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Use our interactive fee lookup tool or download data files containing the most recent fee schedule information.
Effective July 6, 2026, outpatient claims with type of bills (TOB) 13X or 14X will be returned to provider (RTP) for reason code 34554 if modifier ER, PO, or PN is billed on all service lines, and the practice location address is missing fr…
Read the Part A second quarter edition of the CERT Insider's Guide to learn more about claim errors assessed during the CERT review process and ways to mitigate these errors in the future.
Each year, First Coast invites members of the provider community to join the provider outreach and education advisory group for their geographic area. This document lists the members of Puerto Rico’s Part A and Part B advisory groups.
Would you like to reduce the time you spend contacting Medicare? Having difficulties locating a claim? Here's some tips to help locate a claim not on file.
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.
The Medicare Part A DDE user manual has been updated to include changes from the October 2025 release and a new section with tips. October 2025 release details include changes to the inquiry menu. Review the change summary chart at the end…
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.
Learn what documentation to include when submitting a Medicare Part A appeals request.