Prior Authorization Request for Outpatient Services: Panniculectomy

Prior Authorization Requests Submitted by Exempt Providers Alert The National Government Services PA Department has observed an increase in submission of PAR for exempt providers. These submissions are from the HOPD and/or physician offices on [...]

Hospice Cap

Medicare Number

Chapter I: Online System Terminology Medicare Number Purpose The FISS DDE Provider Online System utilizes the terminology MBI to identify the beneficiary’s Medicare number. For the purpose of this manual, “Medicare [...]

Prolonged Services: Comparative Differences of Face-to-Face/Non Face-to-Face CPT Codes

Prolonged Services: Comparative Differences Face-to-Face vs. Non Face-to-Face CPT Codes Face-to-Face ( CPT Codes 99354-99355, 99356-99357) Non Face-to-Face (CPT Codes 99358-99359) Have been [...]

Prolonged Services: Face-to-Face

Prolonged Services: Face-to-Face Coding Guidelines Counseling and Coordination of Care Office versus Hospital Setting Excluded Time Examples NGS JK MAC has noted an increase in claims representing face-to-face prolonged [...]

Tips to Ensure an Optimal NGSMedicare.com Experience

Tips to Ensure an Optimal NGSMedicare.com Experience Most of you are probably aware, but if not, on Friday, 5/14/2021, we launched our new combined homepage. These changes were a result of your feedback. You now only need to go to [...]

NGSMedicare Crosswalk Reference

Skilled Nursing Facility Patient Driven Payment Model Billing For Noncovered Days With An Occurrence Span Code 76

Skilled Nursing Facility Patient Driven Payment Model Billing For Noncovered Days With An Occurrence Span Code 76 The CR 11992 updated the CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 6, Sections 40.3.2 and 40.6 to [...]

FQHC PPS Calculator

Refunds Due to Beneficiaries by Providers

Refunds Due to Beneficiaries by Providers In some situations providers are responsible for refunding monies to beneficiaries that have paid for services that providers have determined to be noncovered and nonpayable by Medicare. When an ABN [...]

There’s Still Time to Register – National Government Services Preventive Service Week

There’s Still Time to Register – National Government Services Preventive Service Week National Government Services Provider Outreach and Education Team is holding a Special Virtual Conference on Medicare Preventive Services. Join us on [...]

Testosterone Pellet Dosage

Testosterone Pellet Dosage The dosage approved by the US Food and Drug Administration for testosterone pellet replacement therapy in androgen-deficient males is 150 mg to 450 mg subcutaneously every 3-6 months. Effective for dates of [...]

Register for EDI

Medicare Quality Improvement Organization

Medicare Quality Improvement Organization Questions or complaints regarding quality of care and patient rights for a Medicare-covered service, please contact 1-800-MEDICARE (1-800-633-4227) to locate each state’s QIO.       [...]

DME National Supplier Clearinghouse

DME National Supplier Clearinghouse The primary role of the National Supplier Clearinghouse is to process the Medicare enrollment application from a DME supplier in order to be eligible to receive Medicare payment for covered services [...]

Railroad Retirees Part B Questions

Railroad Retirees Part B Questions Palmetto GBA processes all Railroad Retirement Part B (medical) coverage claims and handles all inquiries for Railroad Retirees on a national basis. Railroad Retirees can call 877-772-5772 for their Part [...]

About Medicare

About Medicare Part A Hospital Services Part A (hospital insurance) provides coverage of inpatient hospital, limited skilled nursing facility, home health & hospice care, and health care center services. National Government Services [...]

CMS National Training Program

CMS National Training Program Access to the Centers for Medicare & Medicaid Services National Training Program Resources