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4,428 Results for
  • Posting Date: 02/26/2022
    Pulmonary Rehabilitation

    Pulmonary Rehabilitation Select Pulmonary Rehabilitation from the left-side navigation. Medicare Part B (Medical Insurance) covers a comprehensive pulmonary rehabilitation program if a Medicare beneficiary has moderate to very severe COPD. [...]

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  • Posting Date: 02/26/2022
    Acupuncture Benefits

    Acupuncture Benefits Select Acupuncture Benefits from the left-side navigation. Medicare Part B (Medical Insurance) covers up to 12 acupuncture visits in 90 days for chronic low back pain. Medicare covers an additional eight sessions if [...]

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  • Posting Date: 02/26/2022
    Therapy

    Therapy Select Therapy (Occupational, Physical/Speech) from the left-side navigation.  The Therapy Services Information panel will provide information on the current year’s Occupational, Physical and Speech therapy amounts used and if [...]

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  • Posting Date: 02/26/2022
    Diabetes Self Management Training (DSMT)

    Diabetes Self Management Training (DSMT) Select Diabetes Self Management Training (DSMT) from the left-side navigation. Medicare Part B (Medical Insurance) covers outpatient DSMT if a patient has been diagnosed with diabetes. Medicare may [...]

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  • Posting Date: 02/26/2022
    Medical Nutrition Therapy (MNT)

    Medical Nutrition Therapy (MNT) Select Medical Nutrition Therapy (MNT) from the left-side navigation. Medicare Part B (Medical Insurance) may cover MNT services and certain related services if a patient has diabetes or kidney disease, or has [...]

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  • Posting Date: 02/26/2022
    Accessing Eligibility for MDPP in NGSConnex

    Accessing Eligibility for MDPP in NGSConnex Select Medicare Diabetes Prevention Program from the left-side navigation. The Medicare Diabetes Prevention Program expanded model is a structured intervention with the goal of preventing type 2 [...]

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  • Posting Date: 10/21/2024
    Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating

    Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating Did you know that tobacco cessation counseling is a covered Medicare service? Brief tobacco counseling provides substantial health benefits while producing cost savings. [...]

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  • Posting Date: 02/26/2022
    Hospice Notice of Elections

    Hospice Notice of Elections Select Notice of Elections Information from the left-side navigation. The Hospice Notice of Elections information section will display information if the beneficiary has currently elected to receive hospice care or [...]

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  • Posting Date: 02/26/2022
    Hospice Benefit Periods

    Hospice Benefit Periods Select Hospice Benefit Periods from the left-side navigation. The Hospice Benefit Periods information section will display information if the beneficiary has elected to receive hospice care or has elected to receive [...]

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  • Posting Date: 02/26/2022
    Smoking Cessation Counseling

    Smoking Cessation Counseling Select Smoking Cessation Counseling from the left-side navigation.  Medicare Part B (Medical Insurance) covers up to eight visits of smoking and tobacco-use cessation counseling visits in a 12-month [...]

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  • Posting Date: 10/21/2024
    10/21/2024

    table, td, th table { border-collapse: collapse; width: 50%; } Self-Service Pulse: What You Need To Know This Week As your MAC, National Government Services wants to provide you with a comprehensive source containing the most [...]

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  • Posting Date: 11/12/2021
    NGSConnex Online Web Application Can Save Time and Money

    NGSConnex Online Web Application Can Save Time and Money NGSConnex is a free, secure web-based system that allows providers and suppliers to conduct business via online instead of calling into an IVR or contact center. NGSConnex provides [...]

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  • Posting Date: 11/19/2021
    NGS Check Provider Enrollment Application Status Tool

    NGS Check Provider Enrollment Application Status Tool The Check Provider Enrollment Application Status Tool can be used to check on the status of your CMS-855 enrollment application. Reviewed 10/21/2024

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  • Posting Date: 11/15/2021
    National Correct Coding Initiative

    National Correct Coding Initiative In 1996, CMS developed the NCCI to promote national correct coding methodologies and to eliminate improper coding. NCCI edits are developed based on coding conventions defined in the American Medical [...]

