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CMS's Targeted Probe and Educate ("TPE") Program - Get Counsel Involved Early!

First few Article Sentences

On October 1, 2017, CMS expanded its pilot Targeted Probe and Educate ("TPE") program to include all MACs. CMS's stated purpose for the expansion is "to reduce appeals, decrease provider burden, and improve the medical review/education process." CMS has described the program as "designed to help providers and suppliers reduce claim denials and appeals through one-on-one help." This is a 3-round program conducted by the provider's local MAC. It offers one-on-one education and is intended to reduce payment error rates for the provider. Hopefully, the provider is also able to use the program to avoid an overpayment demand or payment suspension.

Cooper, Esq., Richard


McDonald Hopkins LLC

CMS TPE Program

February 1, 2018

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