CMS Will Allow Nonparticipating Physicians to Start Participating in Medicare

July 16 Is Last Day to Change Status

June 28, 2010 04:30 pm News Staff

Physicians who are not currently participating in Medicare have an opportunity to take part in the program and to change their status from nonparticipating to participating, according to CMS. The offer, which only applies to physicians whose current status is nonparticipating, is available through July 16.

The offer comes only a few days after the enactment of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010(frwebgate.access.gpo.gov), which provides a 2.2 percent payment increase in the Medicare physician payment rate until Nov. 30.

Nonparticipating physicians who would like to participate in the program should download and complete the Medicare Participating Physician or Supplier Agreement, Form CMS-460(www.cms.gov).

According to the agency, "any new CMS-460 form received during this limited enrollment period will be retroactive for claims with dates of service of Jan. 1, 2010, and later."

However, the change in participation status will only apply to new Medicare physician fee schedule claims submitted after the physician's new status as a participating physician is processed, according to CMS. "Claims previously submitted and processed will not be adjusted for only a change in participation status."

Medicare claims administration contractors and carriers will accept and process requests to become participating physicians submitted on the CMS-460 form. The requests have to be postmarked on or before July 16.