Opting Out of Medicare: How to Get Out and Stay Out

Daniel F. Shay, JD


Fam Pract Manag. 2017;24(6):17-20. 

In This Article

Abstract and Introduction


Physicians can cut ties with Medicare and privately contract with Medicare beneficiaries, but doing it incorrectly can be costly.


For many physicians, the administrative side of practicing medicine has grown increasingly complex in recent years. The challenges are particularly evident in the Medicare program, where a host of initiatives (e.g., meaningful use, the Physician Quality Reporting System, Value-based Payment Modifier, the Medicare Access and CHIP Reauthorization Act, and now the Quality Payment Program) require tracking more information, submitting more data, and working more closely with electronic health record (EHR) systems. For physicians who are too overwhelmed or unprepared to successfully participate, these programs threaten payment penalties and potential exposure to false claims liability. Family physicians' Medicare participation rates have remained stable despite the demands,[1] but opting out remains a viable option for those who want to set their own fees free of Medicare's limiting charges and are prepared to navigate the complicated requirements. This article explains how.