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Part A service-specific review - hyperbaric oxygen therapy (G0277)

View this summary for outpatient rehabilitation services (December 2020).

Part A service-specific review - (CPT 97530 therapeutic activities)

View this summary for outpatient rehabilitation services (January through August 2021).

Part A service-specific review -- (CPT 97110 therapeutic activities)

View this summary for outpatient rehabilitation services (August - November 2020).

Part B service-specific review – psychotherapy services (CPT codes 90832-90839)

View this summary for psychotherapy services (December 2020 - March 2021).

Targeted probe and educate (TPE)

TPE is one process that a MAC can utilize when providers are selected by medical review.

Targeted probe and educate (TPE) round results: Inpatient rehabilitation facilities (IRF)

Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).

Post-payment service-specific reviews

Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically reasonable and necessary.

Skilled nursing facility (SNF) 5-claim probe and educate (P&E) review

View this article for information concerning requirements of change request 13164.

Tips on how to avoid billing a duplicate claim

Duplicate claim denials continue to be one of the top billing errors. Duplicate submission of Medicare claims causes an increase in cost, valuable time, and resources for you, as well as First Coast.

Checklist: Critical care service

This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for critical care services.