LCD and Article Updates May/June 2024

LCD and Article Updates May/June 2024 Billing and Coding Articles L37485 Prostate Rectal Spacers This policy is retired and is no longer in effect for services rendered on or after 5/1/2024. A52863 Billing and Coding: Pain Management - [...]

Recovery Audit Contractor Reminders

Recovery Audit Contractor Reminders Did you know that Performant is now the RAC for all of National Government Services Part A and Part B lines of business in Jurisdiction 6 and Jurisdiction K? As part of the audit process, Performant may [...]

MLN Connects® Newsletter: May 30, 2024

MLN Connects® Newsletter: May 30, 2024 News Hospice Interdisciplinary Team: Addition of Marriage and Family Therapists & Mental Health Counselors Revised Part B Inflation Rebate Guidance: Using the 340B Modifier — Reminder MLN [...]

FY 2026 Hospital Wage Index Development Timetable Final

National Government Services: Raising Awareness about Care Management

National Government Services: Raising Awareness about Care Management According to the CDC, six in ten adults in the U.S. have a chronic disease and four in ten adults have two or more. As your Medicare Contractor for Jurisdiction 6 and [...]

You Can Help Your Patients Quit Tobacco Use - The Great American Smokeout Is Coming!

You Can Help Your Patients Quit Tobacco Use - The Great American Smokeout Is Coming! Join us for our webinar series on Medicare’s preventative services, "Counseling to Prevent Tobacco Use" and “Telehealth and Tobacco Counseling.” Statistics [...]

FY 2026 PUF Release

FY 2026 PUF Release Availability and Revisions to Wage Index PUF On Thursday, 5/23/2024, CMS released the preliminary FY 2026 Worksheet S-3, Parts II and III wage index PUF. The FY 2026 IPPS wage index will be calculated based on Federal FY [...]

National Government Services Proposed LCDs for Comment

National Government Services Proposed LCDs for Comment The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 5/30/2024 through 7/14/2024. These [...]

June 2024

In This Issue National Government Services Articles for Part A and Part B Providers Important Reminders for Your EDI Enrollment Save the Dates! CMS National Provider Enrollment Conference in San Diego: 8/28/2024-8/29/2024 A/B DME MAC [...]

Attention Illinois, Massachusetts and Rhode Island Providers: Senior Medicare Patrol Can Assist Medicare Providers!

Attention Illinois, Massachusetts and Rhode Island Providers: Senior Medicare Patrol Can Assist Medicare Providers! National Government Services is proud to announce a special project to assist our providers with your Medicare patients [...]

Attention Illinois, Massachusetts and Rhode Island Providers: Senior Medicare Patrol Can Assist Medicare Providers!

Supplemental Insurance

Section 2: Medicare Basics Supplemental Insurance Table of Contents Supplemental Insurance Medigap Plans Medigap Plans A–N Low-Income Beneficiaries Qualified Medicare Beneficiary Program Specified Low-Income Medicare [...]

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today for June 11th Sessions!

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today for June 11th Sessions! We’re gearing up for our second in the series of Medicare Part B 2024 Spring/Summer Virtual [...]

SNF PPS Web Pricer

MLN Connects® Newsletter: June 6, 2024

MLN Connects® Newsletter: June 6, 2024 News CMS Roundup (May 31, 2024) Quality Payment Program: 2022 Performance Information on Medicare.gov Compare Tool Skilled Nursing Facility Value-Based Purchasing Program: June Confidential Feedback [...]

EDI Enrollment Process User Guide

This guide provides information on the different options available within the National Government Services EDI Enrollment Process User Guide. Please share your thoughts about your experience with our EDI Enrollment process.   Reviewed 6/6/2024

EDI Enrollment

Welcome This page is for providers who wish to submit Part A/B claims to Medicare. Once you have completed the initial provider enrollment and received your Welcome letter with Medicare, you can begin the EDI Enrollment process. Table of [...]

