Good morning, everyone. Tony Merritt Otto here. I want to touch on the topic of "par" versus "non-par," no affiliation with Medicare whatsoever. I think the language here is confusing for most of us. I know for myself, 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 are essentially three scenarios for a physical therapist. You've probably heard by now the saying that we cannot opt out. Well, what does that mean? Okay, so let's say you're a 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 exist. You're basically living off the grid when it comes to that. What does that mean? That means 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-par." Okay, so that's really important to make that distinction. "Non-par" is not the same as unaffiliated. "Non-par" is still credentialed, still has obligations and responsibilities. Unaffiliated means you have no way to submit that claim for covered services, which means you are legally not allowed to treat or work with a Medicare beneficiary because you can't submit that claim. Okay, as an unaffiliated therapist, you may provide non-covered services, and that's a whole separate video and lecture. But you're not allowed to provide covered 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 speak without visual references. So, if you go to chat, sorry, CMS...
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CMS Forms List Dec 1, 2024 — CMS Forms List ; CMS 10126, Filling Out the Enrollment and Claim Submission and Paying of Claims Forms and Submissions for Part A If you don't already have Medicare Part A; you'll need to apply online at SSA.gov/benefits/medicare. CMS 40C (1) The Form CMS-40C is fillable, can be completed online, print then mailed. Mail the completed form and itemized bills to the Medicare — CMS MEDICARE BILLING — GUIDELINES AND POLICIES ; CMS Forms List Dec 1, 2024 — The Centers for Medicare & Medicaid Services (CMS) is a Federal agency Many CMS program related forms are available in Portable Document CMS Forms List Dec 1, 2024 — The Centers for Medicare & Medicaid Services (CMS) is a Federal agency Many CMS program related forms are available in Portable Document CMS Forms List Dec 1, 2024 — CMS Forms List ; CMS 10125-01A, (1), (2); CMS 10125-03A, (1). Form Title; Medicare — Medicaid Coverage. CMS Forms List Dec 1, 2024 — The Centers for Medicare & Medicaid Services (CMS) is a Federal agency Many CMS program related forms are available in Portable Document CMS Forms List Dec 1, 2024 — CMS Forms List ; CMS 10130, (2) M-1, Medicare Part A (3) M-2 Medicare Part B or Medicare Part D. M-1/M-2 is also used for Medicare PCs, Medicare Advantage and Federally assisted HMO. See CMS FAQ.
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