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Good morning everyone Tony Merritt Otto here I want to touch on the topic of par vers non parvis no affiliation with Medicare whatsoever I think the language here is confusing for most of us I know for myself I I didn't know until I started delving deep into the policies and procedures CMS is putting out but let's just go through the definition of each so there's essentially three scenarios for a physical therapist you've probably heard by now the the saying that we cannot opt out well what does that mean okay so let's say you your brand-new grad you're just getting your MPI for the first time maybe you don't even have an MPI you have no affiliation with Medicare that's one category Medicare doesn't know you exists you you basically you're just living off the grid when it comes to that what does that mean that means that you are unable to submit a claim to Medicare for covered services if you are unaffiliated if you've never submitted an application for credentialing with Medicare you're not par you're not non pas okay so that's really important to make that distinction non par is not the same as unaffiliated non-power is still credentialed still has obligations and responsibilities unaffiliated means you have no way to submit that claim for covered service which means you are legally not allowed to treat or work with a Medicare beneficiary because you can't submit that claim okay so as an unaffiliated therapist you may prnon covered services and that's a whole separate video in lecture but you're not allowed to prcovered services to a Medicare beneficiary because you were unable to submit the claim now let me show you I'm gonna jump into my screen because I hate to to speak without visual references so if you go to chat sorry CMS chapter 15 PDF Medicare benefit policy manual so this is updated february 1st 2019 scroll down the section 40 this is where they talk about a opt-out who can opt-out who cannot opt-out physical therapists may not opt out you may still be unaffiliated but you're not opt out I hope that I mean it's as clear as mud I know and the main thing here is if you scroll down I don't remember the exact section you'll find the rules on the mandatory claim submission let me see if I can just do a quick right here is section 40 point 33 mandatory claim submission this is where it explains if you're providing coverage services you are federally required by law to submit a claim to Medicare if you have no affiliation with Medicare you cannot submit that claim you're not in their system hence it's illegal to prcovered services ok let's move past that so that was number one unaffiliated now we get into par or non par and there are several articles if you just you know look up like this is