Medical review
Part A service-specific review -- (CPT 97110 therapeutic activities)
View this summary for outpatient rehabilitation services (August - November 2020).
Part A service-specific review - (CPT 97530 therapeutic activities)
View this summary for outpatient rehabilitation services (January through August 2021).
Part B service-specific review – drugs and biologicals (J0178 Eylea, J0897 Prolia, J2778 Lucentis, J9217 Lupron (Leuprolide))
Summary for drugs and biologicals (April-May 2021).
Part B service-specific review – psychotherapy services (CPT codes 90832-90839)
View this summary for psychotherapy services (December 2020 - March 2021).
Part B service-specific review – clinical laboratory presumptive and definitive drug testing
Summary for Clinical Labs (November 2020).
Part B service-specific review – clinical laboratory lipid panel (80061)
Summary for clinical laboratory lipid panel (June and July 2021).
Skilled nursing facility (SNF) 5-claim probe and educate (P&E) review
View this article for information concerning requirements of change request 13164.