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Posting Date: 08/05/2022
Modifier 25
Modifier 25 National Government Services has identified problems common with claims submitted for evaluation and management (E/M) services where modifier 25 was appended. This article is designed to provide education regarding the correct [...]
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Posting Date: 08/05/2022
Modifier 33
Modifier 33 Table of Contents Preventive Services Anesthesia Services Moderate Sedation Related Content [Return to Top] Preventive Services When the primary purpose of the service is the delivery of an evidence-based service in [...]
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Posting Date: 10/20/2022
Medicare Part A and B Billing for the COVID-19 Vaccine and Monoclonal Antibody
Medicare Part A and B Billing for the COVID-19 Vaccine and Monoclonal Antibody Table of Contents Medicare Part A and B Billing for the COVID-19 Vaccine and Monoclonal Antibody Roster Billing How to Submit a Centralized Bill Medicare [...]
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Posting Date: 04/10/2023
Medicare Coverage of Over-the-Counter COVID-19 Tests
Medicare Coverage of Over-the-Counter COVID-19 Tests The OTC COVID-19 test demonstration ended on 5/11/2023. Starting on 5/12/2023, Medicare no longer covers or pays for OTC COVID-19 tests for those with Medicare Part B benefits. Beginning [...]
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Posting Date: 10/07/2024
HHH - Promo 1 (Think Green Go Paperless)
Think Green Go Paperless /web/ngs/edi-solutions?selectedArticleId=907003
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Posting Date: 10/26/2023
Part B - Promo 1
Banner saying "NGS RuralServ - Changing the way we deliver education to you." /web/ngs/ruralserv?selectedArticleId=1987743
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Posting Date: 10/28/2022
Electronic Data Interchange
Medicare Part B 101 Manual Electronic Data Interchange Table of Contents Electronic Data Interchange Transactions Benefits of Submitting Electronically Becoming an Electronic Submitter PC-ACE EDI: Beyond Claims and Extra Features [...]
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Posting Date: 10/07/2022
National Provider Identifier
Medicare Part B 101 Manual National Provider Identifier Table of Contents National Provider Identifier Background Application Process Sharing Your NPI NPI Contractor Mailing Address NPI Registry [Return to Top] National [...]
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Posting Date: 10/26/2022
About Provider Outreach and Education
Medicare Part B 101 Manual About Provider Outreach and Education Table of Contents About Provider Outreach and Education Educational Activities Provider Outreach and Education Advisory Group [Return to Top] About Provider Outreach [...]
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Posting Date: 03/04/2021
Appendix 3: Place of Service Codes
Medicare Part B 101 Manual Appendix 3: Place of Service Codes Table of Contents Place of Service Codes Health Insurance Portability and Accountability Act Special Considerations Homeless Shelter (Code 04) Indian Health Service [...]
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Posting Date: 10/14/2024
Reminder – Beginning 11/18/2024, Beneficiary Eligibility Information Not Offered on the IVR
Reminder – Beginning 11/18/2024, Beneficiary Eligibility Information Not Offered on the IVR To help protect Medicare beneficiaries against fraud, CMS is instructing all MACs to remove beneficiary eligibility information from our IVR [...]
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Inpatient Hospital Issued Notices
Inpatient Hospital Issued Notices Applies to: All hospitals Medicare beneficiaries and hospitals have certain rights and protections related to financial liability and appeals under the Medicare Program. These financial liability and appeal [...]
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Posting Date: 10/31/2022
Modifier Usage
Modifier Usage Table of Contents E/M Services Within a Global Surgical Period – Modifiers 24, 25 and 57 24 – Unrelated E/M Service by the Same Physician During a Postoperative Period 25 – Significant, Separately Identifiable E/M [...]
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Posting Date: 08/05/2022
Proper Use of Modifiers 59 and 91
Proper Use of Modifiers 59 and 91 Table of Contents Modifier 59 Appropriate Usage Inappropriate Usage Modifier 91 Appropriate Usage Inappropriate Usage Additional Information Related Content [Return to Top] [...]
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Posting Date: 08/04/2022
Repeat Procedures - Modifiers 76 and 77
Repeat Procedures - Modifiers 76 and 77 Exact duplicate data fields submitted for claims include: Same beneficiary Same provider Same dates of service Same types of services Same place of service Same procedure codes Same billed [...]
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Posting Date: 10/26/2022
Deceased Beneficiary Claims
Medicare Part B 101 Deceased Beneficiary Claims Table of Contents Deceased Beneficiary Claims Unpaid Bills Paid Bills Assigned Claims [Return to Top] Deceased Beneficiary Claims Medicare law outlining the payment of the medical [...]
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Posting Date: 10/07/2022
Payment Floor Standards
Medicare Part B 101 Manual Payment Floor Standards The “payment floor” establishes a waiting period during which time the contractor may not pay, issue, mail or otherwise finalize the initial determination on a clean claim. The “payment [...]
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Posting Date: 10/06/2021
Limiting Charge
Medicare Part B 101 Manual Limiting Charge Table of Contents Federal Limiting Charge Federal Limiting Charge for Medicare Secondary Payer [Return to Top] Federal Limiting Charge As part of the Omnibus Budget Reconciliation Act of [...]
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