Award of Medicare Administrative Contractor Contract for Jurisdiction K

Award of Medicare Administrative Contractor Contract for Jurisdiction K CMS selected National Government Services to retain the JK MAC contract. As a result, there will be no changes to your service or the support we provide you. NGS looks [...]

April 2022 LCD and Billing and Coding Article Updates

April 2022 LCD and Billing and Coding Article Updates LCDs Effective 4/1/2022 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) (L33559/A56737) The LCD was returned for comment from 6/3/2021 through [...]

MLN Connects® Special Edition for Wednesday, March 30, 2022

MLN Connects® Special Edition for Wednesday, March 30, 2022 Fiscal Year 2023 Hospice Payment Rate Update Proposed Rule - Comment by May 31 On March 30, CMS issued a proposed rule (CMS-1773-P) that would provide routine updates to [...]

New Evaluation and Management Frequently Asked Questions for Prolonged Services

New Evaluation and Management Frequently Asked Questions for Prolonged Services We’ve added new frequently asked questions to the Prolonged Services section of our E/M FAQs to clarify proper billing for CPT codes 99354-99356, 99358-99359, and [...]

MLN Connects® Special Edition for Monday, April 4, 2022

MLN Connects® Special Edition for Monday, April 4, 2022 Biden-Harris Administration Announces a New Way for Medicare Beneficiaries to Get Free Over-the-Counter COVID-19 Tests On April 4, The Biden-Harris Administration announced that more [...]

MLN Connects® Special Edition for Wednesday, April 6, 2022

MLN Connects® Special Edition for Monday, April 6, 2022 Eligible Individuals Can Receive Second COVID-19 Booster Shot at No Cost On April 6, CMS announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna [...]

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport The Repetitive, Scheduled Nonemergent Ambulance Transport Prior Authorization Model establishes a process through which a request for provisional affirmation [...]

Availability and Contact Information

Availability and Contact Information Hours of Availability To optimize your NGSConnex experience, you are encouraged to complete your NGSConnex transactions between the following hours: Monday–Friday: 6:00 a.m.–7:00 p.m. ET Saturday: 7:00 [...]

Related Content

Related Content JK Ambulance Suppliers RSNAT Sample Introductory Letter Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) CMS IOM, Publication 100-02, Medicare Benefit Policy Manual, Chapter 10 CMS IOM, [...]

Submitting a Prior Authorization Request

Submitting a Prior Authorization Request Ambulance suppliers or beneficiaries should legibly complete the National Government Services Prior Authorization Request for Repetitive, Scheduled Non-Emergent Ambulance Transports. The Cover [...]

Related Content

Related Content J6 Ambulance Suppliers RSNAT Sample Introductory Letter Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) CMS IOM, Publication 100-02, Medicare Benefit Policy Manual, Chapter 10 CMS [...]

Prior Authorization Request for Repetitive, Scheduled Nonemergent Ambulance Transports Medicare Part B Fax/Mail Coversheet

Five Steps to Webinar Success

Increased Volume of Appeal Status Inquiries

Increased Volume of Appeal Status Inquiries National Government Services has seen an increase in pending reopenings and redetermination levels, resulting in cases being completed beyond the 60 calendar-day timeframe. We are sharing some [...]

PC-ACE Medicare Secondary Payer Reference Guide for Part B

PC-ACE Medicare Secondary Payer Reference Guide for Part B Payers (Insurance) Setup Payer Information Screen Patient Selection and Setup Setting up the Patient’s Insurance Information MSP Claim Entry (Line Level) MSP Claim Entry (Claim [...]

MLN Connects® Special Edition for Monday, April 18, 2022

MLN Connects® Special Edition for Monday, April 18, 2022 CMS Proposes Policies to Advance Health Equity & Maternal Health, Support Hospitals On April 18, CMS issued a proposed rule for inpatient and long-term hospitals that builds on the [...]

Part B Issue for Coinsurance Payments on Drug Code Claims

Due to an issue with a recent system update, 20% coinsurance for drug codes has been incorrectly calculated during the period of 10/27/2021-11/1/2021.

Anesthesia Conversion Factor Pricing Incorrect for 2022

The incorrect conversion file was loaded to production for dates of service starting 1/1/2022 which caused incorrect payments.

April and May 2022 Billing and Coding Article Updates

April/May 2022 Billing and Coding Article Updates Billing and Coding Articles Billing and Coding: Complex Drug Administration Coding (A58620) J0248 remdesivir (Veklury®) was added under Infusions Non-Chemotherapy Generic/Trade Names table [...]

