View this page to easily locate information related to drugs and biologicals, such as billing and coding guidelines, related policy information, IOMs, and resources.
This article has been revised to include instructions for completing the PAR, the PAR review and decision process, guidance on multiple or staged procedures, as well as best practices, tips and reminders related to the PAR.
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process allows the provider to submit documentation prior to providing or billing the service. The contractor will then al…
This edition includes information on proposed payment rules for fiscal year 2027, events, guidance on new requirements for hospital price transparency, and more.