Hospital outpatient department (OPD) prior authorization exemption process
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to...
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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...
Update history: LCD and article updates
View the most recent updates for our LCDs and articles. The comment period for a proposed LCD is currently open and will close...
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...
View NCDs
CMS develops NCDs to describe circumstances for Medicare coverage nationwide for an item or service. NCDs generally outline the...
Fast facts: CERT vaccine and roster billed claims
Read this article to learn more about CERT reviews for vaccine and roster billed claims.