Reimbursement Policies

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Reimbursement Policies

Reimbursement Policies are listed in alphabetical order.

A|B|C|D|E|F|G|H|I|J|K|L|M|N|O|P|Q|R|S|T|U|V|W|X|Y|Z

A back to top Download (PDF)
After Hours and Weekend Care Download (PDF)
Allergy Testing Immunotherapy (Commercial/Medicare) 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, Medicare, and Medicaid) Download (PDF)
Computer Assisted Surgical Navigation Download (PDF)
Co-Surgeon/Team Surgeon-Modifiers 62/66 Download (PDF)
COVID-19 Billing Guidelines Download (PDF)
COVID-19 Testing Download (PDF)
COVID-19 Vaccine and Monoclonal Antibody Infusions Policy - Revised August 2021 Download (PDF)
CPT and HCPCS Billing Guidelines 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)
DME In-Office/Non-Facility Download (PDF)
DME Rental vs. Purchase Download (PDF)
Drug Alcohol Testing (Commercial/Medicaid) Download (PDF)
Eback to top Download (PDF)
Evaluation and Management (E&M) Services Download (PDF)
Fback to top Download (PDF)
From/To Date Span Download (PDF)
Hback to top Download (PDF)
Home Health Care Services Download (PDF)
Hospital Readmissions Download (PDF)
Iback to top Download (PDF)
Intraoperative Neurophysiology Monitoring Services (IONM) Download (PDF)
Lback to top Download (PDF)
Laboratory/Venipuncture 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)
Modifiers PN & PO for Clinic Visit Services (G0463) – (Medicare) Download (PDF)
Multiple & Bilateral Surgical Procedures Policy Download (PDF)
Multiple Diagnostic Imaging Payment Reduction Policy (Commercial) Download (PDF)
Nback to top Download (PDF)
National Drug Code (NDC) Requirements for Drug Claims – Commercial, Medicare, and Medicaid 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 (Medicare) Download (PDF)
Preventive Medicine and Screening (Commercial) Download (PDF)
Prolonged Services (Commercial, Medicare and Medicaid) Download (PDF)
Rback to top Download (PDF)
Revenue Codes Requiring Detailed Coding (Commercial) - New 2/01/2021 Download (PDF)
Robotic Surgery Download (PDF)
Routine Foot Care Services Download (PDF)
Sback to top Download (PDF)
Split Surgical Care (Modifiers 54/55/56) (Commercial) Download (PDF)
Tback to top Download (PDF)
Telehealth – Supplemental Telehealth Guidelines Download (PDF)
Telehealth/Virtual Care Services-effective 6/01/2022 Download (PDF)
Treatment Room Download (PDF)
Uback to top Download (PDF)
Unlisted Codes Download (PDF)