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Payment policies

ABNs and GY Modifiers

Acute Admissions and Level of Care

Ambulatory surgical centers

Billing and Cost-Sharing for Dual Eligible Members

Clinical Trials, Investigational Device Exemption (IDE) studies, Coverage with Evidence Development (CED) studies

Continuous Glucose Monitors & National Drug Codes (CGMs & NDCs)

Critical Access Hospital (CAH) Billing

Common modifiers

Emergency department services

FQHC services

Home Health Services Billing

Inpatient readmissions

NDC Billing Guidelines

NOMNC Compliance, Documentation, and Provider Requirements in Appeals

Observation services

Off-Campus outpatient clinic services

Organ Transplants

Paper check transaction fee

Preventive services

Primary care services

Provider terminations and the Q6 modifier

Radiopharmaceuticals

Rural health clinics

Sepsis DRG review

Telehealth Services

Three Day Payment Window (Outpatient Services Treated as Inpatient)

TIN Validation

Vision services