Medical review
Targeted probe and educate (TPE) topics and schedule of review
View this updated listing of targeted probe and educate (TPE) review topics.
Understanding repetitive scheduled non-emergent ambulance transports
Review these FAQs to learn more about the prior authorization for repetitive scheduled non-emergency ambulance transport.
Understanding prior authorization (PA) for certain hospital outpatient department (OPD) services
The following document was developed based on questions and answers posed during our webinars on the prior authorization (PA) program for certain hospital outpatient department (OPD) services.
Understanding prior authorization (PA) for certain hospital outpatient department (OPD) services
The following document was developed based on questions and answers posed during our webinars on the prior authorization (PA) program for certain hospital outpatient department (OPD) services.
Targeted probe and educate (TPE) round results: Drugs and biologicals (HCPCS J7318-J7329, J7331-J7332)
View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).
Targeted probe and educate (TPE) round results: Wound debridement
View TPE round results for wound debridement (CPT 11102-11103, 11200-11201, 11300-11303, 11305-11313 and 11401-11406, 11421-11424, 11426, 11440-11446).
Targeted probe and educate (TPE) round results: Drugs and biologicals (HCPCS J7318-J7329, J7331-J7332)
View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).
Targeted probe and educate (TPE) round results: Wound debridement
View TPE round results for wound debridement (CPT 11102-11103, 11200-11201, 11300-11303, 11305-11313 and 11401-11406, 11421-11424, 11426, 11440-11446).
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…
Checklist: Skilled nursing facility (SNF) documentation
This checklist is an aid to assist skilled nursing facilities with responding to medical record documentation requests.