Non-participating status for Medicare is punitive against the non-par doctor. There is a separate fee schedule for non-participating physicians, which is set 5% less than the participating fee schedule.
-- If you do not accept assignment on a claim, the maximum amount you may charge is 115 percent of the approved fee schedule amount for non-participating providers. This amounts to only 9.25 percent more than the fee schedule amount for participating providers (115% x 95%).
-- Non-participating providers may accept assignment on a claim-by-claim basis, but these claims are approved at 95 percent of the participating physician fee schedule for the same service.

If you choose to Opt-out of Medicare entirely (the feds call this "Private Contracting"), the patient gives up all Medicare or supplement payment for services furnished by the "opt out" physician. Essentially, you now have an uninsured patient.

Every time I read through this, I wonder how I got myself into this deal with the devil.

John
Internal Medicine