Benefits of EDI and Real Time Claim Status

There are a number of advantages to enrolling and submitting claims online. Claims and other transactions submitted electronically process considerably faster than paper submission. For example, HIPAA-compliant electronic claims are held in the [...]

Reset My FISS / DDE Password

CMS has directed it’s datacenters to enforce password requirements set forth in the United States Defense Information Systems Agency’s (DISA) Security Technical Implementation Guide (STIG) with regard to RACF password quality rules. The HPE VDC [...]

I Am Not Yet Enrolled in Medicare

You can only begin set up with EDI if you are a participating provider in the Medicare program. If you have not submitted an application to enroll in Medicare, please visit our Enrollment section of the site for guidelines. If you have a [...]

Trading Partner ID Recertification

All active trading partners are required to recertify their access annually. CMS requires any changes in demographic, contact information or access for a trading partner ID (TP ID) are communicated to the A/B MAC within 30 days of the change. [...]

National Government Services Contractor Codes

National Government Services Contractor Codes The Contractor Code is a five-digit numeric code that indicates your MAC, also known as the Carrier Code, or Payer ID. Part B Professional: Connecticut 13102 Illinois 06102 Maine 14112 [...]

Supporting Documentation Information

Supporting Documentation Information

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers on Tuesday, June 4th

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers on Tuesday, June 4th! Our first in our series of Medicare Part B 2024 Spring/Summer Virtual Conference Tuesdays is right around [...]

Hospice Billing Instructions for Influenza, Pneumococcal and Hepatitis B Vaccines

Hospice Billing Instructions for Influenza, Pneumococcal and Hepatitis B Vaccines Medicare covers influenza virus, pneumococcal and hepatitis B vaccines in accordance with coverage requirements, when furnished by a hospice to those [...]

Exemption Process for the Prior Authorization Program for Certain Hospital Outpatient Department Services

The Centers for Medicare & Medicaid Services (CMS) implemented a prior authorization program for certain hospital outpatient department (OPD) services for date of service (DOS) on or after 7/1/2020 and subsequently added an exemption process. [...]

Home Health Claims Returned to Providers with Reason Code 31755

CMS reactivated RC 31755 effective 1/3/2023 and some HH claims are being RTP due to billing errors. These claims need to be corrected with the information provided in the Provider Action section of this article. Medicare is still receiving [...]

MLN Connects® Newsletter: June 13, 2024

MLN Connects® Newsletter: June 13, 2024 News Medicare Shared Savings Program: Apply for January 1 Start Date by June 17 Men’s Health: Encourage Your Patients to Prioritize Their Health Compliance Hospital Beds & Accessories: [...]

Paper Enrollment Process

Paper Enrollment Process Enrollment via paper is an option, but PECOS is the preferred method to process the application with streamlining features. Paper-based enrollment applications are available. Determine which CMS Paper Form you will [...]

Complete All Topics

Complete All Topics Instructions for completing all PECOS topics: Select the ‘Topic View’ tab and add information in every topic Note: The electronic funds transfer (EFT) topic must be completed by: groups suppliers sole owner group [...]

Upload Supporting Documents

Upload Supporting Documents Instructions for PECOS to upload required supporting documentation: Select the ‘Topic View’ tab Select “Required and/or Supporting Documents” Upload documents Mandatory for all provider/supplier types: [...]

Resolve All Errors and Verify Warnings

Resolve all Errors and Verify Warnings Instructions for resolving all errors and warnings: Select the ‘Errors/Warning Check’ Tab.   Correct all errors identified and verify any warnings.   Related Content Resolving PECOS [...]

Verify and Manage Signature(s)

Verify and Manage Signature(s) Verify signatures on all application(s) submitted including applications that were “Return for Corrections”, by returning to the enrollment box in PECOS. Important: The reassignments are viewed by selecting [...]

Determine your Business Structure

Determine your Business Structure When starting a business, you must decide what form of business entity you wish to establish. The legal structure you choose for your business has more to do with tax, liability and management arrangements. [...]