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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.
Find news about local and national coverage determinations, learn how to search the Medicare coverage database, use the procedure/diagnosis code lookup tool, and review clinical trials.
Read this article to learn more about the CERT awareness month campaign focusing on responding to CERT documentation requests.
View targeted probe and educate (TPE) round results for 15271-15278.
The Medicare Part A DDE user manual has been updated to include changes from the October 2025 release and a new section with tips. October 2025 release details include changes to the inquiry menu. Review the change summary chart at the end…
This edition includes information on a 2026 proposed physician payment rule and information on expanded access to gene therapies.
Please take a moment to complete our customer service satisfaction survey when calling the Provider Contact Center.
Learn what documentation to include when submitting a Medicare Part A appeals request.
To expedite receiving tentative settlement payments, record provider payments and receivables correctly in Worksheet E-1 Part I.
This special edition includes information on lifting the current claims hold.