Payer Guidelines

Commercial Payers

Aetna Polices and Guidelines

Empire Blue Cross Blue Shield Medical Policies and Clinical UM Guidelines

Excellus Medical Guidelines

Health Now Medical Protocols

MPV Health Care Medical and Pharmacy Policy Updates - Monthly Updates

Access to current MVP Medical Coverage Policies require a username and password.

Government Payers

Medicare

1995 E&M Documentation Guidelines

1997 E&M Documentation Guidelines

Advance Beneficiary Notice (ABN)

Coverage Determinations

"Incident to"

Locum Tenes

Medicare Learning Network

MLN Provider Compliance

Internet Only Manuals

Teaching Physician Services - Pages 156-177

  • Exception for E/M Services Furnished in Certain Primary Care Centers - Pages 162-164
  • Teaching Physician Services - Surgical Procedures - Pages 164-166

Medicaid

New York State Medicaid - Home

Ambulatory Payment Groups (APGs)

eMedNY

Locum Tenes

Medicaid Updates - New York State Department of Health

Supervising/Teaching Physicians as of April 2008