ASCRS Updates Medicare Participation Guide for 2015; Know Your Options

ASCRS has updated the Medicare Participation Guide for 2015. The guide informs physicians of their choices of Medicare status, which include, being a participating provider, a non-participating provider or electing to opt-out of Medicare and privately contract. The guide also provides sample letters that providers can use to inform patients they are not accepting new Medicare patients or opting out of Medicare and a sample Medicare private contract.

Without Congressional action, physicians will face a -21.2% reduction in Medicare physician payments due to the SGR on April 1, 2015. Under the provisions of the Budget Control Act of 2011, Medicare physician payments will also be subject to an additional 2 percent sequestration cut. ASCRS•ASOA continues to advocate for a full repeal and replacement of the SGR. 

Physicians also need to consider that in 2015, CMS will impose penalties under the Value Based Payment Modifier (VBPM) program. Some quality program penalties that will be applied in 2015 based on 2013 performance such as PQRS, Meaningful Use and eRx, will decrease the limiting charge amounts that nonparticipating physicians can bill patients for unassigned claims. The VBPM penalties, however, will not apply to unassigned claims. Therefore, practices facing a VBPM penalty next year could avoid the penalty by choosing the nonparticipating physician option.

Physicians have through December 31, 2014 to modify their status with the Medicare program and will want to consider their options carefully.