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View targeted probe and educate (TPE) round results for 15271-15278.
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.
View helpful hints for completing the CMS-855B application.
View instructions on completing the CMS-20134 enrollment application.
Access tools and forms related to the prior authorization program, CERT, and provider audit.
This edition includes information on fiscal year 2026 final payment rules.
This edition includes information on crushing fraud, preventing E/M claim denials, a CMS listening session, and more.
Medical decision-making (MDM) is one of the key components used to determine the level of service for Evaluation and Management (E/M) coding. Since 2021, the American Medical Association (AMA) and CMS have emphasized MDM (or time) as the pr…
This edition includes information on critical access hospitals, seasonal flu vaccine pricing for 2025-2026, nursing home care compare updates, and more.
Use these checklists to ensure you have met medical documentation requirements based on specific services.