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.
This edition includes information on critical access hospitals, seasonal flu vaccine pricing for 2025-2026, nursing home care compare updates, and more.
Breaking news for critical access hospitals (CAHs): CMS has directed MACs to immediately turn off reason codes 31006 and 31007 to give providers time to submit all method II reassignments to their Part A CAHs promptly. Read further to learn…
Effective for dates of service on or after August 7, 2019, Medicare will pay claims from approved providers for administration of autologous T-cells expressing at least one CAR for the treatment for cancer. Article was last updated January…
First Coast provides a variety of CERT-related educational resources to assist providers with navigating CERT program requirements and achieving Medicare program compliance. Review our newest releases of the CERT Insider's Guide, Fast facts…