Pre-Claim Review

Advance Determination of Medicare Coverage (ADMC) - View information about voluntary program that allows suppliers and beneficiaries to request prior approval of "eligible" items before item delivery 

Required Prior Authorization Programs - CMS has implemented prior authorization (PA) as a condition of payment for specific HCPCS codes. View details
 

Last Updated Jun 05, 2019

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Prior Authorization Lookup Tool

Determine which HCPCS codes require a Prior Authorization

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