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Prior Authorization Initiatives

News & Alerts

Repetitive Scheduled Non-Emergent Ambulance Transport

Effective 12/01/14, for dates of service on or after 12/15/14, the Centers for Medicare & Medicaid Services (CMS) will prior authorize certain repetitive scheduled non-emergent ambulance transports in New Jersey and Pennsylvania.

Effective 12/15/15, for dates of service on or after 01/01/16, CMS will prior authorize repetitive scheduled non-emergent ambulance transports in Delaware, Maryland and the District of Columbia.

By submitting a complete cover sheet and the required documentation, a supplier can receive provisional prior authorization for as many as 40 round trips (80 transports) in a 60-day period.

For details, links, and submission guidelines refer to Repetitive Scheduled Non-Emergent Ambulance Transport.

Non-Emergent Hyperbaric Oxygen

The prior authorization model for non-emergent hyperbaric oxygen ended on 02/28/18, based on date of service. Facilities and beneficiaries may continue to submit prior authorization requests after 02/28/18 for treatments occurring prior to 03/01/18. The independent evaluation of the model is ongoing. Results will be available once completed.

Effective 07/15/15, for dates of service on or after 08/01/15, CMS will prior authorize non-emergent hyperbaric oxygen therapy at New Jersey facilities.

By submitting a complete cover sheet and the required documentation, a provider can receive provisional prior authorization for as many as 40 sessions in a 12-month period.

For details, links and submission guidelines refer to Non-Emergent Hyperbaric Oxygen.

Contact

By Phone

1-855-340-5975

By Fax

1-877-439-5479 (request cover sheet and documentation)

By Mail

Novitas Solutions
P.O. Box 3702
Mechanicsburg, PA 17055-3717


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Last modified:  06/14/2018