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Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to prior authorization (PA) may be eligible for exemption. This exemption would remain in effect for a 12-month peri…
Review this checklist to learn about the documentation requirements for medical professionals related to the repetitive, scheduled, non-emergency prior authorization program.
Review this checklist to learn about the documentation requirements to ensure an affirmed decision on your prior authorization request (PAR) for repetitive, scheduled, non-emergency transport.
Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy),…
CAC meetings are for the purpose of discussing literature related to proposed LCDs before they are developed. CAC meetings are open for the public to attend as observers. Read more information regarding the meeting format schedule, and regi…
Multi-jurisdictional CAC meeting minutes
Learn how the local coverage determination (LCDs) process works with this informative guide. General information on the local coverage development (LCD) process.
View these additional FAQs about clinical trials and device coverage.
Flowcharts for new LCD and LCD reconsideration requests to provide step-by-step instructions of the processes.
Visit our Journey to LCD coverage page to find more information related to LCDs, including the LCD development process and how to become involved, as well as how local and national coverage guidelines relate to claims processing.