Can I Bill as an Out Of Network Provider for Medicare Part B?

The short answer is definitely not.

The long answer is that it’s a huge pain in the butt; authorization is required on a case by case basis, and the billing is a nightmare.

So the long and the short of it is that if you don’t have a physical Medicare contract, and you haven’t been assigned a PTAN, you can’t bill for Medicare Part B.

This also means that if they have a Medicare primary and private insurance secondary plan, you will still be out of luck.

This is a surprisingly common issue with billing and we wanted to let you folks out there know!

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