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Posting Date: 06/22/2020
What Part B Providers Need to Know About the Prior Authorization Program for Certain Medicare Services Performed in the Hospital Outpatient Department
What Part B Providers Need to Know About the Prior Authorization Program for Certain Medicare Services Performed in the Hospital Outpatient Department Hospitals submitting claims for certain outpatient department services will be required to [...]
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Posting Date: 02/24/2020
Reminder: 2020 New Codes for Care Management
Reminder: 2020 New Codes for Care Management We are reminding you that the 2020 final rule with regard to the new care management codes is not policy at this time. CMS is considering these changes identified in the final rule. If CMS decides [...]
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Posting Date: 08/25/2020
Proper Billing for Opioid Treatment Program Weekly Bundles for HCPCS Codes G2067-G2075
Proper Billing for Opioid Treatment Program Weekly Bundles for HCPCS Codes G2067-G2075 Medicare introduced the OTP as a covered Part B benefit beginning with dates of service on and after 1/1/2020. Payment is made to Medicare-enrolled OTP [...]
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Posting Date: 10/09/2020
Prior Authorization: Part B Physician Implications
Prior Authorization: Part B Physician Implications For dates of service on and after 7/1/2020, CMS has implemented a prior authorization program for certain hospital OPD services. This has been done to ensure that Medicare beneficiaries [...]
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Posting Date: 08/25/2020
Fee Schedule Adjustments Reminder for 99441-99443
Fee Schedule Adjustments Reminder for 99441-99443 National Government Services has received several inquiries from providers regarding the adjustment of CPT codes 99441-99443. When CMS announced that they were changing the fee schedule [...]
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Posting Date: 03/05/2020
Chiropractors Billing Medicare for Therapy Services
Chiropractors Billing Medicare for Therapy Services Chiropractors in the Medicare fee-for-service realm are only allowed to be considered for spinal manipulation via submission of CPT codes 98940‒98942. Medicare pays for these services when [...]
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Posting Date: 12/11/2020
2021 E/M Prolonged Service Billing Changes for Medicare
2021 E/M Prolonged Service Billing Changes for Medicare National Government Services has received several inquiries regarding changes to office or other outpatient prolonged service coding effective 1/1/2021. When the AMA released the changes [...]
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Posting Date: 11/30/2020
Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement
Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement The CMS-588 Electronic Funds Transfer Authorization Agreement is to be submitted for billing providers upon initial enrollment, change in bank information and [...]
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Posting Date: 03/20/2020
Social Security Income Ratios
Social Security Income Ratios Attention All Part A Inpatient Prospective Payment System Hospitals, Inpatient Rehabilitation Facilities and Long-Term Care Hospitals The federal fiscal year 2018 SSI ratios for IPPS hospitals, IRFs and LTCHs [...]
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Posting Date: 01/08/2020
New EDI Service Offering for the Part A/FQHC/HHH 276/277 Claim Status Inquiry and Response
New EDI Service Offering for the Part A/FQHC/HHH 276/277 Claim Status Inquiry and Response National Government Services is pleased to announce the availability of a ‘near’ real time response to claim status inquiries submitted to EDI with the [...]
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Posting Date: 11/30/2020
Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement
Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement The CMS-588 Electronic Funds Transfer Authorization Agreement is to be submitted for billing providers upon initial enrollment, change in bank information and during [...]
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Posting Date: 08/20/2020
Opioid Treatment Add-on Code G2078 and G2079 MUE Values
Opioid Treatment Add-on Code G2078 and G2079 MUE Values The July 2020 quarterly update for the NCCI added an MUE value of one for OTP HCPCS codes G2067-G2075 and G2078 and G2079. It was later determined by CMS that the incorrect MUE value was [...]
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Posting Date: 09/18/2020
October 2020 Release "Dark Days" for the Common Working File Hosts
October 2020 Release "Dark Days" for the Common Working File Hosts For the upcoming October 2020 Release: For Production, CWF will be observing dark days starting Friday, 10/2/2020 through Sunday, 10/4/2020 to accommodate the anticipated [...]
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Posting Date: 09/15/2020
October 2020 Fiscal Intermediary Standard System Direct Data Entry Screen Changes
October 2020 Fiscal Intermediary Standard System Direct Data Entry Screen Changes The DDE CWF Inquiry Screen (MAP175M) will display the ABPM and will include the technical and professional dates for HCPCS 93784. The MBI Eligibility FROM and [...]
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Posting Date: 06/24/2020
Registered Dietitians and COVID-19 Allowances for Billing
Registered Dietitians and COVID-19 Allowances for Billing National Government Services has received clarification from CMS in regard to registered dietitians/nutritionists billing. When CPT codes 98966‒98968 were originally opened to coverage [...]
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Posting Date: 05/07/2020
Radiopharmaceuticals Invoice or Acquisition Cost Submission Reminder
Radiopharmaceuticals Invoice or Acquisition Cost Submission Reminder National Government Services has identified situations where claims are being submitted for radiopharmaceuticals without an invoice or acquisition cost provided. For [...]
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Posting Date: 03/02/2020
Quality Innovation Networks - Quality Improvement Organizations Quality Initiatives
Quality Innovation Networks - Quality Improvement Organizations Quality Initiatives CMS leads a national health care quality improvement network of Quality Innovation Networks – Quality Improvement Organizations (QIN-QIOs). Locally, an [...]
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Posting Date: 08/28/2020
Providers' Obligation to Report and Refund Medicare Overpayments with Appropriate Forms
Providers' Obligation to Report and Refund Medicare Overpayments with Appropriate Forms Healthcare providers have an obligation to report and refund federal program overpayments and continue to do so, but National Government Services would [...]
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Posting Date: 10/07/2020
Provider Enrollment Reconsideration Request Reminders
Provider Enrollment Reconsideration Request Reminders National Government Services has been receiving reconsiderations of provider enrollment credentialing requests that do not fall into the appropriate criteria for reconsiderations due to the [...]
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Posting Date: 06/09/2020
Proper Billing for Telehealth Services Claims
Proper Billing for Telehealth Services Claims We have received a high volume of paper CMS-1500 claim forms for telehealth services with dates of service during the PHE that we have to reject because they are improperly coded with two different [...]
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