Annual Medicare Participation Announcement

See the 2026 Letter to Medicare Providers (PDF).

Each year from mid-November through December 31, physicians and suppliers can decide if they want to participate in Medicare for the upcoming year. 

We’re pleased that we continue to have a high participation rate. As you plan for the coming year, see below for information that may help you determine whether you want to continue or become a Medicare-participating physician or supplier.

Participating vs. Non-Participating

Medicare “participation” means you agree to accept assignment on all claims for all Medicare-covered services furnished to your patients. By accepting assignment, you agree to accept Medicare-allowed amounts as payment in full. You may not collect more from the patient than the applicable Medicare deductible and coinsurance or copayment.

Participating Physician or SupplierNon-Participating Physician or Supplier
  • Medicare pays the full Medicare Physician Fee Schedule allowed amount
  • Medicare pays you directly
  • Medicare forwards claim information to Medigap (Medicare supplement coverage) insurance
  • Medicare pays 5% less than the Medicare Physician Fee Schedule allowed amount
  • You can’t charge the patient more than the limiting charge, 115% of the Medicare Physician Fee Schedule amount for non-participating suppliers
  • You may accept assignment on a case-by-case basis
  • You have limited appeal rights

 
Choose the situation that applies to you to find out what to do between mid-November and December 31 each year. 

I'm already participating, and I want to next year.

You don’t need to do anything.

I'm not participating, but I want to next year.

Complete the Medicare Participating Physician or Supplier Agreement (CMS-460) (PDF) and mail it (or a copy) to each MAC to which you’ll send Part B claims. 

I'm a new provider.

Submit the Medicare Participating Physician or Supplier Agreement (CMS-460) (PDF) electronically with your enrollment application.

I'm currently participating, but I don't want to next year.

Write to each MAC to which you send Part B claims telling them that you’re terminating your participation in Medicare effective January 1. This written notice must be postmarked before December 31 of the previous effective year. 

I'm not participating, and I don't want to next year.

You don’t need to do anything.

 

Page Last Modified:
12/03/2025 12:17 PM
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