We restricted our analysis to Part B covered services (physician and other professional services, ambulance, durable medical equipment, and Part B drugs) that were active nationally in the precertification program for all of 2017 and required medical review. We excluded steerage reviews, which encour...
Hayes KJ, Pettengil J, Stensland J Getting the price right: medicare reimbursement rates for cardiovascular services . Health Aff 2007; 26 :124–36. doi:10.1377/hlthaff.26.1.124Hayes, Keven J., Julian Pettengill, and Jeffrey Stensland. 2007. "Getting the Price Right: Medicare Payment Rates...
* The procedure code is eligible for separate reimbursement according to the status indicators on the CMS fee schedule for the relevant provider type (physician fee schedule, ASC, OPPS, etc). * The medical records documentation supports the appropriate use of modifier 25. All of the required key...