Medical review
Targeted probe and educate (TPE) round results: Clinical laboratory services
View targeted probe and educate (TPE) round results for clinical laboratory services.
Prior authorization (PA) program for certain hospital outpatient department (OPD) services - submitting the prior authorization request (PAR)
View these submission guidelines when submitting prior authorization requests for certain hospital outpatient department services.
Prior authorization (PA) program for certain hospital outpatient department (OPD) services - submitting the prior authorization request (PAR)
View these submission guidelines when submitting prior authorization requests for certain hospital outpatient department services.
Prior authorization fax coversheet
CMS is implementing a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020. Review the fax coversheet needed for submission.
CBR Guide - Part B
The Comparative Billing Report (CBR) for Part B providers furnishes a detailed examination of the comparative data that Medicare considers when determining how the provider’s billing patterns…
Prior authorization fax coversheet
CMS is implementing a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020. Review the fax coversheet needed for submission.
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…
Cervical fusion with disc removal
Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for cervical fusion with disc removal if performed…
Cervical fusion with disc removal
Effective for dates of service July 1, 2021, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for cervical fusion with disc removal if performed…