Home Health PPS PC Pricer

MLN Connects® Special Edition for Thursday, July 29, 2021

MLN Connects® Special Edition for Thursday, July 29, 2021 4 Final FY 2022 Payment Rules Hospice Payment Rate Update: FY 2022 Final Rule IRF Prospective Payment System: FY 2022 Final Rule IPF Prospective Payment System: FY 2022 Final Rule [...]

Tips for Success

Tips for Success Speak naturally and clearly in a quiet environment. Use mute when you are not speaking. Avoid the use of cellular phones or speaker phones. Have all of the information available and organized before you call. Use [...]

Tips for Success

Tips for Success Speak naturally and clearly in a quiet environment. Use mute when you are not speaking. Avoid the use of cellular phones or speaker phones. Have all of the information available and organized before you call. Use [...]

Determine/Pay Application Fee

Determine/Pay Application Fee

Determine/Pay Application Fee

Cervical Fusion with Disc Removal

Cervical Fusion with Disc Removal National Government Services will begin accepting PARs for Cervical Fusion with Disc Removal on 6/17/2021 for services provided beginning on or after 7/1/2021. Checklist of PAR information to include: [...]

Low and No Medicare Utilization Cost Report

Low and No Medicare Utilization Cost Report No Utilization Cost Reports To comply with program cost reporting requirements, a provider that has not furnished any covered Medicare services during a cost reporting period must only complete the [...]

MLN Connects® Special Edition for Thursday, March 31, 2022

MLN Connects® Special Edition for Thursday, March 31, 2022 IPF & IRF Proposed FY 2023 Payment Rules Inpatient Psychiatric Facilities: Fiscal Year 2023 Proposed Rule — Submit Comments by May 31 Inpatient Rehabilitation Facilities: [...]

New Evaluation and Management Frequently Asked Question for Emergency Department

New Evaluation and Management Frequently Asked Question for Emergency Department We’ve added a new frequently asked question to the Emergency Department section of our E/M FAQs to further define how time can be used as a factor in billing [...]

New Evaluation and Management Frequently Asked Question for Time-Based Services

New Evaluation and Management Frequently Asked Question for Time-Based Services We’ve added a new FAQ for E/M time-based services. Please define rules for using time to level-set a service in the inpatient setting. ​​​​​​​Answer: In [...]

Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice"

Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice" The 2022 HH+H MAC Collaborative Summit: One Program, One Voice is now available for early bird registration. This huge [...]

MLN Connects® Newsletter for Thursday, May 12, 2022

MLN Connects® Newsletter for Thursday, May 12, 2022 Biosimilars Curriculum: Resources for Teaching Your Students News Comprehensive Error Rate Testing Documentation Center Moved on April 13 Physicians, Teaching Hospitals, Physician [...]

We’ve Rebranded!

We’ve Rebranded! National Government Services is excited to share we’ve refreshed our brand! Our new brand line Where Next Begins reflects Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More.   Over the [...]

Implanted Spinal Neurostimulators

General Documentation Requirements for Trial or Permanent Implanted Spinal Neurostimulators National Government Services will begin accepting PARs for Implanted Spinal Neurostimulators on 6/17/2021 for services provided beginning on or after [...]

Outpatient Claims with Reason Code W7120 Returned in Error

Outpatient Claims with Reason Code W7120 Returned in Error A system error caused the CMS to return the following outpatient claims with reason code W7120: Bill types 13X and 85X Designated surgical ranges 10000-69999 or 0000T-9999T [...]

MLN Connects® Special Edition for Monday, August 2, 2021

MLN Connects® Special Edition for Monday, August 2, 2021 CMS Final Rule Improves Health Equity, Access to Treatment, Hospital Readiness, and COVID-19 Vaccination Data Reporting of Hospital Workers Hospital Inpatient Prospective Payment System [...]

Revised Evaluation and Management Frequently Asked Question for Teaching Environment Services

Revised Evaluation and Management Frequently Asked Question for Teaching Environment Services We’ve revised an FAQ within the Teaching Environment section of our E/M FAQs to further define documentation requirements. Review the information at [...]

How to Get Started

How to Get Started Making the change is easy. If you use a clearinghouse to submit claims, contact your clearinghouse to ask how to enroll for the electronic remittance service. If you currently have a claim submission software program, [...]

