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Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).
Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically reasonable and necessary.
View this article for information concerning requirements of change request 13164.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for critical care services.
CMS implemented a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020.
View these submission guidelines when submitting prior authorization requests for certain hospital outpatient department services.