Reimbursement Policies
| 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) |
| 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) |
| Hback to top | 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) |
| Modifier Reference Policy (Commercial) – effective 9/1/2021 | 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 (Commercial) - Effective 10/01/2021 | 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) |
| 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) |
