Prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services
CMS is implementing a five-year demonstration project for the PA of certain services provided in ASCs, for a limited number of...
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Medicare remit easy print (MREP)
An updated Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) “Codes.ini” file is now available for...
A step-by-step guide to getting started submitting electronic claims for third party entities
The following information outlines procedures related to getting started with EDI along with additional electronic features...
Health care payment and remittance advice
Article includes flow of the remittance advice and links to the claims adjustment reason codes and the remittance advice remark...
Update to CARC and RARC codes for use with MREP 4.6
An updated remittance advice remark code (RARC) and claim adjustment reason code (CARC) “Codes.ini” file is now available for...
National Part A/B MAC Ambulance Supplier Coalition
In response to numerous and continued requests from the ambulance community, the Part A/B Medicare Administrative Contractors...
Radiopharmaceutical HCPCS codes no longer requiring a paper invoice (JN)
To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.
When the invoice information...
Prior authorization program initiatives
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process...
Medicare Part A DDE user guide manual
The Medicare Part A DDE user manual has been updated to include changes from the October 2025 release and a new section with...