Medicare to require prior authorization for certain outpatient department services

To ensure that Medicare beneficiaries continue to receive medically necessary care –while protecting the Medicare Trust Fund from improper payments and, at the same time, keeping the medical necessity documentation requirements unchanged for providers, Medicare is requiring prior authorization for certain outpatient department services starting July 1, 2020. According to CMS, in order to help control unnecessary increases in these procedures that are likely to be cosmetic surgical procedures and/or are directly relate to cosmetic surgical procedures that are not covered by Medicare, but may be combined with or masquerading as therapeutic services. Read article here…

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