The Additional Medicare Tax is 0.9% on wages, RRTA compensation, and self-employment income above the filing-status threshold: $250,000 joint, $125,000 married filing separately, and $200,000 single, head of household, or qualifying surviving spouse. Wages and self-employment income combine for the test, and a self-employment loss is left out rather than netted. RRTA compensation should be separately compared to the threshold. Withholding follows a simpler employer rule: once an employer's wages to a worker exceed $200,000 for the year, it withholds, whatever the worker's filing status and whatever other employers paid. The worker reconciles any balance on Form 8959, including the reduction of the SE threshold by Medicare wages received.
Worked example
Seth files single with $210,000 of Medicare wages and $40,000 of SE income. Combined income is $250,000. Against a $200,000 single threshold the excess is $50,000, so Additional Medicare Tax is \(50{,}000 \times 0.9\% = 450\). His employer withheld on wages above $200,000 ($10,000 of wages); the remaining liability is reconciled on Form 8959.