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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…
Read this article for information on the rural emergency hospital (REH) specialty type.
Find information on global surgery billing guidance and other related resources.
View materials and listen to recordings from past meetings.
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.