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Disclaimer

LICENSE FOR USE OF "PHYSICIAN'S CURRENT PROCEDURAL TERMINOLOGY" (CPT), FOURTH EDITION End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2022 American Medical Association (AMA).

All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.
You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials:
Local Coverage Determinations (LCDs),
Local Medical Review Policies (LMRPs),
Bulletins/Newsletters,
Program Memoranda and Billing Instructions,
Coverage and Coding Policies,
Program Integrity Bulletins and Information,
Educational/Training Materials,
Special mailings,
Fee Schedules;

internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare and Medicaid Services (CMS), formerly known as Health Care Financing Administration (HCFA). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA website. Applicable FARS/DFARS restrictions apply to government use.

AMA Disclaimer of Warranties and LiabilitiesCPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this agreement.

CMS DisclaimerThe scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

AMA - U.S. Government Rights

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a )June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

ADA CURRENT DENTAL TERMINOLOGY, (CDT)
End User/Point and Click Agreement: These materials contain Current Dental Terminology (CDTTM), Copyright © 2016 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING ON THE BUTTON LABELED "ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.

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IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.

Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the ADA website.

Applicable Federal Acquisition Regulation Clauses (FARS)\Department of restrictions apply to Government Use.

ADA DISCLAIMER OF WARRANTIES AND LIABILITIES: CDT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CDT. The ADA does not directly or indirectly practice medicine or dispense dental services. The sole responsibility for the software, including any CDT and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third party beneficiary to this Agreement.

CMS DISCLAIMER: The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

End Disclaimer



This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. For the most comprehensive experience, we encourage you to visit Medicare.gov or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
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Part B

Find information regarding the appeals process -- levels, forms, training, FAQs, and how to appeal Medicare coverage and payment decisions.
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Find the latest news pertaining to Medicare billing and general coverage changes, learn how to employ preventive measures to promote patient health, use tools to improve your billing, and locate deductible information.
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Features key resources to help you understand claim submission guidelines and current processing issues and how they may impact you. It also includes essential information that will help you decrease the time you need to spend calling the provider contact center and increase the volume of claims that process correctly -- the first time. You’ll be able to review the top inquiries, denials, and return unprocessable claims (RUC) (or Inquiries, Rejects, and RTPs) and learn how to avoid them.
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This section will enable you to find the information you need about claim review programs. Learn about medically unlikely edits (MUE), comprehensive error rate testing (CERT) program, inpatient Medicare severity-related diagnosis-related groups (MS-DRG), the recovery audit program, and National Correct Coding Initiative (CCI) edits.
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Find resources to improve your coding accuracy and keeps you informed on coding-related topics including ICD-10, modifiers, place of service, and procedure codes.
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Find telephone numbers, departmental contact information, holiday and training closures, how to submit general inquiries and provide feedback to First Coast, additional resources, and more.
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Find the latest Electronic Data Interchange (EDI) news, software updates, forms, pre-pass edits, and companion documents and learn how to begin submitting your claims electronically.
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Learn about First Coast’s online and instructor-led training opportunities; get involved with the Provider Outreach and Education Advisory Group (POE-AG); and find links to the educational resources available on the Centers for Medicare & Medicaid Services (CMS) website.
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Learn more about billing for evaluation and management (E/M) services including its key components, CPT code ranges, and documentation requirements. You’ll also find helpful tips, tools, and information regarding other online E/M resources available to providers.
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Find answers to your questions regarding billing issues, drugs and biologicals, coding inpatient cost outlier claims, eligibility, skilled nursing facilities, provider enrollment, overpayment, claims overlap, and more.
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Use our interactive fee lookup tool, download data files containing the most recent fee schedule information to use in developing a database of fees, and search our extensive archive of retired fee schedules.
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Feedback & Inquiries
Providers can use the forms on our new feedback page to submit comments regarding their interchange with various operational areas throughout First Coast Service Options Inc. and to submit comments related to this website and its functionality.
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Find the forms you need for an overpayment refund request, extended repayment schedule for corporations or groups, overpayment redetermination request, periodic interim payment request, an influenza virus vaccine roster, or a credit balance report.
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Find various help documents, how-to guides, and resources on disaster information. Here you can also access MEDPARD information, find updates on the Medicare Modernization Act (MMA), learn how to prevent fraud and abuse, and more.
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Learn how to use our interactive voice response system for 24-hour access to general information regarding new Medicare legislation, office closures, publications, remittance code definitions, and other information. The IVR can also help you access eligibility and claim specific information during hours beyond customer service availability.
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Find news about local and national coverage determinations, learn how to search the Medicare coverage database, use the procedure/diagnosis code lookup tool, and review clinical trials.
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Medical record documentation is required to record pertinent facts, findings, and observations about an individual’s health history including past and present illnesses, examinations, tests, treatments, and outcomes. Find tips, tools and resources for the documentation of clinical services provided to Medicare patients.
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Medical Review focuses on identification of aberrancies or patterns of inappropriate billing, educating providers on Medicare coverage and coding requirements, and performing medical review of claims and supporting documentation. Learn more about the medical review process including the Targeted Probe and Educate program, as well as the Prior Authorization program.
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Find the latest provider enrollment news as well as the forms, tools, and resources you need to become a Medicare provider and learn how to successfully complete enrollment forms the first time with helpful tips and tutorials.
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Learn the latest news, information, and eligibility requirements for the Centers for Medicare & Medicaid Services’ (CMS) incentive programs that help improve the quality and efficiency of beneficiary care through provider participation.
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Find the latest news and information identified specifically for providers of specialty services including ambulance, chiropractic, hospice, oncology, rehabilitation services, and several more.
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First Coast’s Secure Provider Online Tool (SPOT) is a free Web-based application hosted through the Centers for Medicare & Medicaid Services’ Enterprise Identity Management (IDM) system. The SPOT offers providers the convenience of online access to essential Medicare data, including claim status, payment history, benefits/eligibility information, and data reports. It also serves as an alternative submission channel for additional development response (ADR), appeal, overpayment, and reopening forms.
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This page features a one-stop shop for all of First Coast’s self-service tools.
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New providers -- begin your Medicare journey the right way with First Coast’s Right Start program.
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First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
Part B