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Review these FAQs to learn more about the prior authorization for repetitive scheduled non-emergency ambulance transport.

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Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.

View TPE round results for wound debridement (CPT 11102-11103, 11200-11201, 11300-11303, 11305-11313 and 11401-11406, 11421...

View targeted probe and educate (TPE) round results for nail cutting / pairing and debridement (CPT 11055-11057, 11719-11721 &...

View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).

CMS annually updates the durable medical equipment prosthetics, orthotic, and supplies (DMEPOS) for DME MAC and Part B MAC...

Access tools and forms related to the prior authorization program, CERT, and provider audit.

This checklist is an aid to assist skilled nursing facilities with responding to medical record documentation requests.

Avoid negative impacts to your claims by providing medical records with your initial claim submission for the pathology and lab...