Medical Review Frequently Asked Questions (FAQs)

Q1: Does Medical Review have review results with trending errors posted for providers to see?
A1: Part A Medical Review will soon be posting review results on the top 2 services with errors noted on our Medical Review webpage at

Q2. Are there services/procedures that require prior authorization at this time?
A2: CMS established a new nationwide Prior Authorization process to assist in controlling unnecessary increases in specific services and still ensure Medicare beneficiaries are receiving medically necessary care needed. The below hospital outpatient department (OPD) services will require Prior Authorization on or after July 1, 2020.

  1. Blepharoplasty
  2. Botulinum toxic injections
  3. Panniculectomy
  4. Rhinoplasty
  5. Vein ablation

Watch for further information on the Prior Authorization process at and/or Noridian Medicare website.


Last Updated Feb 04, 2020