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  • Posting Date: 11/15/2021
    National Coverage Determination

    National Coverage Determination NCDs are policies developed by CMS that indicates whether and under what circumstances certain services are covered under the Medicare Program. NCDs are the same for all contractors across the country. [...]

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  • Posting Date: 11/15/2021
    National ICD-10-CM-PCS: The Next Generation of Coding

    National ICD-10-CM-PCS: The Next Generation of Coding The ICD-10-CM-PCS classification system provides significant improvements through greater detailed information and the ability to expand to capture additional advancements in clinical [...]

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  • Posting Date: 11/15/2021
    National Provider Calls and Events

    National Provider Calls and Events MLN Connects® National Provider Calls (MLN Connects® Calls) are educational conference calls held by CMS for the Medicare provider and supplier community to educate and inform participants about new policies [...]

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  • Posting Date: 11/19/2021
    National Provider Identifier

    National Provider Identifier A National Provider Identifier is a unique 10-digit identification number issued to health care providers in the United States by the CMS. The NPI has replaced the UPIN as the required identifier for Medicare [...]

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  • Posting Date: 11/15/2021
    National Provider Identifier Registry

    National Provider Identifier Registry The NPI Registry is free and enables providers to search provider National Plan & Provider Enumeration System information. All information produced by the NPI Registry is provided in accordance with [...]

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  • Posting Date: 11/15/2021
    National Uniform Claim Committee

    National Uniform Claim Committee The NUCC is a voluntary organization that replaced the Uniform Claim Form Task Force in 1995.  The committee was created to develop a standardized data set for use by the noninstitutional health care [...]

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  • Posting Date: 11/15/2021
    Open Door Forums

    Open Door Forums CMS conducts ODFs. The ODF addresses the concerns and issues of providers. Providers may participate via conference call and have the opportunity to express concerns and ask questions. For more information, including signing [...]

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  • Posting Date: 11/15/2021
    P.O. Box Mailing Addresses

    P.O. Box Mailing Addresses For the P.O. Box mailing addresses, please visit the Contact Us page on our website. Reviewed 10/21/2024

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  • Posting Date: 11/15/2021
    Patient Protection and Affordable Care Act of 2010

    Patient Protection and Affordable Care Act of 2010 ​​​For information related to the HIPAA Privacy and Security Rules, visit the Office for Civil Rights website. The Privacy and Security Rules are available for download, and you will find [...]

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  • Posting Date: 11/16/2021
    Physician Quality Payment Program

    Physician Quality Payment Program The MACRA ended the SGR formula for clinician payment under the MPFS and established a quality payment incentive program, the QPP. This program provides clinicians with two ways to participate: through [...]

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  • Posting Date: 11/16/2021
    Provider Contact Center

    Provider Contact Center For information about the Provider Contact Center, please visit the Contact Us page on our website.  Reviewed 10/21/2024

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  • Posting Date: 11/16/2021
    Provider Enrollment

    Provider Enrollment The Provider Enrollment Customer Service Department has direct telephone lines available for provider enrollment inquiries. Toll-Free Provider Enrollment Numbers Please use the following toll-free provider enrollment [...]

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  • Posting Date: 11/16/2021
    Reconsideration (Second Level of Appeal)

    Reconsideration (Second Level of Appeal) A written reconsideration request must be filed with a QIC within 180 days of receipt of the redetermination. When providers receive an unfavorable redetermination, providers shall follow the [...]

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  • Posting Date: 11/16/2021
    Recovery Audit Program

    Recovery Audit Program The Recovery Audit Program’s mission is to identify and correct Medicare improper payments through the efficient detection and collection of overpayments made on claims of health care services provided to Medicare [...]

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  • Posting Date: 11/16/2021
    Redetermination (First Level of Appeal)

    Redetermination (First Level of Appeal) A redetermination is an examination of a claim by National Government Services personnel who are different from the personnel who made the initial claim determination. The appellant (the provider filing [...]

