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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…
Follow the steps in this article to import the updated codes file, which is now available.
This edition includes information on men’s health, preventing claim denials for hospital beds and accessories, the clinical laboratory fee schedule annual public meeting, and more.
This edition includes information on crushing fraud, opioid use disorder, the Medicare participating physician agreement form expiration, and more.
Facet joint interventions may be used in pain management for chronic cervical/thoracic and lumbar/sacral pain arising from the paravertebral facet joints. Imaging guidance (fluoroscopy or CT per code descriptor) is used to assure accurate p…
Is your facility receiving denials for a claim overlapping a skilled nursing facility (SNF) stay? Claims overlapping with a skilled nursing facility (SNF) stay can occur for several reasons. This article is intended to assist providers with…
This edition includes information on the Medicare Shared Savings Program, providers accepting CHAMPVA, national coverage determination 20.36, and more.
This edition encourages public input on improving technology to empower beneficiaries.
This edition includes information on critical access hospitals, seasonal flu vaccine pricing for 2025-2026, nursing home care compare updates, and more.
This special edition includes information on 2027 proposed rules as well as CMS' proposed reforms to speed up patient access to drugs, increase transparency, and reduce administrative burden.