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PC-ACE upgrade and installation instructions
PC-ACE version 6.9 is now available. Follow these instructions to complete the required quarterly upgrades or the full...
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...
Modifier 66 fact sheet
Surgeons append modifier 66 to claims indicating they were on a team of surgeons performing a specific procedure on the same...
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...