Update history: LCD and article updates
View the most recent updates for our LCDs and articles. An LCD has been posted for notice to become effective May 17.
Articles
Article Type
Category
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.
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...
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...
Ambulance Prior Authorization Documentation Requirements
Review this checklist to learn about the documentation requirements to ensure an affirmed decision on your prior authorization...
View NCDs
CMS develops NCDs to describe circumstances for Medicare coverage nationwide for an item or service. NCDs generally outline the...
Part B reimbursement fees: Transportation of portable X-ray equipment (R0070/R0075)
View current and prior year's portable x-ray reimbursement rates.
Fast facts: CERT vaccine and roster billed claims
Read this article to learn more about CERT reviews for vaccine and roster billed claims.