MLN Connects Newsletter for November 14, 2025

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Date
2025-11-14
Title
Special Edition: Medicare Participation Announcement for CY 2026: Decide by December 31
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Medicare Participation Announcement for CY 2026: Decide by December 31

As you plan for next year, CMS reminds you of the advantages of participating in Medicare:

  • You’re paid the full Medicare Physician Fee Schedule allowed amount. If you’re a non-participating provider, Medicare pays 5% less than the Medicare Physician Fee Schedule allowed amount.
  • Medicare pays you directly (on an assignment-related basis).
  • Medicare forwards claim information to Medigap (Medicare supplement coverage) insurance (if any).

By December 31, 2025, all physicians, practitioners, and suppliers – regardless of their Medicare participation status – must decide whether to participate for CY 2026.

You don’t need to do anything if you’re:

  • Already participating in Medicare, and you want to continue your participation
  • Not currently participating, and you don’t want to participate

See the Annual Medicare Participation Announcement webpage for more information on how to change your Medicare participation.

National Plan and Provider Enumeration System (NPPES) Taxonomy

Please check your data in NPPES and confirm that it still correctly reflects you as a health care provider with the appropriate taxonomy and correctly reflects your current practice address.

Incorrect data in NPPES may lead to unnecessary inquiries about your credentials and delay enrollment with Medicare and health plans.
 


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