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Prior authorization program for repetitive scheduled non-emergent ambulance transports

February 17, 2026
Background Submissions Extended affirmation periods

Checklist: Pulmonary rehabilitation services

February 18, 2026
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for pulmonary rehabilitation services.

Checklist: Annual wellness visit (AWV)

March 11, 2026
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for AWV. Health care providers retain responsibility to submit complete and accurate documentation.

Checklist: Inpatient rehabilitation facility (IRF)

March 17, 2026
This checklist is intended as reference to use when responding to additional documentation requests for IRF services.

Checklist: Cardiac rehabilitation services

May 14, 2026
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for cardiac rehabilitation services.

Review programs FAQs

September 23, 2025
Search our FAQs to find answers to common questions. 

CBR Guide - Part B

May 14, 2026
The Comparative Billing Report (CBR) for Part B providers furnishes a detailed examination of the comparative data that Medicare considers when determining how the provider’s billing patterns contrast with those of other providers of the sa…

Medical necessity requirements for skilled nursing facility (SNF) admissions

December 23, 2025
This questionnaire is intended to provide health care providers with a reference for use when screening a new patient for a SNF admission. This criteria is required to meet Medicare guidelines for a SNF covered stay and medical necessity.

Targeted probe and educate (TPE) round results: Endovascular cardiac valve replacement and supplement procedure (DRG 266 & 267)

May 14, 2026
Review the top denial/partial denial reasons and high-level results from each round of DRG 226 and 267 TPE.

Checklist: Transitional care management (TCM)

April 30, 2026
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for transitional care management (TCM) services.
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