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 [...]

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 [...]

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 [...]

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 [...]

REVALIDATION: Do I need to revalidate if it has not been five years since my last revalidation?

REVALIDATION: How do I know I need to revalidate?

REVALIDATION: Where is the revalidation notification letter sent?

SIGNATURES: Who signs the CMS applications and forms for an entity? (ex. 855A, 855B, 20134, 460, 588)

SIGNATURES: Who signs the CMS applications and forms for an entity? (ex. 855A, 855B, 20134, 460, 588)

Split/Shared and Incident To Services

Split/Shared and Incident To Services Please define the substantive portion of a split (or shared) visit in 2024? Answer: The following factors apply in 2024 in determining the substantive portion of a split (or shared) visit:   [...]

PECOS: In PECOS, please advise how to respond when the MAC needs additional information or supporting documentation for a submitted application.

Complex and Chronic Care - HCPCS Code G2211

Complex and Chronic Care - HCPCS Code G2211 Please define appropriate usage and billing for HCPCS code G2211. Answer: CMS has approved G2211 for 2024 as an add-on code for complex and/or continuous office and outpatient E/M services [...]

Documentation

Documentation What are the basic documentation requirements for a service submitted to Medicare for payment? Answer: For all services submitted to Medicare, the medical record (whether electronic or paper) must clearly define the provider [...]

APPLICATION FEE: What is the amount of the application fee?

DETERMINATION LETTER: How can I get a copy of the determination (approval/denial) letter for a submitted application?

PECOS: I received an email to sign an application; how do I do this?

PECOS: In PECOS, how do I know if the authorized/delegated official or individual provider signed the application?

PECOS: In PECOS, how do I submit an application?

PECOS: In PECOS, how do you find an enrollment to submit an application?

PC-ACE: Is there a resource I can use to assist me with Medicare Secondary Payer (MSP) claims when using PC-ACE?