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Medicare Participation Enrollment for Calendar Year 2020

The open enrollment period for Medicare participation during CY 2020 extends from 11/14/2019 through 12/31/2019. Physicians, practitioners and suppliers must make their Medicare participation decision for CY 2020 by 12/31/2019. Providers who want to maintain their current participation status, participating or nonparticipating, do not need to take any action during this annual participation enrollment program.

Why Participate in Medicare?

  • Medicare fee schedule amounts are 5% higher if you participate.
  • Inclusion in the Medicare Participating Directory (MEDPARD)
  • Participants have "one stop" billing for beneficiaries who also have Medigap coverage and who assign their Medigap payments to the participant. When a participating provider bills us, we automatically advise the Medigap insurer to pay the participant for the beneficiary's co-insurance and/or deductible. 
  • Direct and timely reimbursement.

When is the Enrollment Period? 

The annual participation enrollment program for calendar year 2020 will commence on 11/14/2019 and will run through 12/31/2019. Participation agreements cover the period 1/1/2020 through 12/31/2020, and may not be changed after 12/31/2019.

What to do: 

To be a participating physician:

If you are currently participating and wish to remain so, do nothing

If you are not currently a Medicare participant, complete and mail the CMS-460 - Medicare Participating Physician or Supplier Agreement, found on our Forms web page, making sure to include all of the names and identification numbers under which you bill.

To be a nonparticipating physician:

If you are currently not participating and wish to remain so, do nothing

If you are currently a participant, submit a written, dated notice that includes: 

  • Provider’s name and NPI
  • A statement indicating that you are rescinding your participation agreement.

The written notice must be postmarked prior to 1/1/2020.

Submit the Participation Agreement or Disenrollment to:

Jurisdiction 6  – States of Illinois, Minnesota and Wisconsin
National Government Services, Inc.
P.O. Box 6475
Indianapolis, IN 46207-7149

Jurisdiction K – States of Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island and Vermont
National Government Services, Inc.
P.O. Box 7149
Indianapolis, IN 46207-7149

Fee Schedule Information

To view the calendar year 2020 Medicare Physician Fee Schedule and Anesthesia Conversion Factors as they become available, please visit our Fee Schedule Look-up Tool.

We encourage you to visit the Medicare Learning Network® (MLN) the place for official CMS Medicare fee-for-service provider educational information. There you can find one of our most popular products, MLN Matters national provider education articles. These articles help you understand new or changed Medicare policy and how those changes affect you. A full array of other educational products (including web-based training courses, hard copy and downloadable publications, and CD-ROMs) are also available. You can also find other important websites by visiting the Physician Center webpage and the All Fee-For-Service Providers webpage.

In addition to educational products, the MLN also offers providers and suppliers opportunities to learn more about the Medicare Program through MLN National Provider Calls. These national conference calls, held by CMS for the Medicare Fee-For-Service provider and supplier community, educate and inform participants about new policies and/or changes to the Medicare program. Offered free of charge, continuing education credits may be awarded for participation in certain National Provider Calls. To learn more about MLN National Provider Calls including upcoming calls, registration information, and links to previous call materials, visit the MLN Calls & Webcasts webpage.

2020 Participation Postcard Mailing

You may receive this postcard in the mail informing you about the annual participation process stating:

This is a reminder that the 2020 Annual Participation Open Enrollment Period is approaching. The open enrollment period runs mid-November through December 31. Refer our website to obtain more specific information about the Annual Participation Open Enrollment Period. Medicare Physician Fee Schedule for services rendered during 2020 are also posted on your local Medicare contractor’s website.

If you do not have internet access, contact our Provider Contact Center at the number listed below to request a hardcopy Participation Enrollment and Information Package which includes the new Medicare fees.

Jurisdiction 6: Illinois, Minnesota and Wisconsin
TTY: 888-897-7523

Jurisdiction K: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont
TTY: 866-786-7155

Posted 11/8/2019

Last Modified: 11/7/19
Medicare Participation Enrollment for Calendar Year 2020
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