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Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.
This edition includes information on a new model to target wasteful, inappropriate services in Original Medicare, CY 2026 proposed rules for ESRD and home health, revalidation deadline for skilled nursing facilities, and more.
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External user services (EUS) help
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Read this article for instruction to submit a provider enrollment rebuttal.
View evaluation and management (E/M) related FAQs.
Read this article to learn more about the CERT awareness month campaign focusing on responding to CERT documentation requests.
Get the latest news regarding provider audit and reimbursement, along with forms for interim rate and periodic interim payment requests as well as statistical and reimbursement report fax sheets.
Read this article for instructions for special payment addresses and EFT.
View contact information for the Provider Audit and Reimbursement department.
The Official UB-04 Data Specifications Manual 2025, copyrighted by the American Hospital Association, is the only official source of UB-04 billing information adopted by the National Uniform Billing Committee (NUBC).