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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…
View contact information for the Claims area.
Surgeons append modifier 66 to claims indicating they were on a team of surgeons performing a specific procedure on the same patient during the same operative session. Billing modifier 66 requires documentation to support the claim.
Find information on vaccine payment allowances and fee schedules, links to related enrollment for mass immunizers, and more. Recent additions include upcoming vaccine administration coding updates beginning July 1, 2026, for TOFIDENCE® IV i…
Find information on global surgery billing guidance and other related resources.
View materials and listen to recordings from past meetings.
The MDS is a tool used for implementing standardized assessment and for facilitating care management in skilled nursing homes and non-critical access hospital swing beds.
Sections D - E - GG
Section D: Mood
D0150 Resident Mood Interview (PHQ-2 to 9©)
This edition includes information on preventing claim denials for psychiatric care, MPFS July update, skilled nursing facility Part D payments, and more.
This article includes requirements that providers must be operational when enrollment applications are submitted. Review this article for help in preventing processing impacts to your application.