Prior authorization

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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…

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…

Rhinoplasty and related services

Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.

Botulinum toxin injections

Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and excessive muscle contractions, such as dystonia, spasms, and twitches.

Botulinum toxin injections

Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and excessive muscle contractions, such as dystonia, spasms, and twitches.

Vein ablation and related services

Vein ablation and related services; some patients may want varicose vein treatment for cosmetic reasons. Medicare does not cover cosmetic surgery or expenses incurred in connection with such surgery.

Vein ablation and related services

Vein ablation and related services; some patients may want varicose vein treatment for cosmetic reasons. Medicare does not cover cosmetic surgery or expenses incurred in connection with such surgery.

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…

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…

Rhinoplasty and related services

Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.