Part B
Critical care services
CMS updated guidelines for critical care services effective January 1, 2022. These updates were implemented, and address billing and coding processes.
The SPOT User Guide: Section 7 - Claim submission / ERA
Complete review of the Claim submission / ERA feature in SPOT.
The SPOT User Guide: Section 7 - Claim submission / ERA
Complete review of the Claim submission / ERA feature in SPOT.
MLN Connects for April 9, 2026
This edition includes information on proposed payment rules for fiscal year 2027, events, guidance on new requirements for hospital price transparency, and more.
Participating provider versus non-participating provider
Review this article to learn the difference between participating and non-participating providers in the Medicare program.
MLN Connects for April 9, 2026
This edition includes information on proposed payment rules for fiscal year 2027, events, guidance on new requirements for hospital price transparency, and more.
Prior authorization (PA) program for certain hospital outpatient department (OPD) services - submitting the prior authorization request (PAR)
This article has been revised to include instructions for completing the PAR, the PAR review and decision process, guidance on multiple or staged procedures, as well as best practices, tips and…
Critical care services
CMS updated guidelines for critical care services effective January 1, 2022. These updates were implemented, and address billing and coding processes.
Prior authorization (PA) program for certain hospital outpatient department (OPD) services - submitting the prior authorization request (PAR)
This article has been revised to include instructions for completing the PAR, the PAR review and decision process, guidance on multiple or staged procedures, as well as best practices, tips and…
Clinical nurse specialist (CNS)
View the qualification and documentation requirements for becoming a Medicare-enrolled clinical nurse specialist.