Payer Guidelines
Commercial Payers
Empire Blue Cross Blue Shield Medical Policies and Clinical UM Guidelines
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
- Local Coverage Determinations (National Government Services)
- Click on "Go to Home Page" underneath "Part A Connecticut New York"
- "Accept" the Attestation
- In the "Quick Links" box on the left, select "Medical Policy Center (LCD)
- National Coverage Determinations (NCDs) - Index
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)
- Provider Manuals - the list of all available provider manuals is at the bottom of the page
Medicaid Updates - New York State Department of Health
Supervising/Teaching Physicians as of April 2008
- Anesthesia Guideline Updates, New York State Department of Health Medicaid Update, November 2010
- Medical Record Documentation for Supervising/Teaching Physicians - New York State Department of Health Medicaid Update, November 2003
- Primary Care Exception
