Eligibility elimination from the IVR
The option to obtain patient eligibility information from the interactive voice response (IVR) system was eliminated on December...
Update of the 2025 dollar amount in controversy required to sustain appeal rights for an Administrative Law Judge (ALJ) Hearing or Federal District Court Review
Section 1869(b)(1)(E) of the Social Security Act (the Act), as amended by Section 940 of the Medicare Prescription Drug...
PC-ACE user guide index
Detailed instructions to use the free PC-ACE software for billing Medicare claims electronically.
MLN Connects for January 8, 2026
This edition includes information on the new CMS LEAD model, the new BALANCE model, 2026 updates, and more.
DMEPOS HCPCS codes jurisdiction list
CMS annually updates the durable medical equipment prosthetics, orthotic, and supplies (DMEPOS) for DME MAC and Part B MAC...
2026 influenza, pneumococcal, and hepatitis B vaccine reimbursement
Read this article for information on vaccine fees for calendar year 2026.
The SPOT User Guide: Section 9 - Prior Auth
Part A and B providers can easily submit their Prior Authorization Request (PAR) forms in SPOT for certain hospital outpatient...
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...
Streamline Medicare Billing with Electronic Claim Submission
Still submitting Medicare Part B claims on paper? Discover how to save time and money while receiving quicker Medicare...
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...