Tag: Medicare exemption

Medicare prior authorization exemption

Navigating Medicare’s Prior Authorization Exemption for Hospital Outpatient Departments

The Centers for Medicare & Medicaid Services (CMS) have established a pathway for certain hospital outpatient departments (OPDs) to obtain a temporary exemption from the prior authorization process. This exemption, which lasts for 12 months, is designed to reward providers that consistently demonstrate compliance with Medicare coverage, coding, and payment rules. Understanding how to qualify, […]