Medicare typically covers 80% of the Medicare-approved amount for Mohs surgery after the Part B deductible is met.

Medicare Part B covers Mohs surgery when it is medically necessary to treat skin cancer. The patient is responsible for the remaining 20% coinsurance after meeting the annual deductible. Medicare pays for the surgical procedure, laboratory analysis, and related services under specific CPT codes. Coverage includes both the surgical removal and microscopic examination of tissue layers until cancer-free margins are achieved.

Medicare Coverage Details for Mohs Surgery

Covers 80% of approved amount after deductible
Patient pays 20% coinsurance
Coverage includes surgical procedure and lab analysis
Requires medical necessity documentation
Specific CPT codes determine payment amounts

Cost Comparison: Medicare vs Other Insurance

Insurance Type	Patient Pays	Coverage Details
Medicare	20% coinsurance	After deductible, covers approved amount
Private Insurance	Varies by plan	Often similar to Medicare, may differ
Medicaid	Usually $0	State-dependent, typically full coverage

Factors Affecting Medicare Payment Amounts

Geographic location and Medicare locality payments
Whether performed in office or facility setting
Physician participation status (accepting assignment)
Additional procedures performed during same visit
Specific diagnosis and medical necessity requirements

Steps to Verify Medicare Coverage

Confirm Medicare eligibility and active Part B coverage
Obtain detailed procedure information and CPT codes
Contact Medicare or use Medicare.gov tools for cost estimates
Verify provider accepts Medicare assignment
Review Explanation of Benefits after service

Additional Financial Considerations

Medigap policies may cover coinsurance amounts
Medicare Advantage plans may have different cost-sharing
Prior authorization may be required for some cases
Uncovered services may result in balance billing
Annual deductible must be met before coverage begins