The Centers for Medicare & Medicaid Services (CMS) uses coverage determinations to decide how Medicare should cover treatments, services, and items. These rules usually apply nationwide. The CMS ...

The Centers for Medicare & Medicaid Services (CMS) uses national coverage determinations to determine how it should cover all treatments, services, and items. The CMS makes national coverage ...

Providers recently had to report on adherence for respiratory assist devices (RADs) and home mechanical ventilators (HMVs) ...

The Centers for Medicare & Medicaid Services (CMS) has released uniform policies to prevent Medicare and its beneficiaries from paying for three so-called “never events” — serious, preventable errors, ...

On September 9, 2025, the Government Accountability Office (GAO) published a report titled “National Coverage Determinations Are Generally Timely, but Improvements Are Needed” (the Report). CMS makes ...

CMS updated its national coverage determination edits — what Medicare will cover — to factor in ICD-10 codes, according to ICD-10 Watch. Providers can use the updates to predict how their ...

Both the use of next-generation sequencing (NGS) testing for cancer and the rate of claim denials for such testing increased between 2016 and 2021, despite implementation of a recent Medicare national ...

The final U.S. Medicare national coverage determination for transcatheter tricuspid valve replacement (TTVR) devices comes with an expected coverage with evidence development mandate, but some ...

The RAPID coverage pathway is designed to address the historically significant lag (sometimes referred to as the “valley of death”) between the point at which a medical device receives FDA market ...

Both the use of next-generation sequencing (NGS) testing for cancer and the rate of claim denials for such testing increased between 2016 and 2021, despite implementation of a recent Medicare national ...

Both the use of next-generation sequencing (NGS) testing for cancer and the rate of claim denials for such testing increased between 2016 and 2021, despite implementation of a recent Medicare national ...