Will Doctors Refuse Medicare? 
There are actually three Medicare contractual options for physicians . Physicians may sign a participating -LRB- PAR -RRB- agreement and accept Medicare 's allowed charge as payment in full for all of their Medicare patients . They may elect to be a non-PAR physician , which permits them to make assignment decisions on a case-by-case basis and to bill patients for more than the Medicare allowance for unassigned claims . Or , they may become a private contracting physician , agreeing to bill patients directly and forego any payments from Medicare to their patients or themselves.Physicians who wish to change their status from PAR to non-PAR or vice versa may do so annually . Once made , the decision is generally binding until the next annual contracting cycle except where the physician 's practice situation has changed significantly , such as relocation to a different geographic area or a different group practice . To become a private contractor , physicians must give 30 days notice before the first day of the quarter the contract takes effect . 