Hospital Outpatient Department Prior Authorization
The Centers for Medicare & Medicaid Services (CMS) established a nationwide prior authorization (PA) process as a condition of payment for certain hospital outpatient department (OPD) services. Effective for dates of service July 1, 2020, Part A hospital OPDs must submit a prior authorization request (PAR) and supporting documentation to their Medicare Administrative Contractor (MAC) and receive a decision before rendering the service and submitting a claim for processing.