All current topics for review are listed below with the Medical Review Part B schedule for each round. We will notify the selected providers in writing with further details of the topic being reviewed, the reasons for selection which will be supported by data analysis, and the process of review.
Please note that a status of active review means there are currently reviews underway for the specific round and topic.
A status of inactive review means there are currently no active TPE reviews for the specific round and topic.
For additional information and specific educational resources, see the topic specific links below.
End stage renal disease (ESRD) services (CPT 90960-90961)
Inactive
ESRD checklist
ESRD results
Rehabilitation services: Outpatient physical and occupational therapy (CPT 97530)
Therapy checklist
Therapy results
Surgical services: Cataract extraction (CPT 66982-66984)
Active
Cataract checklist
Cataract results
Drugs and biologicals: Drug injections - (Hyaluronan Acid Therapies) with associated administration and placement codes)
Drug injection checklist
Drug Injection results
Psychiatric services: Psychotherapy (CPT 90832, 90834, and 90837)
Psychotherapy checklist
Psychotherapy results
Mohs micrographic surgery (MMS) (CPT 17311-17315)
MMS checklist
MMS results
Nail cutting/Paring and debridement (CPT 11719-11721, 11055-11057, HCPCS G0127)
Foot care checklist
Foot care results
Anesthesia services: Anesthesia for diagnostic or therapeutic injections; prone position (CPT 01992)
Anesthesia checklist
Anesthesia results
Trigger point injections (CPT 20552-20553)
Trigger point injection checklist
Trigger point injection results
Paravertebral facet joint injections (CPT 64490-64491)
Facet joint injection checklist
Facet joint injection results
Epidural steroid injections for pain management (CPT 62323)
Epidural steroid injection checklist
Epidural steroid injection results
Rehabilitation services: Outpatient physical, occupational and speech therapy services billed with KX modifier
Therapy KX results
Removal of benign skin lesions (CPT 11102-11103, 11200-11201, 11300-11303, 11305-11313 and 11401-11406, 11421-11424, 11426, 11440-11446)
Skin lesion removal checklist
Removal of benign lesions results
Laboratory services: Definitive drug testing (HCPCS: G0480, G0481, G0482, G0483)
Laboratory services checklist
Laboratory results
Acupuncture (CPT 97810-97811; 97813-97814)
Acupuncture checklist
Acupuncture results
Evaluation & management (E/M) services: Established office/outpatient visits (CPT 99215, 99214, 99213), Subsequent hospital inpatient or observation care (CPT 99232)
E/M checklist
Evaluation & Management results
Annual Wellness Visits (G0438, G0439)
AWV checklist
Coming soon
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