Medical review
Tools & forms: Compliance / Review
Access tools and forms related to the prior authorization program, CERT, and provider audit.
Tools & forms: Compliance / Review
Access tools and forms related to the prior authorization program, CERT, and provider audit.
Checklist: Skilled nursing facility (SNF) documentation
This checklist is an aid to assist skilled nursing facilities with responding to medical record documentation requests.
Prior authorization program for repetitive, scheduled non-emergent ambulance transports (RSNAT)
CMS has implemented the prior authorization program for certain repetitive, scheduled non-emergent ambulance transports in Florida, Puerto Rico and the US Virgin Islands. Learn more about the program…
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 demonstration states effective for dates of services (DOS) on or after…
ASC HCPCS codes no longer requiring a paper invoice (JN)
To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.
Drug HCPCS codes no longer requiring a paper invoice
To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.
ASC HCPCS codes no longer requiring a paper invoice (JN)
To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.
Skin substitute HCPCS codes no longer requiring a paper invoice (JN)
To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.