Question

According to the CMS guidelines for Reasonable and Necessary care, there are two criteria that must be met for the services to be reimbursed. What are those criteria? a) Medical Necessity and Cost-Effectiveness

b) Physician Approval and Patient Consent
c) Time Efficiency and Accessibility
d) Public Demand and Provider Availability

Answer 1

According to the CMS guidelines for Reasonable and Necessary care, the two criteria that must be met for the services to be reimbursed are Medical Necessity and Cost-Effectiveness.

Step-by-step explanation:

According to the CMS guidelines for Reasonable and Necessary care, there are two criteria that must be met for the services to be reimbursed: Medical Necessity and Cost-Effectiveness.

Answer 2

According to the CMS guidelines for Reasonable and Necessary care, there are two criteria that must be met for the services to be reimbursed. Those criteria are Medical Necessity and Cost-Effectiveness.

Therefore, correct option is a) Medical Necessity and Cost-Effectiveness.

Step-by-step explanation:

According to the CMS (Centers for Medicare & Medicaid Services) guidelines for Reasonable and Necessary care, the two criteria that must be met for services to be reimbursed are Medical Necessity and Cost-Effectiveness (a).

Medical Necessity implies that the service or treatment must be essential and directly related to the diagnosis or treatment of the patient's condition. Cost-Effectiveness emphasizes the efficient use of resources, ensuring that the services provided offer value in terms of benefits relative to their costs.

Physician Approval and Patient Consent (b), Time Efficiency and Accessibility (c), and Public Demand and Provider Availability (d) are not the specific criteria outlined by CMS for reimbursement, making option (a) the correct choice.

Therefore, correct option is a) Medical Necessity and Cost-Effectiveness.