [2]. Note that number: it makes sure you and a billing office are looking at the same claim.
What does "Maximum You May Be Billed" mean?
"...the total amount the provider is allowed to bill you, and can include a deductible, coinsurance, and other charges not covered." [2]
The same definition says Medigap or other insurance may pay all or part of it [2]. It is a ceiling, not a statement of what your parent will end up paying. We can't tell you what your parent owes; the provider's billing office and any supplemental insurer can.
Assigned vs. unassigned claims, and the "limiting charge"
Part B claims are labeled assigned or unassigned [3]. Medicare.gov explains [4]:
- Accepts assignment: the provider takes the Medicare-approved amount as full payment, agrees to charge only the Medicare deductible and coinsurance, and submits the claim without charging for it. Most providers do.
- Non-participating: the provider may accept the approved amount case by case. Your parent might pay the full amount up front, and the provider can charge more than the approved amount, but in many cases no more than 15% above it. That cap is the "limiting charge" (115% of the fee schedule amount for physician-fee-schedule services, per the regulation [5]). It doesn't apply to some supplies and equipment.
- Opted out: Medicare won't pay, except in emergencies.
How do I compare a provider's bill with the MSN?
Medicare.gov suggests comparing bills and receipts with the MSN, including bills paid before the MSN arrived [1].
- Match the date and provider. The MSN's checklist asks whether you recognize each provider and whether there was an appointment that day [2].
- Match the services. The MSN says you can ask the provider for an itemized statement for any claim [2]. Compare it line by line.
- Put the amounts side by side: the bill's amount next to that claim's "Maximum You May Be Billed" [2].
- Check for other insurance. If a note says the claim went to a Medigap policy, that plan may pay your parent's share [2].
- List what doesn't match: claim number, date of service and both amounts. That list is your set of questions.
Who can I ask when the numbers don't match?
- The provider's billing office. If a service was denied, Medicare.gov suggests checking that it submitted the correct information; if not, it may resubmit [1].
- 1-800-MEDICARE (1-800-633-4227), about a coverage or payment decision on the notice [2]. Medicare can share your parent's information with you only with your parent's verbal permission during the call, or if your parent has added you as an authorized representative (form CMS-10106) [6][7].
- Your parent's State Health Insurance Assistance Program (SHIP), for free, local counseling [2][7].
Where is the appeal section?
On the last page, with the date by which Medicare's claims office must receive an appeal, based on 120 days from when your parent gets the notice [2]. See how to appeal a denied Medicare claim and the appeal deadline tool.
Sources
- Medicare.gov, "Medicare Summary Notice (MSN)" (no date shown; read October 23, 2026).
- CMS, "Sample Part B Medicare Summary Notice" (illustrative sample linked from CMS's Medicare Summary Notice page, last modified May 14, 2026; read October 23, 2026).
- Medicare.gov, "What's in your Medicare Summary Notice? Part B" (annotated sample; read October 23, 2026).
- Medicare.gov, "Does your provider accept Medicare as full payment?" (no date shown; read October 23, 2026).
- LII / Cornell Law School, "42 CFR § 414.48 - Limits on actual charges of nonparticipating suppliers" (as amended Oct. 31, 1997; read October 23, 2026).
- CMS, "Authorization to Disclose Personal Health Information," Form CMS-10106 (form dated 03/2026; read October 23, 2026).
- Medicare.gov, "Talking with a Friend's or Family Member's Doctor During an Appointment," CMS Product No. 11441 (dated 04/2025; read October 23, 2026).
General information to help you organize, not medical, legal or financial advice. Rules change and individual situations differ: check the official source, the notice you received, or a qualified professional. Starry Night is not affiliated with or endorsed by Medicare, CMS, HHS or any health system.