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Read this article to learn more about CERT reviews for vaccine and roster billed claims.
View TPE round results for evaluation and management services - outpatient office visits.
View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for musculoskeletal system and connective tissue procedures (DRG 515, 516 and 517).
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for outpatient hospital services.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for hyperbaric oxygen (HBO) therapy services.
Read this article for information about how CERT may grant temporary administrative relief to certain affected providers and suppliers during a disaster.
View this updated listing of targeted probe and educate (TPE) review topics.
View these round results for rehabilitation services outpatient.
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to prior authorization (PA) may be eligible for exemption. This exemption would remain in effect for a 12-month peri…