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  • Posting Date: 11/16/2021
    U.S. Government Printing Office

    U.S. Government Printing Office The GPO is responsible for the production and distribution of information products and services including the official publications of Congress, the White House and other federal agencies in digital and print [...]

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  • Posting Date: 11/16/2021
    Washington Publishing Company

    Washington Publishing Company Washington Publishing Company, Inc. is a private company categorized under the commercial Printing and Newspaper Publishing Combined company that is an established health care IT and consulting company. WPC [...]

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  • Posting Date: 01/14/2022
    Meeting Schedules

    Meeting Schedule Jurisdiction 6 ‒ Home Health and Hospice (Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Jersey, New York, Northern Mariana Island, Oregon, Puerto Rico, U.S. Virgin [...]

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  • Posting Date: 10/22/2024
    Utilizing Third Party Billing Companies

    During this webinar, we’ll provide education related to using third party billers for your Medicare claims. We’ll identify vulnerabilities, share how to identify inappropriate third-party activities and reduce costs.

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  • Posting Date: 07/20/2023
    Contractor Advisory Committee Meeting

    Contractor Advisory Committee Meeting As part of the 21st Century Cures Act, contractors are mandated to base an LCD on robust evidence. Part of the process is to convene SMEs as necessary to review the literature and provide input that [...]

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  • Posting Date: 09/07/2021
    CMS-1500 Claim Form Completion Instructions

    CMS-1500 Claim Form Completion Instructions Table of Contents General Information Claim Filing Instructions for Paper and Electronic Submission Regulations on Charging for Claim Form Completion Optical Character Recognition System [...]

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  • Posting Date: 01/27/2022
    General E/M Information

    General E/M Information Please explain the terms “auxiliary personnel” and “clinical staff” in the context of Medicare services.   Answer: These terms are often used in defining which staff members can perform Medicare services [...]

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  • Posting Date: 10/22/2024
    32243

    Avoiding/Correcting This Error Review the claim and either update the charges or remove the line containing zero or blank charges. Return the claim for processing. 

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  • Posting Date: 10/22/2024
    W7088

    Avoiding/Correcting This Error Each FQHC PPS claim must be billed with a qualifying visit code, and associated line-item charges, along with all other FQHC services furnished during the encounter. A qualifying visit code is the code that [...]

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  • Posting Date: 10/22/2024
    37098

    Avoiding/Correcting This Error Verify billing and, if appropriate, correct and return the claim. Related Content Billing for FQHC MAO Plan Supplemental Payment (PPS Providers) CMS Internet-Only Manual 100-04, Medicare Claims Processing [...]

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  • Posting Date: 10/22/2024
    31836

    Avoiding/Correcting This Error Verify billing and, if appropriate, correct and resubmit the claim for payment. Related Content MLN® Booklet: How to Use the PFS Look-up Tool

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  • Posting Date: 10/22/2024
    31605

    Avoiding/Correcting This Error The occurrence span code 77 should only be used to indicate the span of days that were not covered on claims. Related Content Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77  

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  • Posting Date: 10/22/2024
    37402

    Avoiding/Correcting This Error Hospice – This error occurs when a claim is submitted and the previous month's claim has not been found in the system or there is a gap between Through date of the previous claim and From date on this claim. [...]

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  • Posting Date: 10/22/2024
    37402

    Avoiding/Correcting This Error Hospice – This error occurs when a claim is submitted and the previous month's claim has not been found in the system or there is a gap between Through date of the previous claim and From date on this claim. [...]

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  • Posting Date: 10/22/2024
    W7113

    Avoiding/Correcting This Error Prevent future similar errors by checking the I/OCE and ICD-10 official guidelines prior to claim submission. Verify the diagnosis codes reported; correct and resubmit. Related Content The I/OCE Quarterly [...]

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  • Posting Date: 10/22/2024
    U523A

    Avoiding/Correcting This Error Hospice – This reason code is a notification to the provider of a VBID patient. For more information, including calendar-year specific downloadable lists of service area plan benefit packages (PBPs) and contact [...]

