Get correct billing instructions for modifiers GA, GX, GY, and GZ, including when to use each, required documentation, and HMSA claim tips.

Learn about cost-based items, including reimbursement methodologies, billing requirements, and guidelines for accurate claims processing and payment.

Review HMSA customizations to commercial claims editing software, including coding updates and processing rules aligned with reimbursement policies.

Guidelines for delivery and birthing claim documentation, including required clinical records, supporting documentation, and criteria to support medical necessity and reimbursement.

Learn about vision diagnosis coding guidelines, including code selection, documentation requirements, and best practices for accurate and compliant billing.

View DME, prosthetics, and orthotics HCPCS codes over $500 that do not require precertification, including billing guidelines and coverage criteria.

Learn about DME, prosthetics, and orthotics HCPCS codes requiring precertification, including guidelines, eligibility, and approval requirements.

Access information on HMSA fee schedules, including how to view Maximum Allowable Charges (MACs), determine the appropriate fee schedule, and submit fee schedule requests for reimbursement inquiries.

Review HMSA guidelines for gender-specific drugs, including coverage criteria, billing requirements, and documentation for accurate claim processing.

Learn about physical medicine services, including chiropractic care, occupational therapy (OT), and physical therapy (PT), with coverage and billing guidelines.08/03/2026