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Medical review

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Targeted probe and educate (TPE)

TPE is one process that a MAC can utilize when providers are selected by medical review.

Service-specific reviews

View these current post-payment service-specific reviews and available results.

Service-specific reviews

View these current post-payment service-specific reviews and available results.

Part B service-specific review - ambulance services (HCPCS code A0428 with A0425)

Summary for ambulance services (October 2020).

Part B service-specific review -- hyperbaric oxygen therapy (CPT code 99183)

Summary for hyperbaric oxygen therapy (October 2020).

Part B service-specific review -- outpatient rehabilitation services (CPT code 97110)

View this summary for outpatient rehabilitation services (August - November 2020 and August 2021).

Part A service-specific review - hyperbaric oxygen therapy (G0277)

View this summary for outpatient rehabilitation services (December 2020).

Part A service-specific review -- (CPT 97110 therapeutic activities)

View this summary for outpatient rehabilitation services (August - November 2020).

Part A service-specific review - (CPT 97530 therapeutic activities)

View this summary for outpatient rehabilitation services (January through August 2021).

Part B service-specific review – drugs and biologicals (J0178 Eylea, J0897 Prolia, J2778 Lucentis, J9217 Lupron (Leuprolide))

Summary for drugs and biologicals (April-May 2021).