NEW: On Dec. 22, 2011, CMS announced that it would extend the enrollment period -- for this year only -- through Tuesday, Feb. 14, 2012. "The effective date for any participation status change during the extension, however, remains Sun., Jan. 1, 2012, and will be in force for the entire year," the CMS announcement stated.
Physicians have three options:
1. Sign a participation (PAR) agreement and accept Medicare's allowed charge as payment in full for all Medicare covered services for their Medicare patients.
2. Elect nonparticipation (non-PAR), which permits physicians to make assignment decisions on a case-by-case basis and to bill patients up to the Medicare limiting charge for unassigned claims.
3. Opt-out and become a private contracting physician, agreeing to bill patients directly and forego any payments from Medicare to their patients or themselves. To become a private contractor, PAR physicians must give 30 days notice before the first day of the quarter the contract takes effect. For non-PAR physicians, the opt-out effective date is the date the affidavit is signed, provided the affidavit is filed within 10 days after the physician signs his or her first private contract with a Medicare beneficiary.
I want to change my Medicare participation status. When during the year can I do that and how much advance notice do I need to give?
Evaluating Your Medicare Options webinar, recorded on Oct. 11, 2010.
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Participating and Non-Participating Providers Web Resources
AMA Participation Kit
CMS: Medicare enrollment information brochure
CMS: Medicare Participating Physician or Supplier Agreement
TrailBlazer: Provider Enrollment
TrailBlazer: Medicare Participating Physician Directory
TrailBlazer: Medicare Fee Schedule
TrailBlazer: Part B Participating Versus Non-Participating Providers Quick Reference
Opt-Out Physician Web Resources
TrailBlazer: Medicare Opt-Out Guidelines for Physicians/Practitioners
TrailBlazer: Medicare Opt-Out Affidavit
TrailBlazer: Medicare Opt-Out Physician/Practitioner List