Novitas Solutions has issued their reminder that is it decision making time. The following information was released in their MLN Connects newsletter on Friday, November 14, 2025:
As you plan for next year, CMS reminds you of the advantages of participating in Medicare:
- You’re paid the full Medicare Physician Fee Schedule allowed amount. If you’re a non-participating provider, Medicare pays 5% less than the Medicare Physician Fee Schedule allowed amount.
- Medicare pays you directly (on an assignment-related basis).
- Medicare forwards claim information to Medigap (Medicare supplement coverage) insurance (if any).
By December 31, 2025, all physicians, practitioners, and suppliers – regardless of their Medicare participation status – must decide whether to participate for CY 2026.
You don’t need to do anything if you’re:
- Already participating in Medicare, and you want to continue your participation
- Not currently participating, and you don’t want to participate
See the Annual Medicare Participation Announcement webpage for more information on how to change your Medicare participation.
National Plan and Provider Enumeration System (NPPES) Taxonomy Please check your data in NPPES and confirm that it still correctly reflects you as a health care provider with the appropriate taxonomy and correctly reflects your current practice address. Incorrect data in NPPES may lead to unnecessary inquiries about your credentials and delay enrollment with Medicare and health plans
