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November 2014
In this Issue
  • Planning to Change Your Medicare Participation Status for 2015?

  • Toward the end of each year, physicians can decide if they want to change their Medicare participation status for the following year.

    However, the Medicare Physician Fee Schedule is not finalized yet due to inaction on Medicare's sustainable growth rate (SGR) formula. Unless Congress acts to either repeal the SGR or provide yet another “payment patch,” a 21.2 percent Medicare payment cut will automatically go into effect on April 1, 2015.  

    With payment issues in question, having to decide in 2014 whether to participate in Medicare in 2015 lands doctors in a timing dilemma.   

    So here’s what to do if you still want to make a participating change for 2015:  

    • Physicians who wish to become PAR for 2015 (to begin participating in Medicare and accept assignment on all claims) must complete the Medicare Participating Physician or Supplier Agreement by Dec. 31, 2014 – or a new date not yet determined.      

    • Physicians who wish to become Non-PAR in 2015 (may accept Medicare assignment on a case-by-case basis) must write to each Medicare contractor to which they submit claims, advising that they are terminating the participation agreement for 2015. This written notice must be postmarked prior to Jan. 1, 2015.

    Physicians who are currently participating in Medicare and choose to continue for 2015 do not have to do anything. Likewise, physicians who are currently non-participating should do nothing if they decide to continue as non-participating.   

    Questions? Call your ISMS Advocacy Team at 800-782-4767 ext. 1470 or send an email

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