Targeted probe and educate (TPE) round results: Evaluation and management services - outpatient office visits
View TPE round results for evaluation and management services - outpatient office visits.
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Targeted probe and educate (TPE) round results: Drugs and biologicals (HCPCS J7318-J7329, J7331-J7332)
View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).
Finding fee schedule policy indicators
How to find policy indicators such as global days for a service, relative value units (RVUs) for a particular code, and more.
Hospital outpatient department (OPD) prior authorization exemption process
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to...
Process for supplying invoice amount on certain HCPCS codes - avoid rejected claims
The code list for drugs has been updated.
Prior authorization program for repetitive, scheduled non-emergent ambulance transports (RSNAT)
CMS has implemented the prior authorization program for certain repetitive, scheduled non-emergent ambulance transports in...
Preventive services: Coverage determination
Find information on local and national coverage determinations specific to preventive services.
Cardiac and pulmonary rehabilitation programs
Medicare pays for cardiac rehabilitation (CR), intensive cardiac rehabilitation (ICR), and pulmonary rehabilitation (PR)...
Ambulance Prior Authorization Documentation Requirements
Review this checklist to learn about the documentation requirements to ensure an affirmed decision on your prior authorization...
Prompt payment interest rate revision
The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 4.625% is in effect...