Medicare Part B is required if you want to bill Medicare for office visits and X-rays. The oral appliance is paid as a global fee which means nothing but the appliance can be billed for 90 days. After 90 days, if you want to charge for any exams, you need to be enrolled in Part B. This is a long and tedious application. This fee allows us to do the paperwork for you. There is no additional fee from Medicare to enroll in Part B. This fee is non-refundable.