08/31/2021

Resumption of Medicare Targeted Probe and Educate Medical Review Strategy

 

On August 12, 2021, CMS announced the restart of the Targeted Probe and Educate (TPE) program. TPE had been suspended since March 2020 due to the COVID-19 Public Health Emergency (PHE). Please note the following:

• All TPE cases that have remained open during the PHE are being closed.
• The TPE review process may include up to three rounds of a prepayment claim review with education.
• Suppliers selected for TPE will start at round 1, regardless of prior inclusion in the program.

Suppliers selected for TPE will receive a notification letter that outlines the TPE process and HCPCS codes that will be reviewed. Read more from Jurisdiction B DME MAC...