Correct or Reopen a Claim Due to an MSP-Related Issue

Table of Contents Correct or Reopen a Claim Due to an MSP-Related Issue Identify the Finalized Status of the Claim and Take the Appropriate Action Depending on the Type of Denial/Correction That Needs to be Made Step 1 Claim Denied as [...]

Prolonged Services Timeline 2024

Prolonged Services Timeline 2024 We’ve updated the Prolonged Services Timetable with 2024 HCPCS and CPT codes, time requirements and date spans. We encourage providers to view this information to ensure you’re billing claims for prolonged [...]

Medicare Part B Overpayments

Medicare Part B Overpayments We developed the Medicare Part B Overpayments Tip Sheet to provide instructions for reporting various overpayment situations. Topics include responding to a demand letter, viewing outstanding overpayments, [...]

Overpayments Right Hand

Resources Medicare Part B Overpayments Tip Sheet Form(s) you'll need: Financial Contact Submissions All Forms

Overpayments Right Hand

Resources Medicare Part B Overpayments Tip Sheet Form(s) you'll need: Financial Contact Submissions All Forms

Ambulance Duplicate Claim Denials

Sample TPE Notification Letter

Sample TPE Notification Letter Mail Date Provider Name Provider Address City, State, Zip Casefolder ID: Casefolder ID Provider Number PTAN: PTAN (Provider Transaction Access Number) Provider Number NPI: NPI (National Provider Identifier) [...]

Sample TPE Notification Letter

Sample TPE Notification Letter Mail Date Provider Name Provider Address City, State, Zip Casefolder ID: Casefolder ID Provider Number PTAN: PTAN (Provider Transaction Access Number) Provider Number NPI: NPI (National [...]

Medicare Preventive Services

Medicare Preventive Services Medicare covers many preventive services to help keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain [...]

LCD and Billing and Coding Article Updates for February/March 2024

LCD and Billing and Coding Article Updates for February/March 2024 Local Coverage Determinations Biomarker Testing for Prostate Cancer Diagnosis (L37733) This LCD has been retired and will no longer be in effect for services performed after [...]

Date of Service on CMS-1500 Billing

Date of Service on CMS-1500 Billing Overview Radiology Services Surgical and Anatomical Pathology Chronic Care Management Care Plan Oversight Home Health Certification and Recertification Physician End-Stage Renal Disease Services [...]

[REVISED] 2024 Gapfill Request

[REVISED] 2024 Gapfill Request National Government Services, the MAC for JK and J6 is in receipt of the new laboratory test codes identified by the CMS to be gap-fill priced for 2024. The PAMA regulations instruct the MACs to establish local [...]

Change Healthcare Security Incident

Change Healthcare Security Incident The CMS and National Government Services are aware that Change Healthcare recently suffered a cyber-attack. Change Healthcare is a clearinghouse vendor that connects providers with insurance payers and has [...]

MLN Connects® Newsletter: February 29, 2024

MLN Connects® Newsletter: February 29, 2024 Events ICD-10 Coordination & Maintenance Committee Meeting — March 19–20 MLN Matters® Articles Appropriate Use Criteria for Advanced Diagnostic Imaging: CY 2024 Update Clinical [...]

Tobacco Counseling via Telehealth

Tobacco Counseling via Telehealth Tobacco use is the leading cause of preventable disease, disability and death in the United States. Each year, nearly half a million Americans die prematurely of smoking or exposure to secondhand smoke. [...]

You Asked, We Listened: Redesigned Events Page Coming Soon

You Asked, We Listened: Redesigned Events Page Coming Soon We’re always looking for and appreciate feedback from our providers. Your ideas and recommendations help drive improvements to our website. Providers suggested that we display the [...]

March 2024

In This Issue National Government Services Articles for Part A and Part B Providers Common Working File (CWF) Host Dark Days for April 2024 Release Health Benefits of Quitting Smoking 2024 Gapfill Request Correct Coding of Molecular [...]

CMS Rural Health Resources

CMS Rural Health Clinics Center

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport CMS implemented the prior authorization program for RSNAT to reduce expenditures while maintaining and/or improving quality of care. This program applies to [...]