Prior authorization
Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders
Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.
Instructions for completing the prior authorization request (PAR) coversheet for repetitive scheduled non-emergency ambulance transport
Learn how to complete the the prior authorization request (PAR) coversheet for repetitive scheduled non-emergency ambulance transports.
Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders
Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.
Prior authorization program for repetitive scheduled non-emergent ambulance transports
Background
Submissions
Extended affirmation periods
Claim submission tips
Prior authorization program for certain hospital outpatient department services - claim submission guidelines
Claims submitted for a prior authorization request (PAR) that received a provisional affirmation PA decision, including any service that was part of a partially affirmed decision, must include the 14…
Prior authorization program for certain hospital outpatient department services - claim submission guidelines
Claims submitted for a prior authorization request (PAR) that received a provisional affirmation PA decision, including any service that was part of a partially affirmed decision, must include the 14…
Implantation of Spinal Neurostimulator
CMS covers the implantation of central nervous system stimulators as a therapy for the relief of chronic intractable pain.
Implantation of Spinal Neurostimulator
CMS covers the implantation of central nervous system stimulators as a therapy for the relief of chronic intractable pain.
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…
Attention exempt hospital outpatient departments (OPDs): Revised additional documentation request (ADR) letters
Due to a claim issue identified, exempt hospital OPDs will be receiving a revised exemption ADR letter with a revised letter fax cover sheet.