Early Termination for First Time Opt-Out Providers
Opt-out affidavits are effective for two years and cannot be terminated early unless during the first time opt-out period and within 90 days of the effective date of the affidavit. A request in writing must be received.
More information on early termination of opt out can be found in the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 40.35.
Revised 6/18/2024
Form(s) you'll need: