Targeted Probe and Educate (TPE) Reviews

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Topic: TPE

Sponsor: Corcoran Consulting Group

Updated: 11/30/2017

Targeted Probe and Educate reviews are another form of Medicare claims data-driven reviews done by your Medicare Administrative Contractor (MAC).

This FAQ addresses the following:

1. What are Targeted Probe and Educate reviews?
2. Why are these reviews being implemented now?
3. How many charts might this entail?
4. Why are there three rounds of TPE review?
5. How do the MACs choose what issues on claims get a review?
6. How is the decision on whether subsequent reviews happen take place?
7. What sort of education is provided if I don’t do well after a round?
8. What resources does CMS provide on TPE?
9. What happens if I don’t do well on round 3 of TPE?
10. How should I protect myself from a TPE review?

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The reimbursement information is provided by Corcoran Consulting Group based on publicly available information from CMS, the AMA, and other sources. The reader is strongly encouraged to review federal and state laws, regulations, code sets, and official instructions promulgated by Medicare and other payers. This document is not an official source nor is it a complete guide on reimbursement. Although we believe this information is accurate at the time of publication, the reader is reminded that this information, including references and hyperlinks, changes over time, and may be incorrect at any time following publication.

© 2026 Corcoran Consulting Group. A Subsidiary of Medical Consulting Group, LLC. All rights reserved. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a retrieval system, without the written permission of the publisher. CPT is a registered trademark of the American Medical Association.