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CAH Part A Method II claims for professional services will return to provider (RTP) if a reassignment isn’t in PECOS. Watch the on-demand learning video, "CAHs Method II Professional Reassignments," for instructions to add reassignments.
CMS implemented a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020.
Read this complete review of the Retrieve Documents feature in SPOT.
View these guidelines for completing the CMS-855A enrollment application for Part A institutional providers.
View this page to easily locate information related to drugs and biologicals, such as billing and coding guidelines, related policy information, IOMs, and resources.
View the qualification and documentation requirements for becoming a Medicare-enrolled clinical nurse specialist.
Complete review of the Claim submission / ERA feature in SPOT.
To bill correctly under the Outpatient Prospective Payment System (OPPS), please review the addendums* listed below.
CMS updated guidelines for critical care services effective January 1, 2022. These updates were implemented, and address billing and coding processes.
This article has been revised to include instructions for completing the PAR, the PAR review and decision process, guidance on multiple or staged procedures, as well as best practices, tips and reminders related to the PAR.