Articles
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The SPOT User Guide: Section 4 - MBI Lookup
Providers must use the patient’s Medicare Beneficiary ID (MBI) for all transactions. Per CMS MBI education, there are three ways...
ACCESS Model HCPCS G-Code Allowed Amounts: July 2026
Pricing information is available for HCPCS codes payable under Medicare when furnished for the Advancing Chronic Care with...
Repetitive Scheduled Non-Emergent Ambulance Transportation Glossary Tool
The following article provides a list of common terms used by the medical review department for prior authorization requests.
Encelto Cell Gene Therapy Drug
This article provides billing guidance and claim submission instructions for providers administering Encelto when provided in an...
Current Processing Issues
Incorrect duplicate denials have occurred for chronic care management (CCM) and remote physiological management (RPM) services...
ACCESS Model HCPCS G-Code Allowed Amounts: October 2026
Pricing information is available for HCPCS codes payable under Medicare when furnished for the Advancing Chronic Care with...
Medicare Deductible and Coinsurance
View annual deductibles and coinsurance for beneficiaries covered through the Medicare fee-for-service program.
Finding Fee Schedule Policy Indicators
How to find policy indicators such as global days for a service, relative value units (RVUs) for a particular code, and more.