Medical review

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

CMS is implementing a five-year demonstration project for the prior authorization of certain services provided in Ambulatory Surgical Centers (ASCs) and will be implementing the demonstration in two…

How to bill correctly for transcranial magnetic stimulation (TMS) in the treatment of adults with major depressive disorder

First Coast is receiving first-level appeals (redeterminations) based on claim denials for providers not including the ordering psychiatrist on the claim when billing for transcranial magnetic…

How to bill correctly for transcranial magnetic stimulation (TMS) in the treatment of adults with major depressive disorder

First Coast is receiving first-level appeals (redeterminations) based on claim denials for providers not including the ordering psychiatrist on the claim when billing for transcranial magnetic…

Repetitive scheduled non-emergency ambulance transport prior authorization claims submission guidelines

Follow this instructions to learn how to file a claim once you received the unique tracking number (UTN) related to the prior authorization of repetitive, scheduled non-emergency ambulance transports…

Targeted probe and educate (TPE) round results: Rehabilitation services outpatient

View these round results for rehabilitation services outpatient.

Targeted probe and educate (TPE) round results: Clinical laboratory services

View targeted probe and educate (TPE) round results for clinical laboratory services.

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).

Targeted probe and educate (TPE) round results: Clinical laboratory services

View targeted probe and educate (TPE) round results for clinical laboratory services.

Targeted probe and educate (TPE) round results: Rehabilitation services outpatient

View these round results for rehabilitation services outpatient.

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).