2023 Additional Medicare Tax Threshold
For 2023, the Additional Medicare Tax Threshold figures are 0.9% (Rate), $250,000 (Married filing jointly), $125,000 (Married filing separately) and $200,000 (All other taxpayers).
Effective 2023-01-01Source: 2023 Instructions for Form 8959 (IRS)Verified 2026-09-03
Compared with 2022
Every figure on this page is unchanged from 2022.
| Item | 2022 | 2023 | Change |
|---|---|---|---|
| Rate | 0.9% | 0.9% | +0% (+0.0%) |
| Married filing jointly | $250,000 | $250,000 | +$0 (+0.0%) |
| Married filing separately | $125,000 | $125,000 | +$0 (+0.0%) |
| All other taxpayers | $200,000 | $200,000 | +$0 (+0.0%) |
Who it applies to
Taxpayers who owe Additional Medicare Tax and must file Form 8959 for tax year 2023, including those filing as married filing jointly or married filing separately.
What changed this year, and why
The Additional Medicare Tax threshold amounts for 2023 were published by the IRS in the Instructions for Form 8959. The thresholds are not indexed for inflation.
Common questions
- What is the Additional Medicare Tax rate for 2023?
- The Additional Medicare Tax rate is 0.9% for 2023. It applies to Medicare wages, Railroad Retirement Tax Act compensation, and self-employment income that exceed the threshold amount for your filing status.
- What is the threshold for married filing jointly?
- For married taxpayers filing jointly, the Additional Medicare Tax threshold is $250,000 for 2023.
- What is the threshold for married filing separately?
- For married taxpayers filing separately, the Additional Medicare Tax threshold is $125,000 for 2023.
- Does the employer withholding threshold match the filing-status threshold?
- No. An employer must begin withholding the 0.9% Additional Medicare Tax once wages for the calendar year exceed a set amount, regardless of the employee's filing status. That employer withholding amount does not change based on whether a taxpayer files jointly or separately. A taxpayer whose income exceeds their filing-status threshold may owe additional tax when filing their return even if the employer did not withhold enough.
Your employer withholds at $200,000 whatever your filing status
Employers must begin withholding the Additional Medicare Tax in the pay period where your wages or RRTA compensation for the calendar year go over $200,000, and must continue to withhold it every pay period for the rest of that year. This $200,000 withholding trigger applies no matter what your filing status is - it is not tied to the $250,000 threshold for married couples filing jointly or the $125,000 threshold for married couples filing separately. As a result, a married taxpayer filing jointly with combined income above $250,000 may find that no employer withheld the tax if neither spouse's individual wages crossed $200,000. Similarly, a married taxpayer filing separately whose income exceeds $125,000 but whose wages stay below $200,000 will also see no withholding. In either case, the taxpayer still owes the tax on the amount over the filing-status threshold and must report it on Form 8959. Any Additional Medicare Tax that was withheld can be claimed as a credit against the total tax liability shown on the return.
Your employer is responsible for withholding the 0.9% Additional Medicare Tax on your Medicare wages or RRTA compensation paid in excess of $200,000 in a calendar year. Your employer is required to begin withholding Additional Medicare Tax in the pay period in which your wages or compensation for the year exceed $200,000 and continue to withhold it in each pay period for the remainder of the calendar year.
2023 Instructions for Form 8959, Additional Medicare Tax (IRS)
These thresholds do not move with inflation
The dollar thresholds that determine when the 0.9% Additional Medicare Tax applies are fixed by statute and do not increase each year with inflation. The confirmed amounts are $250,000 for married couples filing jointly and $125,000 for married couples filing separately; the remaining filing statuses use a threshold that is also set in statute and likewise not adjusted. Because the thresholds are not indexed, more taxpayers may become subject to the tax over time simply as wages rise with general price levels, even if their real income has not grown. Congress would need to pass new legislation to change the threshold amounts; the IRS cannot adjust them through guidance or annual inflation factors. When planning for future years, taxpayers should therefore assume these same dollar figures continue to apply until the law is amended, and should not expect the thresholds to move automatically with the cost of living.
Note. The threshold amounts below aren't indexed for inflation.
