Participating Provider or Non-Participating Provider with Medicare

June 2, 2014
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Rick Gawenda
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I am often asked must physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs) in private practice enroll in the Medicare program if they want to treat Medicare beneficiaries? The answer is yes. PTs, OTs and SLPs in private practices do not have the option to opt out if they want to treat Medicare beneficiaries. They must become Medicare providers.

This then leads to a second question I am often asked. If PTs, OT’s and SLPs must enroll in the Medicare program, what is this non-participating provider status? Doesn’t this mean I don’t participate with Medicare, hence, I can charge the Medicare beneficiary cash? The answer is no.

PTs, OTs and SLPs must enroll in the Medicare program and when they enroll, they have the option of becoming a

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