What term describes when a provider uses practices inconsistent with accepted medical practice that results in unnecessary costs to Medicare?

The appropriate term for practices that are inconsistent with accepted medical standards, leading to unnecessary costs to Medicare, is abuse. Abuse refers specifically to actions that are not intentionally deceptive but still result in improper payments or costs. It encompasses situations where providers may not adhere to best practices or guidelines due to negligence or an overly aggressive approach to billing, thus causing unnecessary costs to Medicare.

In contrast, fraud typically involves a deliberate attempt to deceive or misrepresent services provided in order to gain payment. Unbundling refers to the practice of billing separately for services that should be billed together, while hypercoding involves billing for services at a higher level than what is provided. While these terms both relate to improper billing practices, they do not capture the broader category of actions that constitute abuse in the context of unnecessary costs to Medicare. Thus, abuse is the correct term that encompasses these practices without implying intent to defraud.