Part B

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…

Review the top denial / partial denial reasons and high-level results of SNF TPE round results.

Review the top denial / partial denial reasons and high-level results of SNF TPE round results.

Payment for the hepatitis B vaccine and its administration is only available to Medicare beneficiaries who are at high or intermediate risk of contracting hepatitis B, which includes patients who…

Payment for the hepatitis B vaccine and its administration is only available to Medicare beneficiaries who are at high or intermediate risk of contracting hepatitis B, which includes patients who…

Read the Part B second quarter edition of the CERT Insider's Guide to learn more about claim errors assessed during the CERT review process and ways to mitigate these errors in the future.

Review the top denial / partial denial reasons and high-level results from each round of DRG 470 TPE.

Review the top denial / partial denial reasons and high-level results from each round of DRG 470 TPE.

The place of service or diagnosis may be considered when determining the appropriate TOS. The descriptors for each of the TOS codes listed in the following table are:

The place of service or diagnosis may be considered when determining the appropriate TOS. The descriptors for each of the TOS codes listed in the following table are: