Page 2 - Medicare Benefit Policy Manual

40.12 - Actions to Take in Cases of Failure to Maintain Opt-Out
40.13 - Physician/Practitioner Who Has Never Enrolled in Medicare
40.14 - Nonparticipating Physicians or Practitioners Who Opt Out of Medicare
40.15 - Excluded Physicians and Practitioners
40.16 - Relationship Between Opt-Out and Medicare Participation Agreements
40.17 - Participating Physicians and Practitioners
40.18 - Physicians or Practitioners Who Choose to Opt Out of Medicare

40.19 - Opt-Out Relationship to Noncovered Services
40.20 - Maintaining Information on Opt-Out Physicians
40.21 - Informing Medicare Managed Care Plans of the Identity of the Opt-Out
Physicians or Practitioners
40.22 - Informing the National Supplier Clearinghouse (NSC) of the Identity of the
Opt-Out Physicians or Practitioners
40.23 - Organizations That Furnish Physician or Practitioner Services

40.24 - The Difference Between Advance Beneficiary Notices (ABN) and Private
Contracts
40.25 - Private Contracting Rules When Medicare is the Secondary Payer
40.26 - Registration and Identification of Physicians or Practitioners Who Opt Out

40.27 - System Identification
40.28 - Emergency and Urgent Care Situations
40.29 - Definition of Emergency and Urgent Care Situations
40.30 - Denial of Payment to Employers of Opt-Out Physicians and Practitioners
40.31 - Denial of Payment to Beneficiaries and Others
40.32 - Payment for Medically Necessary Services Ordered or Prescribed by an
Opt-out physician or Practitioner
40.33 - Mandatory Claims Submission
40.34 - Cancellation of Opt-Out
40.35 - Early Termination of Opt-Out
40.36 - Appeals
40.37 - Application to the Medicare Advantage Program
40.38 - Claims Denial Notices to Opt-Out Physicians and Practitioners
40.39 - Claims Denial Notices to Beneficiaries
50 - Drugs and Biologicals

50.1 - Definition of Drug or Biological
50.2 - Determining Self-Administration of Drug or Biological
50.3 - Incident-to Requirements
50.4 - Reasonableness and Necessity
50.4.1 - Approved Use of Drug
50.4.2 - Unlabeled Use of Drug