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Telehealth enrollment scenarios

During the COVID-19 public health emergency (PHE), CMS allowed providers to render telehealth services from their home without reporting their home address on their Medicare enrollment while continuing to bill from their currently enrolled…

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Checklist: Endovascular cardiac valve replacement and supplement procedures

This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for endovascular cardiac valve replacement and supplement procedure (DRG 266 and 267).

Part B service-specific review -- outpatient rehabilitation services (CPT code 97110)

View this summary for outpatient rehabilitation services (August - November 2020 and August 2021).

Part A service-specific review -- (CPT 97110 therapeutic activities)

View this summary for outpatient rehabilitation services (August - November 2020).

Part A service-specific review - hyperbaric oxygen therapy (G0277)

View this summary for outpatient rehabilitation services (December 2020).

Part A service-specific review - (CPT 97530 therapeutic activities)

View this summary for outpatient rehabilitation services (January through August 2021).

Part B service-specific review – psychotherapy services (CPT codes 90832-90839)

View this summary for psychotherapy services (December 2020 - March 2021).

Skilled nursing facility (SNF) 5-claim probe and educate (P&E) review

View this article for information concerning requirements of change request 13164.

Targeted probe and educate (TPE)

TPE is one process that a MAC can utilize when providers are selected by medical review.