Provider Contact Center

MLN Connects® Newsletter for Thursday, May 19, 2022

MLN Connects® Newsletter for Thursday, May 19, 2022 Biosimilars: Safe, Effective, & May Reduce Patient Costs News Biosimilars: Safe, Effective, & May Reduce Patient Costs PECOS Scroll Functionality Clinical Laboratory [...]

PA RSNAT Coversheet

Medicare Provider Enrollment Application Fee Decision Tree Tool

Remote Physiological Monitoring and Cardiovascular Monitoring Service and Billing Information

Billing and Coding and SAD Article Updates for May/June 2022

Billing and Coding and SAD Article Updates for May/June 2022 Billing and Coding: Denosumab (Prolia ™, Xgeva ™) (A52399) The article has been corrected to remove the following statement: (calcium 1000 mg daily and at least 400 IU vitamin D [...]

Modifier Usage

July 2022 Release "Dark Days" for the Common Working File Hosts

July 2022 Release "Dark Days" for the Common Working File Hosts For the upcoming July 2022 Release: For Production, CWF will be observing the Gray Day on Thursday, 6/30/2022 and Dark Days starting Friday, 7/1/2022 through Monday, 7/4/2022 [...]

Remote Monitoring Services

Remote Monitoring Services

Remote Monitoring Services In response to provider inquiries about the use of remote monitoring, National Government Services has developed a comprehensive summary of information for Remote Monitoring Services. NGS separately defined code [...]

Comprehensive Error Rate Testing Program Report: Sample Reduced for Reporting Year 2023

Comprehensive Error Rate Testing Program Report: Sample Reduced for Reporting Year 2023 CMS reduced the number of claims in the Comprehensive Error Rate Testing program report for reporting year 2023. We’ll send you a letter if your claims are [...]

New Version of PC-ACE: July 2021

New Version of PC-ACE: July 2021 PC-ACE Version 5.1 contains several CMS mandates and product enhancements including but not limited to the items listed below. 12206 – FFS Coverage of Costs for Kidney Acquisitions in MW Hospitals for [...]

Medicare University Scheduled Maintenance

Medicare University Scheduled Maintenance Due to scheduled maintenance, Medicare University will be unavailable beginning Tuesday, 6/15/2021 from 8:00 p.m–11:00 p.m. ET. As a result, the Medicare University will not be accessible. We [...]

Billing and Coding for Tempus Next Generation Sequencing Panel

Billing and Coding for Tempus Next Generation Sequencing Panel The Tempus Next Generation Sequencing Panel must be submitted with CPT code 81479. CPT 81479 (unlisted molecular pathology procedure) will be individually reviewed. Posted [...]

COVID-19 Accelerated and Advanced Payment YouTube Video

COVID-19 Accelerated and Advanced Payment YouTube Video National Government Services developed the Part B COVID-19 Accelerated and Advanced Payment, Repayment and Recoupment Process YouTube Video to address common questions we are receiving. [...]

Proper Billing Units for HCPCS Code J7320

Proper Billing Units for HCPCS Code J7320 National Government Services has noticed improper billing units used for HCPCS code J7320, Hyaluronan or derivative, GenVisc 850, for intra-articular injection, 1 mg. GenVisc 850 is indicated for the [...]

Oxygen Coverage and Documentation Requirements

Oxygen Coverage and Documentation Requirements Please review this YouTube video that was developed from the A/B and DME MAC’s collaborative webinar titled ‘Oxygen Coverage and Documentation Requirements’. This video is a collaborative [...]

New NGSMedicare.com is Coming Soon

New NGSMedicare.com is Coming Soon We continue to listen and gain invaluable insight from you on our provider content website, NGSMedicare.com. Coming mid-Summer 2021, you will be able to see your feedback put into action. Posted 6/8/2021

NGSConnex Now Offers One Stop Electronic Appeals Solution

NGSConnex Now Offers One Stop Electronic Appeals Solution Medicare Part A providers and HH+H providers who are located in Jurisdiction 6 and submit fee-for-service claims to National Government Services now have the ability to submit [...]

MLN Connects® for Thursday, January 28, 2021

MLN Connects® for Thursday, January 28, 2021 Medicare Wellness Visits: Get Your Patients Off to a Heathy Start View this edition as a: Webpage | PDF News Care Compare: 2019 Preview Period Open through March 25 Open Payments Data [...]