Payment for Medically Necessary Services Ordered or Prescribed by an Opt-out

40.32 - Payment for Medically Necessary Services Ordered or Prescribed by an Opt-out physician or Practitioner (Rev. 160, Issued: 10-26-12, Effective: 01-28-13, Implementation: 01-28-13) If claims are submitted for any items or services ordered or prescribed by an opt out physician or practitioner under §1802 of the Act, the Medicare contractor may pay for medically necessary services of the furnishing entity, provided the furnishing entity is not also a physician or practitioner that has opted out of the Medicare program.