2023 Instructions for Form 8959, Additional Medicare Tax (IRS)
When Form 8959 is required
You must file Form 8959 if any one of several conditions is met. First, you must file if your Medicare wages and tips reported in box 5 of any single Form W-2 exceed $200,000. Second, you must file if your RRTA compensation reported in box 14 of any single Form W-2 exceeds $200,000. Third, you must file if your total Medicare wages and tips plus your self-employment income (including, for married filing jointly, those of your spouse) are greater than the threshold amount for your filing status shown in the Threshold Amounts chart - $250,000 for married filing jointly, $125,000 for married filing separately, or $200,000 for single, head of household, and qualifying surviving spouse. Fourth, the same rule applies using total RRTA compensation and tips in place of wages and self-employment income. Medicare wages for this purpose include tips from Form 4137 and wages from Form 8919; self-employment income comes from Schedule SE, Part I, line 6, with negative amounts ignored.
Who Must File You must file Form 8959 if one or more of the following applies to you. • Your Medicare wages and tips on any single Form W-2 (box 5) are greater than $200,000. • Your RRTA compensation on any single Form W-2 (box 14) is greater than $200,000. • Your total Medicare wages and tips plus your self-employment income, if any (including the Medicare wages and tips and self-employment income of your spouse, if married filing jointly), are greater than the threshold amount for your filing status in the Threshold Amounts for Additional Medicare Tax chart.
2023 Instructions for Form 8959, Additional Medicare Tax (IRS)
Wages and self-employment income are added together
For purposes of the Additional Medicare Tax, Medicare wages and self-employment income are added together and compared to the threshold for your filing status. This means a taxpayer whose wages fall below the threshold may still owe the 0.9% tax if self-employment income pushes the combined total over the line. When wages and self-employment income coexist, the threshold applied to the self-employment portion is reduced (but not below zero) by the amount of Medicare wages. A self-employment loss is not counted for this purpose, so it cannot increase the tax. For married couples filing jointly, the wages and self-employment income of both spouses are combined against the $250,000 threshold, even if each spouse individually falls below it. For married filing separately, the combined total is compared to the $125,000 threshold.
Medicare wages and self-employment income are combined to determine if your income exceeds the threshold. A self-employment loss shouldn't be considered for purposes of this tax. RRTA compensation should be separately compared to the threshold.
2023 Instructions for Form 8959, Additional Medicare Tax (IRS)
Railroad compensation is measured on its own
Railroad Retirement Tax Act (RRTA) compensation is treated differently from Medicare wages when measuring whether the 0.9% Additional Medicare Tax applies. While Medicare wages and self-employment income are added together and compared to the filing-status threshold, RRTA compensation is separately compared to that same threshold on its own. There is no equivalent rule for RRTA compensation: the threshold at which Additional Medicare Tax applies to self-employment income is reduced (but not below zero) by the total amount of Medicare wages received, but RRTA compensation does not reduce the threshold for any purpose. Similarly, RRTA compensation does not combine with wages or self-employment income when testing against the $250,000 threshold for married filing jointly or the $125,000 threshold for married filing separately. Each spouse's RRTA compensation is measured on its own against the applicable threshold. A railroad employer withholds the 0.9% tax on RRTA compensation it pays above a set dollar amount per calendar year, independent of other employers' payments, but that withholding trigger is distinct from the filing-status threshold used to determine actual tax liability.
There is no equivalent rule for RRTA compensation.
2023 Instructions for Form 8959, Additional Medicare Tax (IRS)
Nonresident aliens and Americans abroad get no special exemption
The Additional Medicare Tax threshold rules apply the same way to nonresident aliens and U.S. citizens living abroad as they do to anyone else in the United States. There is no separate, lower, or higher threshold for people who live outside the country or who are not U.S. residents for tax purposes. If a nonresident alien or an American abroad has wages, railroad retirement compensation, or self-employment income that are subject to regular Medicare tax and those amounts exceed the applicable threshold for their filing status, the 0.9% Additional Medicare Tax applies to the excess just as it would for a domestic taxpayer. For example, a U.S. citizen living overseas who files as married filing jointly still uses the $250,000 threshold, and someone filing as married filing separately still uses the $125,000 threshold. No special exemption, exclusion, or modified calculation exists for these taxpayers under the Additional Medicare Tax rules.
There are no special rules for Additional Medicare Tax for nonresident aliens and U.S. citizens living abroad.
2023 Instructions for Form 8959, Additional Medicare Tax (IRS)
Withholding starts the pay period your wages cross $200,000, not spread over the year
Employer withholding of the 0.9% Additional Medicare Tax is not spread evenly over the year or triggered only at year-end. Instead, once your cumulative wages or railroad retirement compensation from a single employer cross $200,000 in a calendar year, your employer must start withholding the tax in that exact pay period and continue withholding it every pay period for the rest of the year. The $200,000 withholding trigger is fixed and does not change based on your filing status or your spouse's income. This means a married taxpayer filing jointly, whose household threshold is $250,000, may have Additional Medicare Tax withheld even though their combined income will ultimately fall below that $250,000 threshold. Conversely, a married taxpayer filing separately, whose threshold is only $125,000, might not have enough withheld if they have multiple employers each paying below $200,000. The withholding rule is a mechanical payroll threshold, separate from the filing-status thresholds used to determine actual tax liability on Form 8959.
