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Puerto Rico POE-AG minutes - March 19, 2025

Review the minutes of the Puerto Rico Provider Outreach and Education meeting minutes (POE-AG) from Part A/B

Targeted probe and educate (TPE) round results: Psychotherapy services (CPT 90832, 90834, 90837)

View TPE round results for psychotherapy services.

Targeted probe and educate (TPE) round results: Rehabilitation services outpatient (KX modifier)

View TPE round results for rehabilitation services outpatient (KX modifier).

Instructions for completing the EDI SPOT enrollment form for provider organizations

These instructions will assist you in completing the EDI SPOT enrollment form as a provider organization.

SPOT backup approver instructions

Backup approvers may complete these instructions AFTER their organization's designated approver has received an approval communication from the SPOT Help Desk and created their organization in IDM.

Fee schedule for administration of influenza and pneumococcal virus vaccines

The allowances for procedure codes G0008 and G0009 are based on the allowance for code 90471.

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

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

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

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

Part B service-specific review – drugs and biologicals (J0178 Eylea, J0897 Prolia, J2778 Lucentis, J9217 Lupron (Leuprolide))

Summary for drugs and biologicals (April-May 2021).

Targeted probe and educate (TPE) round results: Wound debridement (CPT 11042-11045)

Review the top denial/partial denial reasons and high-level results of wound debridement (CPT 11042-11045) TPE round results for December 2022 - May 2023.