Physician and Non-physician Enrolling in Medicare

Noridian has seen an increase in providers opting out of the Medicare program. A provider has options when applying to Medicare. The provider may enroll as a sole proprietor, a sole owner of a business, or a group member enrolling under an organization. Visit the Noridian Medicare Provider Enrollment website for more information on enrolling as a provider under, Enroll in Medicare.

The enrollment option to order and refer is available when the provider may not bill the Medicare system.

OPT OUT:

  • Two-year contract between provider, beneficiary, and Medicare where no claim is filed to Medicare
    • Beneficiary billed and paid provider direct, with fee-for-service charges not followed
  • No requirement to opt out of Medicare, but if you do:
    • Affidavit must be filed with ALL Medicare contractors in provider’s jurisdiction
    • Keep private contract with beneficiary on file for two-year period
  • Auto-renew unless updated affidavit resubmitted to reinstate approved Medicare provider
    • To cancel automatic renewal extension, you must notify the Medicare Administrative Contractor (MAC), or Noridian, in writing at least 30 days prior to the start of the next two-year opt-out period.
    • Visit the Noridian website for additional information on opting out of Medicare Opt Out of Medicare
Last Updated Mar 29 , 2024