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CGS Administrators, LLC

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April 6, 2020

TPE Review Update from CGS Medical Review

CMS recently published direction concerning the Targeted Probe and Educate (TPE) review strategy for their Medicare Administrative Contractors (MACs) in light of the COVID-19 Public Health Emergency (PHE).  As such, we want to alert our supplier community to the actions we are taking immediately:

If you have not yet responded to a TPE request for documentation (an ADR letter) from CGS Medical Review, you can shred and dispose of the letter – please do NOT submit a response to CGS Medical Review.

Watch your Medicare Remittance Advice statements for updates on TPE claims we released.

Please note, if you have a request for documentation from another entity (i.e., the CERT contractor), you need to respond to them in a timely matter unless otherwise instructed by CMS.

Finally, please continue to monitor our daily ListServ, the CGS News webpages, and our COVID-19 webpage for additional information and updates.

Stay safe and healthy as you take care of your clients!

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