Original Fee-For-Service Medicare: How To Maximize Use

The rules about Participating, Non-Participating and Private Contract apply to some health care providers you may not think about, such as audiologists, chiropractors, dentists, optometrists, physical therapists, podiatrists and speech therapists.

There are some medical providers who must accept Medicare Assignment. In other words, if they treat you they are considered to be Participating and are bound to accept only the Medicare Approved Amount.  These include:

• Physician Assistants.
• Nurse Practitioners.
• Certified Registered Nurse Anesthetists.
• Clinical Nurse Specialists.
• Certified Nurse Midwives.
• Clinical Psychologists.
• Clinical Social Workers.

You may get a list for Medicare participating medical providers from your Medicare Carrier. See Making Contact.

In those states that have enacted limits for non-participating providers that are more strict than the federal rules, you need to check whether the limitation also applies to these providers. Not all will cover the same types of medical providers as the federal rules.

On your first visit to any medical practitioner, make clear whether or not they accept Medicare assignment and ask for written confirmation. 

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