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{"DID":"crit15d1eb","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"07-27-2023 07:43","End Date":"07-28-2023 13:01","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, July 28, 2023, for staff training.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit2114dd","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"08-23-2023 10:46","End Date":"08-25-2023 13:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, August 25, 2023, for staff training.\n","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit32a323","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"06-14-2023 15:04","End Date":"06-16-2023 17:30","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed for an eight-hour staff training on Friday, June 16, 2023.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit34c5e3","Sites":"JJA^JJB^JMA^JMB^JMHHH^Railroad Medicare","Start Date":"03-24-2023 08:40","End Date":"03-26-2023 12:00","Content":"eServices eAudit data is currently unavailable. We are working to resolve this issue and will remove this message when functionality is restored.","URL":"","Target":"_self","Color":"yellow","Mode":"Standard\n","Priority":"no"}, {"DID":"crit4334e1","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"07-11-2023 15:05","End Date":"07-14-2023 13:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, July 14, 2023, for staff training.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit44c243","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"11-16-2023 14:38","End Date":"11-24-2023 18:00","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed November 23 and 24, 2023, in observance of the Thanksgiving holiday.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit5b243c","Sites":"JJA^JJB","Start Date":"08-12-2022 13:00","End Date":"08-31-2022 08:18","Content":"Have a Medicare question and want to chat with a rep? JJ providers are invited to join us on webchat. Just select the green Chat Now button on the bottom right corner of screen! ","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crita42d51","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"08-31-2023 15:00","End Date":"09-04-2023 17:00","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Monday, September 4, 2023, in observance of Labor Day.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crita54bdb","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"05-24-2023 13:47","End Date":"05-29-2023 18:00","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Monday, May 29, 2023, in observance of Memorial Day.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"yes"}, {"DID":"crita5c5ba","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"11-08-2023 10:22","End Date":"11-10-2023 22:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed for an 8-hour training on Veterans Day, Friday, November 10, 2023.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"yes"}, {"DID":"critbca1cd","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"11-28-2023 13:50","End Date":"11-28-2023 20:18","Content":"The Provider Contact Center (PCC) has closed for today, November 28, 2023, due to technical issues. The PCC will resume taking calls tomorrow during normal business hours. We apologize for the inconvenience and appreciate your patience. ","URL":"","Target":null,"Color":"red","Mode":"Standard\n","Priority":"yes"}, {"DID":"critce3553","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"09-13-2023 13:16","End Date":"09-15-2023 12:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, September 15, 2023, for staff training","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critd1a1c4","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"06-29-2023 09:58","End Date":"07-04-2023 17:30","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Tuesday, July 4, 2023, in observance of Independence Day.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critd33c3a","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"11-28-2023 13:50","End Date":"12-01-2023 13:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, December 1, 2023, for staff training.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critdbc2e4","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"10-05-2023 13:16","End Date":"10-09-2023 17:30","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed for an 8-hour training on Columbus Day, Monday, October 9, 2023.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"criteeda42","Sites":"JJA^JJB","Start Date":"11-01-2023 07:00","End Date":"11-28-2023 10:00","Content":"Have a Medicare question and want to chat with a rep? JJ providers are invited to join us on webchat. Just click the green Chat Now button on the bottom right corner of your screen! ","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}

Outpatient Department Prior Authorization (PA)

Published 06/13/2023

The Centers for Medicare & Medicaid Services (CMS) has established a nationwide prior authorization (PA) process and requirements for certain hospital outpatient department (OPD) services. This process serves as a method for controlling unnecessary increases in the volume of these services and to ensure that medical necessity is met.

Blepharoplasty
Botulinum toxin injections
Panniculectomy
Rhinoplasty
Vein ablation

Providers can submit a PA request as early as June 17, 2021, for date of service on or after July 1, 2021, for the following:

Cervical Fusion with Disc Removal
Implanted Spinal Neurostimulators

Providers can submit a PA request as early as June 15, 2023, for date of service on or after July 1, 2023, for the following:

Facet Joint Interventions

Please watch our website for upcoming education regarding OPD PA. You may go to the CMS website to view a full list of HCPCS codes that require a PA.

Resource: Jurisdiction J Part A Outpatient Prior Authorization Request Form (PDF).

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