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View these guidelines regarding what it means for a service to be "reasonable and necessary."
The purpose of the open meeting is to allow interested parties the opportunity to make presentations of information and offer comments related to proposed local coverage determinations (LCDs) and/or the revised portion of a proposed LCD tha…
First Coast may consider coverage of a humanitarian use device, intended to benefit a small patient population, when the provider follows the specific guidelines and submits the appropriate documentation.
View our latest article on SPRAVATO® (esketamine) nasal spray - used to treat treatment-resistant depression in adults - and its documentation requirements.
A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a 10-day period OR at least once per week for at least three weeks. Repetitive ambulance services are often needed…
In the absence of a LCD, NCD, billing and coding article or CMS manual instruction, NCCI or MUE, reasonable and necessary guidelines still apply. Read this article to learn more.
View materials and listen to recordings from past meetings.
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…
Online registration for the June 18 open meeting is now available, and presenter registration will close at noon ET on June 16. Important: Our open meeting will be held via webinar only. Please view our proposed local coverage determination…
Contractor advisory committee (CAC) meeting information and upcoming CAC meetings