Skip over navigation

Post-Pay Reviews - JF Part B

Post-Pay Reviews

The Centers for Medicare & Medicaid Services (CMS) is required to protect the Medicare Trust Fund against inappropriate payments which pose a risk to the Trust Fund. Noridian’s focus includes performing post-payment service specific reviews identified by vulnerabilities that indicate questionable billing patterns.

Information below provides a global notice of what post-payment service topic reviews are currently in process, required documentation, resources used in reviews, and any current findings if the service topic review is completed.

Review Criteria Service Specific
Review
Notification
Current
Review
Results
Current
Review
Status
Annual Wellness/Subsequent Wellness Visit, HCPCS G0438/G0439
Dual-Energy X-ray Absorptiometry (DEXA), CPT® 77080

End-stage renal disease (ESRD) related monthly services, CPT® Codes 90960-90962

Psychotherapy, CPT® 90834

Rituximab, HCPCS Code J9312
Therapeutic Exercise, CPT® 97110

 

Last Updated Mon, 25 Oct 2021 15:28:58 +0000