A provider that has opted out of the Medicare program is not required to complete a separate application to order or refer items/services for beneficiaries to other Medicare providers. However, the opt-out provider must meet the following qualifications:

  • His or her opt-out information must be current. 

Note: For more information regarding opt-out requirements, please click here.

  • He or she must be of a specialty type eligible to order/refer items or services for Medicare beneficiaries.
  • Physicians (doctor of medicine or osteopathy, doctor of dental medicine, doctor of dental surgery, doctor of podiatric medicine, doctor of optometry, optometrists may only order and certify DMEPOS products/services and laboratory and X-Ray services payable under Medicare Part B)
  • Physician Assistants
  • Clinical Nurse Specialists
  • Clinical Psychologists
  • Interns, Residents, and Fellows
  • Certified Nurse Midwives
  • Clinical Social Workers
  • Marriage and family therapist
  • Mental health counselor

 

References