Medical review

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Checklist: Skilled nursing facility (SNF) documentation

This checklist is an aid to assist skilled nursing facilities with responding to medical record documentation requests.

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 Florida, Puerto Rico and the US Virgin Islands. Learn more about the program…

A/B and DME MAC collaboration resources

Find guidance on ordering DME-related supplies.

Prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services

CMS is implementing a five-year demonstration project for the PA of certain services provided in ASCs, for a limited number of demonstration states effective for dates of services (DOS) on or after…

ASC HCPCS codes no longer requiring a paper invoice (JN)

To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.

Drug HCPCS codes no longer requiring a paper invoice

To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.

Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services

Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and…

Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services

Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and…

ASC HCPCS codes no longer requiring a paper invoice (JN)

To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.

Skin substitute HCPCS codes no longer requiring a paper invoice (JN)

To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.