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  • Posting Date: 06/01/2020
    New York State Ambulance Services in Rural Areas (for JK providers only)

    New York State Ambulance Services in Rural Areas NYS has unique requirements for the payment of paramedic intercept services when an ambulance company can provide only BLS services. Paramedic intercept services can be approved in counties and [...]

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  • Posting Date: 03/08/2023
    PECOS Starter Guide

    PECOS Starter Guide Follow the steps outlined below to assist you and your staff with the PECOS processes. Table of Contents New/Initial Enrollee Revalidation Return for Corrections Change of Information Submit Pending Application [...]

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  • Posting Date: 10/31/2022
    General Information

    General Information Original Medicare does not normally cover routine vision services, such as eyeglasses and eye exams. Medicare may cover some vision costs if associated with other covered expenses (that is, Medicare may cover some vision [...]

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  • Posting Date: 10/31/2022
    Provider Qualifications

    Provider Qualifications Definition Ophthalmologist An ophthalmologist is a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) who has completed medical school and an ophthalmology residency that specialized in eye and [...]

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  • Posting Date: 10/31/2022
    Local Coverage Determinations

    Local Coverage Determinations Table of Contents Cataract Extraction LCD L33558 Corneal Pachymetry LCD L33630 Coding Guidelines Ophthalmic Biometry for Intraocular Lens Power Calculation LCD L33621 A-Scan Ultrasound Ophthalmic [...]

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  • Posting Date: 10/31/2022
    National Coverage Determinations

    National Coverage Determinations Table of Contents Hydrophilic Contact Lens for Corneal Bandage Photodynamic Therapy Ocular Photodynamic Therapy Photosensitive Drugs Verteporfin Hydrophilic Contact Lenses Scleral Shell Intraocular [...]

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  • Posting Date: 10/31/2022
    Limitation of Liability (Advance Beneficiary Notice)

    Limitation of Liability (Advance Beneficiary Notice) Services denied as not reasonable and medically necessary, under Section 1862(a) (1) of the Social Security Act, are subject to the Limitation of Liability (ABN) provision. The ABN is a [...]

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  • Posting Date: 10/31/2022
    Glaucoma Screening ‒ Preventive Services Coverage

    Glaucoma Screening ‒ Preventive Services Coverage Medicare provides coverage of an annual glaucoma screening for beneficiaries in at least one of the following high-risk groups: Individuals with diabetes mellitus; Individuals with a family [...]

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