2025 Medicare Participation Open Enrollment Period

Published 11/07/2024

Read this year's announcement (PDF) about the annual Medicare participation open enrollment period. View CMS' website for more information.

Every year from November 15 through December 31, providers can decide if they want to participate in Medicare for the upcoming year. In early to mid-November, we sent a post card reminding you about the annual participation open enrollment period. 

A participating provider enters into an agreement (CMS-460 (PDF)) to accept the Medicare-approved amount as full payment for services and supplies covered under Part B. A participating provider receives five percent more reimbursement than a non-participating provider. 

The participation agreement will automatically renew each year. However, if there is a name or EIN (tax identification number) change, you will need to complete a new participation agreement. 

If you have not signed a participation agreement, you or your organization are listed as a non-participating provider and subject to the limiting charge fee schedule. 

Completing the Participation Agreement

  • Name(s) and Address of Participant: Enter the name and address of your organization
  • Physician or Supplier Identification Code(s): Enter your new Medicare provider number (PTAN). If your PTAN is pending, enter your tax identification or social security number. 
  • Effective Date: Enter the date the CMS-460 form is being delivered or mailed to Palmetto GBA. "Beginning of Agreement" is the date you are mailing your participation agreement to the Palmetto GBA.
  • Signature of Participant or Authorized Representative of Participating Organization
  • Title: Enter the title of provider (M.D., etc.) or representative 
  • Date: Enter the date the agreement is signed 
  • Office Phone Number: Enter the phone number of the organization 
  • Received By, Effective Date, Initials of Carrier Official: This section is to be completed by the Medicare contractor 

Additional Information

  • A group and all members must maintain the same participation status 
  • Members joining a group are not required to sign a CMS-460 
  • Incorporated or group practitioners must complete a CMS-460 application 

Submit a signed Medicare Participating Physician or Supplier Agreement (CMS-460 (PDF)) to become a participating provider.

For Jurisdiction M (North Carolina, South Carolina, Virginia and West Virginia), send completed forms to:

Palmetto GBA – JM Part B
Mail Code: AG-310
P.O. Box 100190
Columbia, SC 29202-3190

Please call Palmetto GBA at 855–696–0705 if you have any questions or need further information on participation.

The calendar year 2025 Medicare Physician Fee Schedule and Anesthesia Conversion Factors will be available as soon as possible after the CY 2025 physician fee schedule regulation is put on display. 


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