Resources

Resources CMS Opioid Treatment Program webpage CMS Roadmap to Address the Opioid Epidemic SAMHSA (Substance Abuse and Mental Health Services Administration) MLN® Fact Sheet: A Prescribers Guide to Medicare Prescription Drug (Part D) [...]

Virtual Multi-Jurisdictional Town Hall Meeting To Be Held 12/10/2024

Virtual Multi-Jurisdictional Town Hall Meeting To Be Held 12/10/2024 National Government Services, along with Novitas Solutions and First Coast Service Options, CGS Administrators, Noridian Healthcare Solutions, Palmetto GBA and WPS Government [...]

Other Medicare Contacts

Other Medicare Contacts   Organization Contact Information ALJ BP Tower & Garage 200 Public Square, Suite 1300 Cleveland, OH 44114-2316 American Medical Association Website  [...]

Other Medicare Contacts

Other Medicare Contacts   Organization Contact Information ALJ BP Tower & Garage 200 Public Square, Suite 1300 Cleveland, OH 44114-2316 American Medical Association Website Phone: [...]

Other Medicare Contacts

Other Medicare Contacts   Organization Contact Information ALJ BP Tower & Garage 200 Public Square, Suite 1300 Cleveland, OH 44114-2316 American Medical Association Website Phone: [...]

Who is My LSO?

Who is My LSO? Select the Manage Account button on the NGSConnex home page. Select User Profile and scroll down to the ‘System Access’ section. Select the Checkbox next to the provider record you want to determine the LSO for. [...]

Medical Review: Targeted Probe and Educate Review Topics

Jurisdiction 6 Part A Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Nail Debridement 11719-11721 55B23– The service provided is not covered Medicare benefit. [...]

LCD/Billing and Coding Article Updates – December 2024–January 2025

LCD/Billing and Coding Article Updates – December 2024–January 2025 Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG) (L39189) – Effective 12/15/2024 Under the Indications of Coverage, added the following language: "The use of [...]

LSO Responsibilities

LSO Responsibilities The LSO is responsible for managing and monitoring access for other NGSConnex users within the organization.  LSOs are responsible for approving access to users requesting data access to a specific provider account [...]

12/12/2024 Part B POE Advisory Group Meeting

12/12/2024 Part B POE Advisory Group Meeting Meeting Minutes Meeting Time: 10:00 a.m.‒12:00 p.m. ET Member Attendees: Elizabeth Aldrich, Dawson Ballard, Doris Barnes, Sheila Bembeneck, Madelon Berger, Louise Bertrand, Kimberly Bischel, [...]

Time Requirements to Notify Medicare of Changes

Report Changes to Your Enrollment Records You must report changes of information in your Medicare enrollment records within 30 days for: Change(s) in ownership or control, including changes in authorized officials(s) All other changes to [...]

IDTF Procedure Codes (65 KB)

Proper Submission of Reopening Requests

Proper Submission of Reopening Requests National Government Services has identified an issue where providers are submitting reopening requests to change or add diagnosis codes on paid claims. These reopening requests do not impact the outcome [...]

Fourth Quarter Top Ten EDI Institutional Edits

Fourth Quarter Top Ten EDI Institutional Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the 2024 fourth quarter. Visit Quarterly Top Ten EDI Institutional Edits to view the edits, their description and learn what you can [...]

Using Nicotine Replacement Therapy for Smoking Cessation

Using Nicotine Replacement Therapy for Smoking Cessation Healthcare providers may choose to offer quit smoking medications to help reduce withdrawal symptoms and cigarette cravings, effectively doubling the chances of quitting successfully. [...]

Inpatient Admission Prior to Medicare Entitlement Job Aid

Inpatient Admission Prior to Medicare Entitlement Job Aid Pre-Entitlement Quick Steps Pre-entitlement is when a beneficiary is admitted as an inpatient to an acute care hospital prior to the beneficiary's Medicare entitlement effective date [...]

Fiscal Intermediary Standard System Direct Data Entry Screen Changes – January 2025

Fiscal Intermediary Standard System Direct Data Entry Screen Changes – January 2025 The January 2025 quarterly system release was implemented on 1/6/2025 with the following changes to the Claims Correction Submenu (03) DDE screen: MAP1704 [...]

Inpatient Psychiatric Facility

Inpatient Rehabilitation Facility

Obtaining Beneficiary Eligibility Information Through NGSConnex

Obtaining Beneficiary Eligibility Information Through NGSConnex  As a reminder, our Customer Service Representatives aren’t permitted to share eligibility information because it’s available through NGSConnex. We encourage new and [...]

Corporate Holiday Schedule

Corporate Holiday Schedule The National Government Services Provider Contact Centers will be closed in 2025 to observe the following corporate holidays: Date Corporate Holiday Observed Wednesday, January 1, 2025 [...]

