Reimbursement Policies
| A back to top | Download (PDF) |
|---|---|
| After Hours and Weekend Care | Download (PDF) |
| Anesthesia Reimbursement Policy | Download (PDF) |
| Assistant at Surgery – Modifiers 80/81/82 and AS (Commercial) | Download (PDF) |
| Cback to top | Download (PDF) |
|---|---|
| Coding Edits Policy (Commercial and Medicare) | Download (PDF) |
| Co-Surgeon/Team Surgeon-Modifiers 62/66 | Download (PDF) |
| COVID-19 Vaccine and Monoclonal Antibody Infusions Policy - Revised August 2021 | Download (PDF) |
| Dback to top | Download (PDF) |
|---|---|
| Daily Maximum Units (Commercial/Medicare) | Download (PDF) |
| Diagnosis Code Guidelines: Manifestation/Secondary Diagnosis Codes | Download (PDF) |
| Discarded Drugs/Biologicals – Modifier JW (Commercial) | Download (PDF) |
| Discontinued Procedures – Modifiers 53, 73 & 74 (Commercial) | Download (PDF) |
| Eback to top | Download (PDF) |
|---|---|
| E/M Supplemental Reimbursement Policy 2021 Update - New 1/01/2021 | Download (PDF) |
| Mback to top | Download (PDF) |
|---|---|
| Mid-Level Practitioner Reimbursement Policy (Commercial) | Download (PDF) |
| Modifier SU – Procedure Performed in Physician’s Office (Commercial) | Download (PDF) |
| Modifier Reference Policy (Commercial) | Download (PDF) |
| Modifier Reference Policy (Commercial)– effective 9/1/2021 | Download (PDF) |
| Nback to top | Download (PDF) |
|---|---|
| National Drug Code (NDC) Requirements for Drug Claims - New 4/19/2021 | Download (PDF) |
| Never Events/Adverse Events & Serious Reportable Events (Commercial) | Download (PDF) |
| No Cost/Reduced Cost Drugs, Implants & Devices | Download (PDF) |
| Oback to top | Download (PDF) |
|---|---|
| Operating Microscope/Microsurgery (CPT 64727/69990) (Commercial & Medicare) | Download (PDF) |
| Ophthalmology Reimbursement Policy | Download (PDF) |
| Outpatient Diagnostic Imaging Self-Referral Payment Policy | Download (PDF) |
| Pback to top | Download (PDF) |
|---|---|
| Preventive Care Services (Commercial) | Download (PDF) |
| Preventive Care Services (Commercial) - Effective 10/01/2021 | Download (PDF) |
| Preventive Care Services (Medicare) | Download (PDF) |
| Prolonged Services (Commercial and Medicare) - New 1/1/2021 | Download (PDF) |
| Rback to top | Download (PDF) |
|---|---|
| Revenue Codes Requiring Detailed Coding (Commercial) - New 2/01/2021 | Download (PDF) |
| Sback to top | Download (PDF) |
|---|---|
| Split Surgical Care (Modifiers 54/55/56) (Commercial) | Download (PDF) |
