Prior authorization

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Ambulatory surgical center (ASC) prior authorization request (PAR) submission guidelines

View these submission guidelines for ASC prior authorization requests.

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…

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

CMS is delaying the start date for the PA demonstration for certain services provided in ASCs and will be implementing the demonstration in two phases. For more information on the delayed…

Ambulatory surgical center (ASC) prior authorization (PA) claim submission guidelines

Prior authorization (PA) for the ASC prior authorization demonstration is voluntary. However, if a provider elects to bypass PA, applicable ASC claims will be subject to prepayment medical review.

Prior authorization request (PAR) ambulatory surgical center (ASC) procedures Medicare Part B fax/mail coversheet

The PAR fax/mail coversheet for ASCs is now available for Florida ASCs participating in the ASC PA demonstration. ASCs in Florida can submit PARs beginning on January 5, 2026, for dates of service (…

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…

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 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.