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This edition includes information on CY2025 updates to Opioid Treatment Programs and more.
Find information pertaining to the 2% reduction in Medicare payments due to sequestration.
Definitions of par fee, nonpar fee, and limiting charge in the Medicare Physician Fee Schedule.
Verify with the sender that you have the correct passphrase/password to open the email attachment or file. Use this information for further troubleshooting with SecureZIP files and attachments.
This edition includes information on hospital price transparency, Part B blood clotting factor furnishing fee guidance, Part B average sales price guidance, and more.
The Comprehensive Error Rate Testing (CERT) review contractor conducts a medical review of randomly sampled post-payment claims. If the claim was billed and paid correctly, the CERT review contractor will issue a “No Error” finding.
These checklists are intended to provide healthcare providers with a reference for use when responding to CERT documentation requests for the selected claim sample.
Avoid the appeals process by making minor claim corrections through a clerical reopening request for Part B claims.
Use the links on the left to access checklists to ensure you have met medical documentation requirements based on specific services.
The help guide for the NCCI PTP lookup is currently being developed. Please check back soon.