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Medical review

Service-specific reviews currently in effect
Modified: 4/7/2021
December 14, 2017 -- Follow-up questions and answers
Modified: 2/8/2021
This article contains questions and answers from the Targeted Probe and Educate webcast.
Post-payment service-specific reviews
Modified: 11/6/2020
Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically reasonable and necessary.
Targeted Probe and Educate
Modified: 9/13/2020
TPE Targeted Probe and Educate
Targeted probe and educate topics for review
Modified: 9/10/2020
TPE review topics
Timely response to additional documentation request
Modified: 9/15/2019
First Coast Service Options (First Coast), frequently requires a clinical review of records to determine the medical necessity of services.
Targeted probe and educate
Modified: 2/1/2019
The Centers for Medicare & Medicaid Services (CMS) has now authorized First Coast Service Options (First Coast) to conduct reviews utilizing a TPE review process.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.