Your employer is required to begin withholding Additional Medicare Tax in the pay period in which your wages or compensation for the year exceed $200,000 and continue to withhold it in each pay period for the remainder of the calendar year.
2023 Instructions for Form 8959, Additional Medicare Tax (IRS)
Withheld Additional Medicare Tax comes back as a credit if you do not actually owe it
Because employers must start withholding the 0.9% Additional Medicare Tax once your wages for the year pass the withholding threshold regardless of your filing status, some taxpayers end up having the tax taken out even though their total income, viewed on the return, never exceeds the threshold that applies to their filing status. The IRS treats that over-withholding as a credit, not a forfeiture. When you file your federal income tax return, you report the Additional Medicare Tax you actually owe on Form 8959 and claim a credit for any amount your employer already withheld. The credit reduces the total tax liability shown on your return dollar for dollar, and any leftover credit flows into your overall refund or reduces any balance due. You cannot, however, ask your employer to stop withholding once the withholding trigger has been reached; the adjustment happens only at filing time. This situation commonly arises for married couples filing jointly when one spouse's wages alone exceed the withholding threshold but combined household income stays below the $250,000 joint threshold.
If you don't owe Additional Medicare Tax, you can claim a credit for any withheld Additional Medicare Tax against the total tax liability shown on your tax return by filing Form 8959.
2023 Instructions for Form 8959, Additional Medicare Tax (IRS)
Your wages eat into the threshold for your self-employment income, but RRTA pay does not
When you have both wages from employment and self-employment income in the same year, the threshold used to figure Additional Medicare Tax on your self-employment is not the full amount that corresponds to your filing status. Instead, you reduce that threshold, but not below zero, by the total amount of Medicare wages you received during the year. The remaining portion of the threshold is what shields your self-employment income from the 0.9% tax. There is no equivalent offset for railroad retirement compensation: RRTA wages do not reduce the threshold applied to self-employment income, and self-employment income does not reduce the threshold applied to RRTA compensation. Each is compared to the threshold on its own terms, except that regular Medicare wages get first claim on the threshold. This ordering can increase the amount of self-employment income subject to the tax for someone whose wages already use up part or all of the filing-status limit.
If you have both wages and self-employment income, the threshold amount for applying Additional Medicare Tax on the self-employment income is reduced (but not below zero) by the total amount of Medicare wages received. There is no equivalent rule for RRTA compensation.
2023 Instructions for Form 8959, Additional Medicare Tax (IRS)
Waiting to pay it with your return can trigger a penalty
The Additional Medicare Tax is not exempt from the estimated-tax penalty system. If you owe Additional Medicare Tax and wait to pay it when you file your return rather than covering it through withholding or quarterly estimated payments during the year, you may be subject to a penalty for failure to make estimated tax payments. The penalty is calculated using the same framework that applies to underpayment of regular income tax. To determine whether the penalty applies to your situation, you need to consult Form 2210, or Form 2210-F if you are a farmer or fisherman, along with their separate instructions. This means that taxpayers who discover they owe Additional Medicare Tax only when preparing their April return may face an additional charge on top of the tax itself. The way to avoid this penalty is to ensure sufficient withholding throughout the year, because withholding is treated as spread evenly across the payment periods, or to make timely estimated tax payments that account for the Additional Medicare Tax liability as it accrues.
You may be subject to a penalty for failure to make estimated tax payments if you owe Additional Medicare Tax and wait to pay the tax with your tax return.
2023 Instructions for Form 8959, Additional Medicare Tax (IRS)
How each figure was verified
Each number below was read from a stored copy of the document named beside it, and checked to occur word for word in the quoted sentence. The digest is of that stored text.
2023 Instructions for Form 8959 (IRS)
- Rate
A 0.9% Additional Medicare Tax applies to your Medicare wages, Railroad Retirement Tax Act (RRTA) compensation, and self-employment income above a threshold amount.
- Married filing jointly
Married filing jointly $250,000
- Married filing separately
Married filing separately $125,000
- All other taxpayers
Single $200,000 Head of household $200,000 Qualifying surviving spouse $200,000