Sunday, August 30, 2015

Announcement About Medicare Participation for Calendar Year 2015

We wish to emphasize the importance and advantages of being a Medicare participating (PAR) provider, and we are pleased that the favorable trend of participation continued into 2014 with a participation rate of  96.6 percent. As you plan for 2015 and become familiar with the coming changes, we are hopeful that you will continue to be a PAR provider or, if you are non-participating (Non-PAR), will consider becoming a PAR provider.

With the help of health care professionals across the country, the Medicare program is improving
faster than ever. The growth in spending per beneficiary is at an all-time low, which means that the
part B beneficiary premium will not increase in 2015. At the same time, the quality of care received
by Medicare beneficiaries continues to improve as indicated by lower hospital readmission rates,
significant reductions in health care acquired conditions, and other measures. And, with your help,
we can build upon these successes in the coming year by promoting the use of new preventive
services and other strategies geared toward disease prevention, early detection, and lifestyle modifications that support a healthier life.


All physicians, practitioners and suppliers must make their calendar year (CY) 2015 Medicare participation decision by December 31, 2014. Providers who want to maintain their current PAR status, or Non-PAR status do not need to take any action during the upcoming annual participation enrollment period. To sign a participation agreement is to agree to accept assignment for all covered services that you provide to Medicare patients in CY 2015. The overwhelming majority of physicians, practitioners and suppliers have chosen to participate in Medicare. As indicated, during CY 2014, 96.6 percent of all physicians and practitioners are billing under Medicare participation agreements.

If you participate and you bill for services paid under the Medicare physician fee schedule (MPFS), your Medicare fee schedule amounts are 5 percent higher than if you do not participate.

If you choose to be a PAR physician in CY 2015:

•Do nothing if you are currently participating, or

•If you are not currently a Medicare participant, complete the available blank agreement and mail it
(or a copy) to each Medicare Administrative Contractor (MAC) to which you submit Part B claims.
(On the form show the name(s) and identification number(s) under which you bill.)

If you decide not to participate in CY 2015:

•Do nothing if you are currently not participating, or

•If you are currently a participant, write to each MAC to which you submit claims, advising of the
termination of your participation in the participating physician program effective January 1, 2015.
This written notice must be postmarked prior to January 1, 2015.

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