Pathology/Lab Coding Alert

Question: Our pathology practice currently opts out of Medicare, and I heard that there’s a change in how we should do that. Is there a change, and if so, what is it?

California Subscriber

Answer: Yes, there has been a recent change to the Medicare opt-out procedures.

Thanks to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), any opt-out affidavit that you sign on or after June 16, 2015 will auto-renew every two years. In the past, you had to manually refile your opt-out authorization every two years — so if you plan to stay out of Medicare indefinitely, the new change will be quite welcome and will save you both time and paperwork.

If, however, you do not want to opt out of Medicare anymore after your current authorization expires, you’ll have to cancel the renewal “by notifying all Medicare Administrative Contractors (MACs) with which you filed an affidavit in writing at least 30 days prior to the start of the next opt-out period,” CMS says in its June 25 MLN Connects Provider eNews document.

Any opt-out affidavits that you filed before June 16, 2015 won’t auto-renew. Instead, you’ll file a renewal affidavit within 30 days of the current opt-out period expiration, if you choose to renew.