These checklists are intended to provide health care providers with a reference for use when responding to CERT documentation requests for the selected claim sample.
The following document was developed based on questions and answers posed during our webinars on the prior authorization (PA) program for certain hospital outpatient department (OPD) services.
View this page to easily locate information related to drugs and biologicals, such as billing and coding guidelines, related policy information, IOMs, and resources.
Information pertaining to Part B rehabilitation services, including links to LCDs/NCDs, education, FAQs, provider enrollment, CMS IOMs, and other resources.
Effective December 9, both the standard and expedited PAR coversheets are updated with new fields to improve the prior authorization request (PAR) process. These fields include selection of modifiers RT, LT or 50, site levels, alternative c…