Understanding the prior authorization (PA) demonstration for ambulatory surgical center (ASC) services
This document was developed based on questions and answers posed during our webinars on the PA demonstration for ASC services.
Articles
Article Type
Category
Checklist: Outpatient hospital services
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation...
Checklist: Musculoskeletal system and connective tissue or procedures
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation...
Fast facts: CERT administrative relief during a disaster
Read this article for information about how CERT may grant temporary administrative relief to certain affected providers and...
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)
TPE is one process that a MAC can utilize when providers are selected by medical review.
Skilled nursing facility (SNF) 5-claim probe and educate (P&E) review
View this article for information concerning requirements of change request 13164.
Part B service-specific review – psychotherapy services (CPT codes 90832-90839)
View this summary for psychotherapy services (December 2020 - March 2021).
Part A service-specific review - (CPT 97530 therapeutic activities)
View this summary for outpatient rehabilitation services (January through August 2021).
Part A service-specific review -- (CPT 97110 therapeutic activities)
View this summary for outpatient rehabilitation services (August - November 2020).