Opting out of Medicare Electing to Order/Certify Items and Services to Medicare Beneficiaries

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
August 10th, 2015

Physicians and practitioners who do not wish to enroll in the Medicare program may “opt-out” of Medicare. This means that neither the physician, nor the beneficiary submits the bill to Medicare for services rendered. Instead, the beneficiary pays the physician out-of-pocket and neither party is reimbursed by Medicare. A private contract is signed between the physician and the beneficiary that states, that neither one can receive payment from Medicare for the services that were performed. The physician or practitioner must submit an affidavit to Medicare expressing his/her decision to opt-out of the program.

The following shows physicians and other practitioners who are permitted by statute to opt-out of the Medicare program:

Physicians who are:

 Practitioners who are:

 Filing an Affidavit to Opt-out

Physicians and non-physician practitioners who want to opt-out must file a written affidavit with Medicare in which they agree to opt-out of Medicare for a period of two years and to meet certain other criteria.

Read more here to decide if this is an option for you


Opting out of Medicare Electing to Order/Certify Items and Services to Medicare Beneficiaries. (2015, August 10). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/opting-out-of-medicare-electing-to-order-certify-items-and-services-to-medicare-beneficiaries-27210.html

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