Targeted probe and educate (TPE)
TPE is one process that a MAC can utilize when providers are selected by medical review.
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Post-payment service-specific reviews
Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically...
Targeted probe and educate (TPE) round results: Inpatient rehabilitation facilities (IRF)
Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).
Part B service-specific review - ambulance services (HCPCS code A0428 with A0425)
Summary for ambulance services (October 2020).
Targeted probe and educate (TPE) round results: Ambulance services - basic life support non-emergent transport and mileage (HCPCS A0428 and A0425)
View targeted probe and educate (TPE) round results for ambulance services: basic life support non-emergent transport and...
Understanding prior authorization (PA) for certain hospital outpatient department (OPD) services
The following document was developed based on questions and answers posed during our webinars on the prior authorization (PA)...
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient (KX modifier)
View TPE round results for rehabilitation services outpatient (KX modifier).
Targeted probe and educate (TPE) round results: Evaluation and management services – initial inpatient care visits and subsequent inpatient care visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services - initial inpatient...
Targeted probe and educate (TPE) topics and schedule of review
View this updated listing of targeted probe and educate (TPE) review topics.
Targeted probe and educate round results: Transitional care management
Top denial/ partial denial reasons and high-level results are listed below from each round of Transitional Care Management (TCM)...