Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2024
Table of Contents
- Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2024
- Why Become a Participating Medicare Provider
- What to Do
- Related Content
Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2024
As you plan for 2024 and become familiar with the coming changes for the year ahead, we wish to emphasize the importance and advantages of being a Medicare PAR provider. We are pleased that the favorable trend of participation continued into 2023 with a participation rate of 98 percent. We hope that you will continue to be a PAR provider or, if you are NON PAR, will consider becoming a PAR provider.
This announcement provides information that may be helpful to clinicians in determining whether to become a Medicare participating provider, or to continue Medicare PAR. The CMS pledges to work with you to put patients first. To do this, we must empower patients and providers to work together to make health care decisions that are best for patients. This means providing meaningful information about quality and costs. It also includes supporting innovative approaches to improving quality, accessibility, and affordability, while finding the best ways to use innovative technology to support patient-centered care. We can’t do all of this without your involvement.
Please visit the CMS Website to learn more about our efforts to strengthen the Medicare Program.
Why Become a Participating Medicare Provider
All physicians, practitioners and suppliers, regardless of their Medicare participation status, must make their CY 2024 Medicare participation decision by 12/31/2023. Those 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.
If you wish to become a PAR provider, you'll need to sign a participation agreement as described below. To sign a participating agreement is to agree to accept assignment for all covered services that you provide to Medicare patients in CY 2024. The overwhelming majority of physicians, practitioners and suppliers choose to participate in Medicare each year. During CY 2023, 98 percent of all physicians and practitioners are billing under Medicare participation agreements.
If you participate in Medicare and bill for services paid under the MPFS, your fee schedule amounts are 5 percent higher than if you do not participate. Your MAC publishes an electronic directory of providers that choose to participate.
What to Do
Do you want to participate in Medicare for the 2024 calendar year?
If you’re already participating in Medicare, you don’t need to do anything.
If you want to participate in Medicare in CY 2024, and you’re not currently participating,
- Complete the Medicare Participating Physician or Supplier Agreement (CMS-460) (On the form, show the billing individual/entity name and address as well as NPI(s) used to bill services rendered.)
- Mail a copy to each MAC that you’ll send Part B claims to.
If you’re newly enrolling with Medicare as a billing provider, you can submit the agreement electronically with your enrollment application on PECOS.
If you don’t want to participate in Medicare in CY 2024, and you’re currently participating, write to each MAC that you sent Part B claims to, telling them that you don’t want to participate effective 1/1/2024. This written notice must be postmarked before 12/31/2023.
If you’re not currently participating, and you don’t want to participate, you don’t need to do anything.
Related Content
- MLN® Educational Tool: Medicare Provider Enrollment
- Learn about the electronic Medicare enrollment system, PECOS
- Understanding Participating, Nonparticipating and Opt Out Status
- Announcement About Medicare Participation for Calendar Year 2024
- Fact sheet on the CY 2024 Physician Fee Schedule Final Rule
- The CY 2024 Medicare Physician Fee Schedule is Now Available
Jurisdiction 6
Jurisdiction K
Reviewed 7/27/2024