Medical review
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient
View these round results for rehabilitation services outpatient.
Prior authorization program for certain hospital outpatient department services
CMS implemented a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020.
Prior authorization program for certain hospital outpatient department services
CMS implemented a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020.
Prior authorization program initiatives
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process allows the provider to submit documentation prior to providing or billing…
Prior authorization program initiatives
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process allows the provider to submit documentation prior to providing or billing…
Prior authorization program for repetitive scheduled non-emergent ambulance transports
Background
Submissions
Extended affirmation periods
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…
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient
View these round results for rehabilitation services outpatient.
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) program for certain hospital outpatient department (OPD) services.
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) program for certain hospital outpatient department (OPD) services.