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We redesigned our provider specialty page to support independent clinical laboratory providers with accessing policy details, CLIA information, enrollment, claims submission and reimbursement tips, and other valuable resources.
Effective August 31, 2023, documentation is required for claims submitted with modifier 22. To avoid claim rejects and future appeals due to incorrect claim submissions, we’re providing guidance on how to properly submit a claim when applyi…
The principal physician of record appends modifier “-AI” to their initial hospital care or nursing facility visit code. All other physicians who perform an initial evaluation on this patient bill without modifier "-AI" to indicate specialty…
Providers are encouraged to use the KX modifier on 837D claims submitted with dental services inextricably linked to covered medical services. Read this article to learn more.
When a medical reviewer contacts the provider requesting to submit an attestation statement or signature log to authenticate a medical record, the provider must submit the attestation statement or signature log within 20-calendar days.
This edition includes information on the 2026 institutional provider enrollment application fee, the 2026 clinical laboratory fee schedule, the 2026 MPFS final rule summary, and more.
This edition includes information on extension of Medicare provisions, HCPCS codes and clinical laboratory improvement amendment edits, hospital price transparency, and more.
Here are additional educational resources identified specifically for rural health services.
Use our interactive fee lookup tool or download data files containing the most recent fee schedule information.
These changes were implemented April 7, 2025, effective for services January 1, 2025, and after.