Policy & review programs
LCDs / Medical Policy
Find news about local and national coverage determinations, learn how to search the Medicare coverage database, use the procedure/diagnosis code lookup tool, and review clinical trials.
Provider Audit & Reimbursement
Part A providers: Find details regarding provider audit and reimbursement, including cost report filing instructions, rate and reimbursement details, wage index, and more.
Compliance & Review
Learn about various programs which focus on ensuring Medicare compliance. Topics include:
- Comprehensive error rate testing (CERT) program
- Prior authorization program
- Targeted probe and educate
These programs are used to identify inappropriate billing, and educate providers on proper documentation, an Medicare coverage and coding requirements.