CERT Insider’s Guide – Part A First Quarter 2025
Read the Part A first quarter edition of the CERT Insider's Guide to learn more about claim errors assessed during the CERT...
Anesthesia
Information pertaining to anesthesia services, including links to LCDs/NCDs, education, FAQs, provider enrollment, CMS IOMs, and...
End stage renal disease (ESRD): Payment for phosphate binders effective January 1
Effective January 1, phosphate binders are paid as a renal dialysis service under Medicare Part B. Read this article to learn...
Opioid treatment program (OTP)
Find the latest Medicare news identified specifically for opioid treatment programs as well as helpful information, education...
Ophthalmology
Information pertaining to ophthalmology services, including links to LCDs/NCDs, education, CMS IOMs, and other resources.
Telehealth service modifiers
Telehealth modifiers should be submitted with distant site telehealth services. Patient must be present and participating in...
Fast facts: CERT claim sampling and review process
Read this article for information about CERT claim sampling and the review process.
Are air ambulance services payable when a patient requires a transfer from one hospital to another hospital?
Yes, air ambulance services are payable from hospital to hospital, if it meets medical appropriateness criteria and the transferring hospital does not have adequate facilities to provide the medical services needed by the patient. We, at First Coast, will only reimburse to the nearest available medically appropriate facility.
Reference
Telehealth enrollment scenarios – address waiver made permanent
During the COVID-19 public health emergency (PHE), CMS allowed providers to render telehealth services from their home without...