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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: 11/08/2024
Navigating Medicare Compliance for Federally Qualified Health Centers
Understanding Medicare compliance is crucial for federally qualified health centers (FQHCs) to ensure proper billing and reimbursement under the FQHC Prospective Payment System (FQHC PPS). This comprehensive webinar is designed to provide an [...]
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Posting Date: 02/08/2021
Psychotherapy Coverage Criteria: Treatment Plans
Psychotherapy Coverage Criteria: Treatment PlansIndividualized Treatment Plan: (A plan is not required if only a few brief services will be furnished)The plan must include:Date plan was established (can be no older than one year prior to the [...]
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Posting Date: 02/04/2021
Medicare Opioid Treatment Program Enrollment and Billing 2021 Updates
Medicare Opioid Treatment Program Enrollment and Billing 2021 UpdatesThe CMS has modified coverage for the Medicare OTP beginning 1/1/2021.The modifications include:Coverage of OTP services in outpatient hospital settingA CMS-855A provider [...]
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Posting Date: 02/03/2021
The NGS Immunization Roster Billing Job Aid is Now Available
The NGS Immunization Roster Billing Job Aid is Now AvailableWe’ve developed the Immunization Roster Billing Job Aid to provide you with instructions that will help you submit your claims correctly the first time. If you are enrolled as a mass [...]
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Posting Date: 02/01/2021
April 2021 Release "Dark Days" for the Common Working File Hosts
April 2021 Release "Dark Days" for the Common Working File HostsFor the upcoming April 2021 Release:For Production, CWF will be observing the Gray Day on Thursday, 4/1/2021 and Dark Days starting Friday, 4/2/2021 through Sunday, 4/4/2021 to [...]
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Posting Date: 02/01/2021
Penalty for Requests for Anticipated Payments Received More Than Five Days Early
Penalty for Requests for Anticipated Payments Received More Than Five Days EarlyThere has been an issue identified in which the Home Health Pricer program is incorrectly applying a penalty to RAPs received more than five days earlier than the [...]
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Posting Date: 02/01/2021
Diabetes and Mental Health Awareness Policy Education Topics Are Available
Diabetes Awareness and Mental Health Awareness Policy Education Topics Are AvailableWe’ve enhanced our policy education web page to provide you with detailed information about Diabetes Awareness and Mental Health Awareness services.Did you know [...]
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Posting Date: 01/27/2021
2020 Calendar Year 1099 Form Information
2020 Calendar Year 1099 Form Information National Government Services will mail all 1099 Forms for calendar year 2020 by 1/31/2021.Medicare providers and beneficiaries, who are serviced by NGS regardless of their location, will receive a single [...]
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Posting Date: 01/27/2021
LCD and Article Updates for January and February 2021
LCD and Article Updates for January and February 2021Billing and Coding: Filgrastim, Pegfilgrastim, Tbo-filgrastim and biosimilars (A52408)HCPCS code Q5122 has been added to the "CPT/HCPCS Codes" section.Billing and Coding: Intravenous Immune [...]
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Posting Date: 01/13/2021
Chiropractors and Physical Therapists Billing Medicare for Therapy Services
Chiropractors and Physical Therapists Billing Medicare for Therapy ServicesIf a chiropractor or a physical therapist submits an “always therapy” code, they MUST submit the appropriate physical therapy modifier (GN, GO, GP) with the code.If the [...]
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Posting Date: 01/08/2021
New Documentation Requirements for Filing Medicare Cost Reports
New Documentation Requirements for Filing Medicare Cost ReportsAttention: The FY 2019 Medicare IPPS final rule changed the required supporting documentation that must be submitted with the Medicare cost report. CMS also published MLN Matters [...]
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Posting Date: 01/13/2021
COVID-19 Cost Report Due Date Extensions
COVID-19 Cost Report Due Date Extensions Due to updated instructions received from CMS relative to the COVID-19 public health emergency, and in [...]
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Posting Date: 11/03/2020
Caring for Medicare Patients is a Partnership
Caring for Medicare Patients is a PartnershipCaring and treating your patients is not something that is done within a silo for any practitioner. In order to provide the best possible service and the best medical outcome for any patient requires [...]
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Posting Date: 01/15/2021
IDM Go-Live Guidance for Providers using PS&R and/or MCReF
IDM Go-Live Guidance for Providers using PS&R and/or MCReFThe EIDM system that you use for accessing PS&R and MCReF is being replaced by the new IDM system on the weekend of 1/15/2021. Your account will be automatically converted from [...]
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Posting Date: 10/07/2010
POE Advisory Group
POE Advisory GroupMeeting MinutesMeeting SchedulesMembership RostersMission and Charter
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Posting Date: 10/07/2010
POE Advisory Group
POE Advisory GroupMeeting MinutesMeeting SchedulesMembership RostersMission and Charter
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Posting Date:
Medicare Diabetes Prevention Program (MDPP)
This section gives you access/education about first time Enrollment.
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Posting Date: 02/16/2021
Supplemental Right Side Content Part A
Helpful ResourcesTPE Manual
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Posting Date: 08/11/2015
How to Respond to Additional Development Requests for Herceptin Billing
How to Respond to Additional Development Requests for Herceptin BillingSeveral providers are responding to Herceptin-related ADRs without providing the required information. Herceptin billing must contain the number of milligrams that were used [...]
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Posting Date: 05/21/2018
How to View and Print ADRs from FISS/DDE
How to View and Print ADRs from FISS/DDESteps to View and Print ADRs from FISS/DDE Provider Online SystemAccess the claims through the Claims Inquiry screen/option. Type 01 at the FISS/DDE Online System Main Menu and then type 12 on the [...]
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Posting Date: 07/07/2021
Outpatient Department Prior Authorization for Implanted Spinal Neurostimulators Alert
Outpatient Department Prior Authorization for Implanted Spinal Neurostimulators AlertImplanted Spinal Neurostimulator Prior AuthorizationNational Government Services Medical Review initiated prior authorization reviews for the outpatient [...]
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