CERT Insider's Guide - Part B Second Quarter 2025
Read the Part B second quarter edition of the CERT Insider's Guide to learn more about claim errors assessed during the CERT...
Hepatitis B vaccination
Payment for the hepatitis B vaccine and its administration is only available to Medicare beneficiaries who are at high or...
CERT Insider’s Guide – Part A Second Quarter 2025
Read the Part A second quarter edition of the CERT Insider's Guide to learn more about claim errors assessed during the CERT...
Billing & coding
Find the latest news pertaining to Medicare billing, coding, and general coverage changes. Access this page to view deductible...
Targeted probe and educate (TPE) round results: Evaluation and management services – initial inpatient care visits and subsequent inpatient care visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services - initial inpatient...
Fast facts: Responding to CERT additional documentation requests
Read this article for information about responding to CERT documentation requests.
Appeals
Find information regarding the appeals process -- levels, forms, FAQs, and how to appeal Medicare coverage and payment decisions...
Type of Service indicators (TOS)
The place of service or diagnosis may be considered when determining the appropriate TOS. The descriptors for each of the TOS...
Documentation requirements to support medical necessity for Inpatient Rehabilitation Facility (IRF) stay
First Coast has compiled a list of questions on specific topics that are listed in the CMS IRF RCD Medical Records Review...