It’s that time of year again — time to decide your Medicare participation status for the coming calendar year. You have until Dec. 31.
There are basically three Medicare contractual options for physicians. Physicians may sign participating (PAR) agreements and accept Medicare's allowed charge as payment in full for all their Medicare patients. They may elect to be non-PAR physicians, which permits them to make assignment decisions on a case-by-case basis and to bill patients for more than the Medicare allowance for unassigned claims. Or they may become private contracting physicians, agreeing to bill patients directly and forego any payments from Medicare to their patients or themselves.
Physicians who wish to change their status from PAR to non-PAR or vice versa may do so annually. Once made, the decision is generally binding until the next contracting cycle, unless the physician's practice situation has changed significantly, such as through relocation to a different geographic area or a different group practice. To become a private contractor, physicians must give 30 days notice before the first day of the quarter the contract takes effect.
The period for deciding your Medicare participation during 2020 extends from Nov. 14, 2019, through Dec. 31, 2019. If you want to maintain your current status (either participating or nonparticipating), you do not need to take any action.
Check your Medicare administrative contractor’s (MAC) website for more information, such as this article posted on the National Government Services’ MAC website.
— Kent Moore, Senior Strategist for Physician Payment at the American Academy of Family Physicians
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