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  • Posting Date: 10/22/2024
    U5181

    Avoiding/Correcting This Error Ensure the usage of an appropriate certification or recertification date in accordance with occurrence code 27. Related Content Avoiding Reason Code U5181: Appropriate Use of Occurrence Code 27/Occurrence [...]

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  • Posting Date: 10/22/2024
    U5111

    Avoiding/Correcting This Error The 8xB (NOTR) transaction should only be submitted when the beneficiary revokes the hospice benefit or is discharged alive and there is no final claim in the system indicating termination of the hospice benefit. [...]

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  • Posting Date: 10/22/2024
    U5111

    Avoiding/Correcting This Error Hospice – When submitting a hospice Notice of Termination/Revocation (TOB 8XB) or a Cancel Notice of Election (TOB 8XD) ensure that the From date on the transaction matches the Start date posted on CWF for that [...]

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  • Posting Date: 10/22/2024
    U5109

    Avoiding/Correcting This Error When submitting a transaction to indicate the beneficiary’s election to revoke the hospice benefit, transfer the patient, cancel the election, or a change of ownership, the information on the transactional bill [...]

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  • Posting Date: 10/22/2024
    U5065

    Avoiding/Correcting This Error Check/verify the beneficiary's entitlement dates in the CWF. A Medicare beneficiary, or their authorized representative, may have requested a new MBI. Verify eligibility and MBI number, correct and return the claim.

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  • Posting Date: 10/22/2024
    U5065

    Avoiding/Correcting This Error Check/verify the beneficiary's entitlement dates in the CWF. A Medicare beneficiary, or their authorized representative, may have requested a new MBI. Verify eligibility and MBI number, correct and return the claim.

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  • Posting Date: 10/22/2024
    N5052

    Avoiding/Correcting This Error The beneficiary’s name listed on the claim has to be an exact match to what is posted on CWF. Be sure that any special characters (including apostrophes, dashes, commas) and suffixes (Jr., Sr., III) that are [...]

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  • Posting Date: 10/22/2024
    U537F

    Avoiding/Correcting This Error Always verify billing before submitting a new NOA for a beneficiary admission. There should not already be an NOA in the system pending processing or finalized prior to submitting a new NOA for a beneficiary. [...]

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  • Posting Date: 10/22/2024
    U5233

    Avoiding/Correcting This Error Collect all insurance information from the beneficiary when admitted to your HHA. Talk to the beneficiary about insurance changes and check CWF before billing Medicare. Many times a claim will overlap an MAO [...]

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  • Posting Date: 10/22/2024
    U5106

    Avoiding/Correcting This Error When the hospice NOE was received it fell within a previously established election period. Verify that the NOE is billed with correct dates. If benefit period from the previous hospice is still open, allow [...]

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  • Posting Date: 10/22/2024
    U5166

    Avoiding/Correcting This Error If a transfer occurred, verify that all claims and notices are submitted in order. The transferring-from hospice agency needs to submit their final claim prior to the transferring-to hospice agency submitting [...]

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  • Posting Date: 10/22/2024
    U5065

    Avoiding/Correcting This Error HHH may only bill services provided to the patient after the effective date of their Medicare coverage. Verify the effective date(s) for the MBI of the beneficiary prior to billing. If a new MBI has been issued [...]

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  • Posting Date: 10/22/2024
    U537F

    Avoiding/Correcting This Error Always verify billing before submitting a new NOA for a beneficiary admission. There should not already be an NOA in the system pending processing or finalized prior to submitting a new NOA for a beneficiary. [...]

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  • Posting Date: 10/22/2024
    U5194

    Avoiding/Correcting This Error In instances where a NOE is not timely-filed, the days of hospice care from the hospice admission date to the date the NOE is submitted to and subsequently processed by the Medicare contractor will not be [...]

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  • Posting Date: 10/22/2024
    U5106

    Avoiding/Correcting This Error When the hospice NOE was received it fell within a previously established election period. Verify that the NOE is billed with correct dates. If benefit period from the previous hospice is still open, allow [...]

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