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Providers in AR, CO, LA, MS, NM, OK, TX, Indian Health & Veteran Affairs

Opting Out of Medicare (Private Contracting) & Current Opt-Out Listing

As provided in § 4507 of the Balanced Budget Act of 1997, a "private contract" is a contract between a Medicare beneficiary and a physician or other practitioner who has "opted out" of Medicare for two years for all covered items and services he or she furnishes to Medicare beneficiaries. In a private contract, the Medicare beneficiary agrees to give up Medicare payment for services furnished by the physician or practitioner and to pay the physician or practitioner without regard to any limits that would otherwise apply to what the physician or practitioner could charge. For more information on opting out/private contracting, visit Chapter 9-Private Contracting (Opt Out) of the Enrollment Reference Guide or visit the CMS Quick Reference Chart.

Opt-Out Listings

The Opt-Out Listing is updated on a quarterly basis. If you are an opt-out provider and cannot locate your information, please call us at 1-877-235-8073. You can download the list or view it in your browser, sorted alphabetically by the provider's last name.

Download complete listing: Opted-Out Medicare Providers - All States [Updated 11/15/2017]

View in browser: Arkansas | ColoradoLouisiana | Mississippi | New Mexico | OklahomaTexas

Affidavit

An example affidavit is provided for consideration. The terms of the affidavit should be carefully reviewed for compliance by all physician/practitioners who are considering opting out of Medicare. The affidavit may be mailed or faxed to us. Our mailing address and fax numbers are as follows:

(Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas, IHS (Indian Health Service) and VA (Veterans Affairs))

Provider Enrollment Services
Novitas Solutions
PO Box 3095
Mechanicsburg, PA 17055-1813
Fax
: 717-728-8759


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Last modified:  11/15/2017