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View these guidelines regarding what it means for a service to be "reasonable and necessary."
The following information outlines procedures related to getting started with EDI along with additional electronic features available to billing services, clearinghouses, and third-party vendors.
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for chronic care management (CCM) services.
To enhance efficiency and ensure the secure handling of appeal information, effective May 1, 2026, all providers will be required to use SPOT to check appeal status and access duplicate appeal decision letters.
There will be Common Working File (CWF) "dark days" Friday, April 3, through Sunday, April 5, affecting the IVR.
View this article for instructions on how and when to use modifier 77.
Use this decision flowchart to assist in correctly applying the 25 modifier.
Read this article for more information on how to get credentialed for Medicare as an anesthesiologist assistant.
Read this article to learn more about CERT reviews for vaccine and roster billed claims.
Use this decision flowchart to assist in correctly applying the 57 modifier.