7 specialties with greatest share of physicians opting out of Medicare

Morgan Haefner - Print  | 

Psychiatrists make up the largest share of physicians who opt out of Medicare and enter private contracts with their Medicare patients, according to Kaiser Family Foundation.

Overall, less than 1 percent of physicians opt out of Medicare, while 96 percent of physicians participate in the program and agree to accept Medicare's standard fee-schedule amount as full payment for Medicare-covered services. The remaining 4 percent are nonparticipating providers — meaning they can decide on a service-by-service basis to charge Medicare beneficiaries higher fees up to 115 percent of a reduced standard fee, with patients accountable for the difference.

Here are the seven specialties representing the largest percentage of all opt-out providers in 2016.

1. Psychiatry, geriatric psychiatry, neuropsychiatry   — 38.10 percent

2. Family medicine/general practice — 15.80 percent

3. Internal medicine — 9.90 percent

4. Obstetrics/gynecology — 6  percent

5. Pediatric specialties — 5.60 percent

6. Neuromusculoskel, osteo manip, sports medicine  — 2.30 percent

7. Orthopedic surgery — 2.20 percent

For its analysis, KFF used 2015 physician counts from the Association of American Medical Colleges and CMS' Medicare opt out data. Click here to see the full report.  

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