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Medicare Participation Kit

Each year physicians have the option of modifying their status with Medicare during Medicare's open enrollment period. The decision period for physicians to change their Participation status for 2016 ends on Dec. 31, 2015. As the "Know your options" guide below explains, the decision to opt out of Medicare and privately contract with patients may be made throughout the year.

Due to recent passage of the Medicare and CHIP Reauthorization Act (MACRA), many changes are being made to the Medicare physician payment system that may affect physicians' Medicare participation decisions. Visit the MACRA resource page for more information about these changes.

There are three Medicare contractual options for physicians:

  • Participating (often referred to as "PAR")
  • Non-participating (referred to as "non-PAR")
  • Private contracting

Whether or not a physician is thinking about modifying their status, it is important to understand the options. Physicians can use the AMA's Medicare Participation Kit to help them evaluate their participation options and choose the direction that is suitable for their practice. The kit contains a detailed explanation of physician options, a calculator and various sample materials for communicating with patients.

Medicare Revenue Calculator

Medicare Calculator The Medicare payment calculator will help you estimate how much your total revenues from Medicare patients would change if you switch your status from Medicare participation (PAR) to non-participation (non-PAR).


Know your options: Medicare participation guide

Medicare revenue worksheet

Frequently asked questions about Medicare participation options

CMS Medicare Participating physician or supplier agreement

CMS "Dear Doctor" letter: Announcement about Medicare participation for 2016

Find contact information for your Medicare contractor here

Sample Medicare private contract

Sample Medicare private contract "opt-out" affidavit