Thanks for the link. I have been working on the provider side of healthcare for almost 30 years with the last 12 involving oversight of billing for physician services. In my experience, traditional Medicare has not required prior authorization for services we provide–inpatient or outpatient. Rather, Medicare has National Coverage Determinations or Local Coverage Determinations that tell us what services are covered by traditional Medicare. As long as our claim and documentation meets the criteria, payment usually follows.
Medicare advantage plans are a totally different ballgame as they are administered by private insurers and follow the rules of the payer/plan.