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 17:03:01 +0000

Comparison Tool

Pre-Claim Review Comparison Tool

Prior Authorization Lookup Tool

Determine which HCPCS codes require a Prior Authorization


Enter HCPCS Code: