General Information

General Information Since 2001, CMS has formally recognized qualified audiologists (specialty 64) to personally furnish diagnostic tests (Section 410.32(b)(2)(ii)) without supervision by a physician or NPP. The statute, at section 1861(ll)(3) [...]

Modifier/Code List

Modifier/Code List CMS established a new modifier, AB, for audiologists to use that describes: audiology service furnished personally by an audiologist without a physician/NPP order for non-acute hearing assessment unrelated to disequilibrium, [...]

Fee Schedule Assistance

Fee Schedule Assistance Illinois Locality/Area and County Information Maine, Massachusetts, New Hampshire, Rhode Island, Vermont Locality/Area and County Information New York Locality/Area and County Information Locate and Download Fee [...]

Prevent an MSP Rejection on a Medicare Primary Claim

Table of Contents Prevent an MSP Rejection on a Medicare Primary Claim Step 1: Identify the MSP Record for the Beneficiary on the CWF that Needs Correction Step 2: Prepare a Medicare Primary Claim for the Beneficiary’s Services Step 3: [...]

Publications for People with Medicare

Publications for People with Medicare Medicare & You Handbook Medicare News Medicare Publications

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  The home health agency (HHA) certification code can be billed only when the patient has not received Medicare-covered home health services for at least 60 days. The HHA recertification code is used after a patient has received services for [...]

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G0179 Frequency Calculator Use this calculator to determine the date the next recertification code G0179 may be billed. Enter the date of the last recertification or certification service that met the billing requirements for code G0179 or [...]

Laboratory Tests Billing Alert: Lipid Panel Test (80061) Completed on the Same Date of Service as an LDL Test (83721)

Laboratory Tests Billing Alert: Lipid Panel Test (80061) Completed on the Same Date of Service as an LDL Test (83721) National Government Services, Inc. Medical Review initiated a review of claims containing both a lipid panel test and [...]

What is Medicare Secondary Payer?

Medicare Secondary Payer is the term used for when a Medicare beneficiary has other insurance or coverage that is the primary payer, based on a federal MSP provision, for the beneficiary’s healthcare services. As a result, Medicare is the [...]

Provider Enrollment: Verify Bank Account Information to Prevent Interruption in Medicare Payment

Provider Enrollment: Verify Bank Account Information to Prevent Interruption in Medicare Payment National Government Services receives numerous electronic funds transfer banking rejections each year due to frozen or closed bank accounts. [...]

Provider Enrollment: Verify Bank Account Information to Prevent Interruption in Medicare Payment

Provider Enrollment: Verify Bank Account Information to Prevent Interruption in Medicare Payment National Government Services receives numerous electronic funds transfer banking rejections each year due to frozen or closed bank accounts. [...]

Prevent an MSP Rejection on a Medicare Primary Claim

Table of Contents Prevent an MSP Rejection on a Medicare Primary Claim Step 1 Step 2 Step 3 Related Content [Return to Top] Prevent an MSP Rejection on a Medicare Primary Claim If you submit a Medicare primary claim when there is [...]

Populating MSP Insurance Type Code on Electronic Claims

Table of Contents Populating MSP Insurance Type Code on Electronic Claims GHP NGHP Related Content [Return to Top] Populating MSP Insurance Type Code on Electronic Claims When you identify beneficiaries that have Medicare as the [...]

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Please refer to the Physician Fee Schedule Look up on the CMS Web site to determine whether the procedure in question has a 90 day global period.

Hospital-Issued Notices of Noncoverage

Inhalation Treatment CPT 94640 – Billing Errors

Inhalation Treatment CPT 94640 – Billing Errors The National Government Services Appeals Department has identified billing errors relevant to CPT code 94640 for inhalation treatment. When you bill more than one unit per episode of care, the [...]

DME CERT Physician's Corner

DME CERT Physician’s Corner In an effort to reduce the CERT claims error rate, CGS Jurisdiction B DME MAC, has created a Physician’s Corner page which is specifically designed for physicians and practitioners to provide detailed information [...]

Download Medicare Remit Easy Print

Download Medicare Remit Easy Print To download MREP, please select the external link below to navigate to the MREP portion of the CMS Website. Download Medicare Remit Easy Print

Prolonged Services Timetable 2024

Prolonged Services Timetable 2024 CPT Code HCPCS Code for Prolonged Service CPT and CMS Base Time CMS-Extra Minutes Needed CMS Time Requirement for Prolonged Services Date Span 99205 G2212 60 15 [...]

Hospice PIP Rate Review Form