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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...
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...
Split or shared E/M guidelines: Medicare Claims Processing Manual updates
This article summarizes the Medicare E/M guidelines for split or shared E/M services effective in 2024.
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...
View NCDs
CMS develops NCDs to describe circumstances for Medicare coverage nationwide for an item or service. NCDs generally outline the...
Modifier 57 flowchart
Use this decision flowchart to assist in correctly applying the 57 modifier.