Quarterly Credit Balance Reports No Longer Required

Quarterly Credit Balance Reports No Longer Required As of 12/1/2024, providers are not required to submit the Medicare Credit Balance Report (CMS-838) on a quarterly basis. However, to ensure that monies owed to Medicare are repaid in a timely [...]

Submitting a Prior Authorization Request

Submitting a Prior Authorization Request Table of Contents Submitting a Prior Authorization Request Documentation Requirements Documentation Checklist for Medical Professionals Supporting the Physician Certification Statement [Return [...]

Meeting Schedules

Meeting Schedules Jurisdiction 6: Illinois, Minnesota, Wisconsin Jurisdiction K: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Meeting Date/Time Provider Type Chairpersons [...]

National Government Services - Telehealth Extension 2025

National Government Services - Telehealth Extension 2025 Section 3207 of the American Relief Act, 2025 modified Section 1834(m) of the Social Security Act to extend the waiver of the geographic, site of service, and practitioner type [...]

J6 Part A

J6 Part A Member Name Facility State Albaitis, Susan DaVita Kidney Care Multiple states (ESRD) Anderson, Brian Advocate Aurora Illinois Anderson, Keith Southern Illinois Healthcare [...]

Hospice Cap Self-Reporting Reminder for the 2024 Cap Year

Hospice Cap Self-Reporting Reminder for the 2024 Cap Year The Hospice Cap Self-Reporting for the 2024 Cap Year (10/1/2023–9/30/2024) is due no later than 2/28/2025. Hospice providers should submit the pro-forma calculation along with [...]

Hospice Cap Self-Reporting

Hospice Cap Self-Reporting Table of Contents Hospice Cap Self-Reporting Cap Year (10/1/XXXX–9/30/XXXX) Completing the Pro-Forma Submitting the Pro-Forma Repaying an Overpayment Requesting an Extended Repayment Plan [...]

Federally Qualified Health Center (All States)

Federally Qualified Health Center (All States) Member Name Facility State Banks, Amy Health Access Network, Inc. Maine Boyd-Gamson, Terry Santa Barbara County Public Health California [...]

Part A Content

Cost Report Contacts: IL, MN, WI, All FQHC: Bobbi Jo Luciano, Manager Office: South Portland, ME Sharon Townsend Office: South Portland, ME J6_Cost_Report_Filing@anthem.com Mailing Address for USPS: National Government Services Attn: Cost [...]

Part A Content

Cost Report Contacts: CT, ME, MA, NH, NY, RI, VT: Bobbi Jo Luciano, Manager Office: South Portland, ME Sharon Townsend Office: South Portland, ME JK_Cost_Report_Filing@anthem.com Mailing Address for USPS: National Government Services Attn: [...]

Clinicians: Are You Ordering Ankle-Foot/Knee-Ankle-Foot Orthoses for Your Patients?

Clinicians: Are You Ordering Ankle-Foot/Knee-Ankle-Foot Orthoses for Your Patients? The DME MACs are providing helpful guidance to assist suppliers in providing a lower limb orthosis to your patient. Medicare must be able to verify that there [...]

PA RSNAT Coversheet

Medicare Part A

Section 2: Medicare Basics Medicare Part A Table of Contents Medicare Part A Benefit Periods—Medicare Part A Ending a Benefit Period Benefit Period Examples [Return to Top] Medicare Part A Medicare Part A is referred to as Hospital [...]

Clinicians: Are You Ordering Knee Orthoses for Your Patients?

Clinicians: Are You Ordering Knee Orthoses for Your Patients? The DME MACs are providing helpful guidance to assist suppliers in providing a knee orthosis to your patient. Medicare must be able to verify that there is medical record [...]

MLN Connects® Newsletter: January 8, 2025

MLN Connects® Newsletter: January 8, 2025 News Medicare Part B Vaccine Administration: CY 2025 Payment Amounts Historically Excepted Tribal Federally Qualified Health Centers: CY 2025 Payment Rate DMEPOS: Adding New Product Category to [...]

Fourth Quarter Top Ten EDI Part B Edits

Fourth Quarter Top Ten EDI Part B Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the 2024 fourth quarter. Visit Quarterly Top Ten EDI Part B Edits to view the edits, their description and learn what you can do to correct [...]

Helping Your Patients Stop Smoking

Helping Your Patients Stop Smoking Quitting tobacco use presents various challenges for patients, and staying motivated can be difficult. All health care providers, especially those with direct patient contact, have a unique opportunity to [...]

31191

Avoiding/Correcting This Error: When submitting the NOA, all date fields must match. Since the NOA is the start of the admission period, the "From" date, "Through" date and "Admission" date should all be the same.

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  

7C625

Avoiding/Correcting This Error Hospice – Clarify reason for discharge. Claim is being returned for one of the following reasons: Remarks are not present or do not indicate valid reason for discharge/transfer. Remarks indicate beneficiary [...]

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. [...]

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 [...]