Weighing Your Medicare Participation Options December 13, 2011 AMA, Medicare, Payment Medicare, Medicare participation 1 Physicians have until December 31 to change your Medicare participation status for 2012. Under the Medicare rules, physicians may be classified as participating, non-participating, or opted-out of the Medicare program. Participating: You agree to accept assignment and the amount approved by Medicare as total payment for covered services. Non-Participating: You can choose whether to accept assignment on a per claim basis, and that you agree to accept 95% of the “par” amount on assigned claims and to charge no more than 115% of the non-par amount on non-assigned claims. Opt-out: You have formally notified Medicare using an approved affidavit that you will not treat any non-emergent Medicare patients unless you have first entered into a private contract with them. To assist physicians in determining the correct Medicare participation status for 2012, the AMA has developed Know your options: Medicare participation guide. The online kit contains a detailed explanation of physician options, a calculator, and various sample materials for communicating with patients. Comments are closed.
