Medicare Provider Participation Options Deadline - December 31

Dec 01, 2014 - Dec 31, 2014 11:00 PM

 

Doctors have until Dec. 31, 2014, to make changes to their Medicare participation status for 2015.

Providers have three choices regarding Medicare: Be a participating provider; be a nonparticipating provider; or opt out of Medicare entirely.

  • A participating physician must accept Medicare allowed charges as payment in full for all Medicare patients.
  • A nonparticipating provider can choose to accept or not accept assignment on Medicare claims on a claim-by-claim basis.
  • Physicians who opt out of Medicare are bound only by their private contracts with their patients. Medicare's limiting charges do not apply to these contracts, but Medicare does specify that these contracts contain certain terms. When a physician enters into a private contract with a Medicare beneficiary, both the physician and patient agree not to bill Medicare for services provided under the contract.

No action on the part of the provider means his or her 2015 participation status will remain the same as it was in 2014. Providers with questions or changes need to contact California's Medicare carrier Noridian


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