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Appeal reminder for medically unlikely edits (MUEs)

We'd like to remind providers of medical documentation you'll need to submit when filing a redetermination or clerical error reopening for a claim (or line item) denied due to an MUE.

Positron emission tomography (PET) for oncologic conditions: Modifier usage

The appeals department is receiving appeals regarding the incorrect usage of modifiers associated with PET scans. Read this article to learn more about billing these services correctly.

2023 fee schedule updates for HCPCS 96380 and 96381 - Puerto Rico and U.S. Virgin Islands

View pricing for two new codes for administration of nirsevimab for RSV infection.

2023 fee schedule updates for HCPCS 96380 and 96381

View pricing for two new codes for administration of nirsevimab for RSV infection.

2023 ambulance fee schedule

Here are payment allowances for ambulance services for services provided January 1-December 31, 2023 (revised).

2023 Fee schedule updates for HCPCS 96380 and 96381: Florida

View pricing for two new codes for administration of nirsevimab for RSV infection.

2022 ambulance fee schedule

Here are payment allowances for ambulance services for services provided January 1 - December 31, 2022.

Medicare physician fee schedule payment policy indicators

This provides definitions of the national policy indicators for each procedure code (and modifier, where applicable) on the Medicare physician fee schedule database (MPFSDB).

Vaccine pricing

View seasonal vaccine payment allowances and effective dates.

2024 Ambulatory Surgical Center (ASC) disclosures (revised)

View revised ASC disclosures for dates of service January 1-March 8 and March 9-December 31, 2024.