Medicare Private Pay Contract - marciajwoodphd.com 2025

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In a private contract, the Medicare beneficiary agrees to give up Medicare payment for services furnished by the eligible practitioner and to pay the eligible practitioner without regard to any limits that would otherwise apply to what the eligible practitioner could charge.
Explanation: A physician or practitioner with a Medicare private contract agrees not to bill for any service or supplies provided to any Medicare beneficiary for at least a specific period of time.
PAR physicians agree to take assignment on all Medicare claims, which means that they must accept Medicares approved amount (which is the 80% that Medicare pays plus the 20% patient copayment) as payment in full for all covered services for the duration of the calendar year.
With that being said, there are two general types of contracts for healthcare services you should be familiar with: fee-for-service and predetermined per-person agreements.