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Critical care services

April 9, 2026
CMS updated guidelines for critical care services effective January 1, 2022. These updates were implemented, and address billing and coding processes.

Split or shared E/M guidelines: Medicare Claims Processing Manual updates

March 30, 2026
This article summarizes the Medicare E/M guidelines for split or shared E/M services effective in 2024.

Leqembi for monoclonal antibodies directed against amyloid for the treatment of Alzheimer's disease

March 25, 2026
Providers may be billing these services incorrectly. Please review this article and pay close attention to the billing loop and segment information detailed within. The NCT number has been added to the instructions.

Submitting a provider enrollment appeal: Corrective action plan or reconsideration request

February 27, 2026
Learn how to submit a provider enrollment appeal in the form of a corrective action plan or reconsideration request.

Reciprocal billing and fee-for-time compensation arrangements (formerly locum tenens arrangements)

March 25, 2026
The requirements for the submission of claims under reciprocal billing and fee-for-time compensation arrangements are the same for assigned and non-assigned claims. This article shows when these requirements apply.

Florida payment localities by county

March 3, 2026
Here is a listing of the counties comprising each payment locality in Florida.

New provider roadmap: Claims submission

April 6, 2026
Once enrolled as a Medicare provider, a billing method with Medicare needs to be established. Step 1: Choose your billing method

Hospital outpatient department (OPD) prior authorization exemption process

March 31, 2026
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to prior authorization (PA) may be eligible for exemption. This exemption would remain in effect for a 12-month peri…

Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services

March 16, 2026
Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy),…

Common inquiries - Part A

March 30, 2026
Reduce the time it takes to answer your Medicare question by viewing common Part A inquiries received by customer service.
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