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Duplicate reject/return to provider (RTP) reason code

February 16, 2026
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.

Submit Part A claims electronically

February 16, 2026
Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your requests to us? Avoid the wait. Learn about the electronic options available for you to submit Part A claims.

Hospice: New requirement for physicians who certify patient eligibility

February 16, 2026
Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims submitted on October 7 and after with dates of service June 3 or later.

Prior authorization fax coversheet

February 16, 2026
CMS is implementing a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020. Review the fax coversheet needed for submission.

Ambulance modifiers

February 16, 2026
Ambulance modifiers identify the place of origin and destination of the ambulance trip and must be included on all ambulance claims.

Prior authorization: Facet joints and cervical fusion

February 16, 2026
CMS has removed CPT codes 64492 and 64495 from the listing of codes requiring prior authorization. View our article to learn more about these changes.

Prior authorization for ambulance transports is for repetitive transports

February 16, 2026
A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a 10-day period OR at least once per week for at least three weeks. Repetitive ambulance services are often needed…

Locate guidelines on the First Coast website

February 16, 2026
A procedure can have other policies or guidelines besides an LCD. Search our website for additional information. Step 1: Perform a standard search in the First Coast website. 

E/M interactive worksheet: Help guide - Initial information

February 16, 2026
Learn how to take advantage of the features of our exclusive E/M interactive worksheet and find the code that best represents the level of evaluation and management services (E/M) furnished during a patient’s visit.

Get involved: Join First Coast POE-AG for 2026

February 16, 2026
The Provider Outreach and Education Advisory Group (POE-AG) for First Coast is a professionally and geographically diverse panel of members representing state and local trade and professional organizations, medical societies, practicing pro…
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