Medicare

[Guest guest]

Today, a physical therapist shared with me that the Medicare intermediary in our

region (Washington DC) assured her that as a PT she could opt out of Medicare.

The representative even gave her a link to the application form.

I explained to her that the intermediary is incorrect. I am submitting this

email to this group just to confirm that I am right. Can someone comment on

this?

According to https://www.cms.gov/Manuals/downloads/bp102c15.pdf PTs are not

allowed to opt out. Is this still the case?

If so, does anyone know whether the APTA is addressing this? I would consider

opting out of Medicare if it were legal.

Here is a section from the manual:

(Rev. 62, Issued: 12-22-06, Effective: 11-13-06, Implementation: 04-02-07)

For purposes of this provision, the term “physician” is limited to doctors of

medicine; doctors of osteopathy; doctors of dental surgery or of dental

medicine; doctors of podiatric medicine; and doctors of optometry who are

legally authorized to practice dentistry, podiatry, optometry, medicine, or

surgery by the State in which such function or action is performed; no other

physicians may opt out. Also, for purposes of this provision, the term

“practitioner” means any of the following to the extent that they are legally

authorized to practice by the State and otherwise meet Medicare requirements

Physician assistant;

Nurse practitioner;

Clinical nurse specialist;

Certified registered nurse anesthetist;

Certified nurse midwife;

Clinical psychologist;

Clinical social worker;

Registered dietitian; or

Nutrition Professional

The opt out law does not define “physician” to include chiropractors; therefore,

they may not opt out of Medicare and provide services under private contract.

Physical therapists in independent practice and occupational therapists in

independent practice cannot opt out because they are not within the opt out

law’s definition of either a “physician” or “practitioner”.

I added the emphasis in the last sentence.

Thanks for the feedback,

>

Jan Dommerholt, PT, DPT, MPS, DAAPM

Bethesda Physiocare®, Inc.

7830 Old town Road, Suite C-15

Bethesda, MD 20814-2440

United States

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dommerholt@...

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Myopain Seminars, LLC

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