H.R. 4204 — Medicare Patient Choice Act

This section expands Medicare's private contract provision—allowing beneficiaries to contract directly with specified providers for covered items or services without submitting Medicare claims (and thus forgoing Medicare payment limits and Medigap coverage)—to include therapists and qualified audiologists (previously limited to physicians and practitioners). It defines therapist as a qualified physical therapist, occupational therapist, or speech-language pathologist (per Medicare definitions in SSA sections 1861(p), (g), and (ll)(4)(A)) and qualified audiologist as defined in SSA section 1861(ll)(4)(B). (Thus, these providers may receive no Medicare reimbursement and charge beneficiaries any amount.)