Prior authorization
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.
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.
Provider documentation tool for non-emergent ambulance transportation
This article is designed to assist medical providers with documenting the beneficiary’s medical condition supporting coverage for non-emergent ambulance transportation.
Ambulatory surgical center (ASC) prior authorization request (PAR) submission guidelines
View these submission guidelines for ASC prior authorization requests.
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 (…
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…
YouTube video: Answers to your prior authorization exemption questions
Are you participating in prior authorization and want to know how to maintain exemption within this program? Do you have questions regarding the different timeframes and dates relating to the…
YouTube video: Answers to your prior authorization exemption questions
Are you participating in prior authorization and want to know how to maintain exemption within this program? Do you have questions regarding the different timeframes and dates relating to the…