• Revenue Cycle Management
  • COVID-19
  • Diabetes Awareness Month
  • Staffing
  • Medical Economics® 100th Anniversary
  • Coding and documentation
  • Business of Endocrinology
  • Telehealth
  • Physicians Financial News
  • Cybersecurity
  • Cardiovascular Clinical Consult
  • Locum Tenens, brought to you by LocumLife®
  • Weight Management
  • Business of Women's Health
  • EHRs
  • Remote Patient Monitoring
  • Sponsored Webinars
  • Medical Technology
  • Billing and collections
  • Acute Pain Management
  • Exclusive Content
  • Value-based Care
  • Business of Pediatrics
  • Concierge Medicine 2.0 by Castle Connolly Private Health Partners
  • Concierge Medicine
  • Business of Cardiology
  • Implementing the Topcon Ocular Telehealth Platform
  • Malpractice
  • Influenza
  • Sexual Health
  • Chronic Conditions
  • Technology
  • Legal and Policy
  • Money
  • Opinion
  • Vaccines
  • Practice Management
  • Patient Relations
  • Careers

Q&A: Opting out of Medicare


If I opt out of Medicare, can I charge patients the same reimbursement rate that Medicare allows?

Q: I manage a physician office, and we have seven providers who are going to opt out of Medicare as of the first of the year. Can you confirm for me that if I have a signed contract with my existing Medicare patients, I can charge them the same reimbursement rate that Medicare allows after the first of the year?

A: It depends on what you mean by "opt out." If the physicians are truly not billing or collecting from Medicare, they can charge whatever they want, regardless of what the agency allows. The patient forfeits any payment by Medicare. But if you mean that you would bill the patient the maximum amount allowed by Medicare, you would also bill the agency for the same amount, which in turn would send a check to the patient, who would pay the physician directly. Either way you need to inform patients and get confirmation that they are responsible for the bill.

Related Videos
Robert E. Oshel, PhD
Gary Price, MD, MBA
Victor J. Dzau, MD, gives expert advice
Ron Holder, MHA, gives expert advice
remote patient monitoring
no shows
effective meetings
© 2023 MJH Life Sciences

All rights reserved.