Medicare Opt Out

SOL THERAPY

SHIRLA DE MAGALHAES, LMFT # 82947 - 8453 La Mesa Blvd, La Mesa, CA 91942
Private-Pay (Opt-Out) Medical Services Contract

Section 4507 of the 1997 Balanced Budget Act allows a physician or practitioner to enter into a private contract with a client who is also a Medicare beneficiary. Throughout this document the word "client" refers to any client who can legally consent to their psychotherapy treatment and the legal representatives of my minor clients. It is my duty to inform my clients that I have not been excluded from providing medical services under Social Security Act Medicare including sections 1128, 1156, 1892, CFR § 405, subpart D. However, I Shirla de Magalhães, LMFT, RPT-S,RSP, have chosen to separate myself ("opt out") from Medicare. My current opt-out started on 03/08/2024 and ends on 03/08/2026. Because I opted out, Medicare requires that clients sign a private-pay medical services contract. Please read carefully the explanation of my opt-out status with Medicare before signing this document and let me know if you have any questions.
WHO PAYS FOR THE PSYCHOTHERAPY SERVICES PROVIDED BY SHIRLA DE MAGALHAES?

Without exception the client pays the bill. The client is financially responsible for paying the ENTIRE cost of services provided by Shirla de Magalhaes.

ARE THERE CHARGE LIMITS for services rendered? No, Medicare charge limits DO NOT apply to services you receive from Shirla de Magalhaes. That means that Shirla de Magalhaes is allowed to charge her clients whatever amount has been agreed to at the commencement of their legal engagement.
WILL MEDICARE HELP ME PAY FOR MY TREATMENT WITH SHIRLA DE MAGALHAES?

No, Medicare will NOT help pay your bill AND because Shirla de Magalhaes has separated from Medicare, it is against the rules for clients to send a bill to Medicare for services provided by Shirla de Magalhaes. Moreover, it is also against the rules to ask Shirla de Magalhaes to send their bill to Medicare.

BUT ISN'T PSYCHOTHERAPY A MEDICARE-COVERED SERVICE?

Yes and no. Yes, Medicare would pay for the same service from a provider who is connected to Medicare. HOWEVER, Medicare won't pay for Shirla de Magalhaes because she has legally separated herself from Medicare.

WHAT OPTIONS DO I HAVE?

You have the right to receive psychotherapy services from a provider connected to Medicare or from me, a provider separated from Medicare. This is your choice and even if you decide to receive services from Shirla de Magalhaes, you can still receive services from other providers connected to Medicare.
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