Reference Source

Penalty for any nonparticipating physician charging more than $500 who does not accept payment for an elective surgical procedure on an assignment related basis and who knowingly and willfully fails to disclose the required information regarding charges and coinsurance amounts and fails to refund on a timely basis any amount collected for the procedure in excess of the charges recognized and approved by the Medicare program. (Penalties are assessed in the same manner as 42 U.S.C. 1395u(j)(2)(B) , which is assessed according to 1320a-7a(a))

For Penalty for any nonparticipating physician charging more than $500 who does not accept payment for an elective surgical procedure on an assignment related basis and who knowingly and willfully fails to disclose the required information regarding charges and coinsurance amounts and fails to refund on a timely basis any amount collected for the procedure in excess of the charges recognized and approved by the Medicare program. (Penalties are assessed in the same manner as 42 U.S.C. 1395u(j)(2)(B) , which is assessed according to 1320a-7a(a)), agency is HHS; statutory authority is 1395u(m)(3); maximum penalty is 19,940, recorded from its source on 2026-08-10.

Agency
HHS our reading
Violation
Penalty for any nonparticipating physician charging more than $500 who does not accept payment for an elective surgical procedure on an assignment related basis and who knowingly and willfully fails to disclose the required information regarding charges and coinsurance amounts and fails to refund on a timely basis any amount collected for the procedure in excess of the charges recognized and approved by the Medicare program. (Penalties are assessed in the same manner as 42 U.S.C. 1395u(j)(2)(B) , which is assessed according to 1320a-7a(a)) verified
Statutory authority
1395u(m)(3) verified
Maximum penalty
19,940 verified
Sourceecfr.gov
Verified
Review by
DatasetFederal civil penalty maximums — current inflation-adjusted amounts across agencies

Values marked our reading are our classification of what the source says — the source does not print them in those words. The quote below is the evidence for each one; judge it yourself.

What the source says

1395u(m)(3) | <https://www.ecfr.gov/current/title-42/section-402.1#p-402.1(c)(14)> 42 CFR 402.1(c)(14) , <https://www.ecfr.gov/current/title-42/section-402.105#p-402.105(d)(2)(xi)> 402.105(d)(2)(xi) | CMS | Penalty for any nonparticipating physician charging more than $500 who does not accept payment for an elective surgical procedure on an assignment related basis and who knowingly and willfully fails to disclose the required information regarding charges and coinsurance amounts and fails to refund on a timely basis any amount collected for the procedure in excess of the charges recognized and approved by the Medicare program. (Penalties are assessed in the same manner as <https://www.govinfo.gov/link/uscode/42/1395u> 42 U.S.C. 1395u(j)(2)(B) , which is assessed according to 1320a-7a(a)) | 2024 | 19,435 | 19,940

ecfr.gov, retrieved 2026-08-10

Source

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