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.

Pre-Claim Hotline - The Pre-Claim hotline is a service for suppliers regarding Prior Authorization and Advance Determination of Medicare Coverage (ADMC) programs

 

Last Updated Tue, 27 Sep 2022 17:02:35 +0000

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Prior Authorization Lookup Tool

Determine which HCPCS codes require a Prior Authorization

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