Fee Schedules

Maximum Payment Limits for Rural Health Centers

Ambulance Fee Schedule

Clinical Laboratory Fee Schedule

DMEPOS Fee Schedule

Hospice Pricer Tool

Opioid Treatment Programs Payment Rates

Physician Fee Schedule

FQHC PPS

Hospital Outpatient PPS

Inpatient PPS PC Pricer

Fee Schedules & Pricers

Claims and Appeals

Overpayment-Part B

Immediate Recoupment Request Form - Electronic/E-mail Complete this online form to initiate a request for immediate recoupment of overpayment(s). All fields are required and the form must be completed in its entirety prior to submitting [...]

Overpayment E-mail-Durable Medical Equipment

Immediate Recoupment Request Form - Electronic/E-mail Automatic Response Please do not reply to this message. This e-mail address is automated, unattended, and cannot help with questions or requests. Thank you for using the National [...]

KeKy Top Page

KE/KY Code Search Tool The KE/KY Modifier Search Tool is currently undergoing maintenance in order to incorporate the changes as clarified in MLN Matters 8864. An Email Update will be sent out once the tool is updated and [...]

DMEPOS Form Description

Profile Update E-mail

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EDI E-mail Inquiry Form Top

EDI E-mail Inquiry Form CMS does not allow National Government Services to accept PHI or PII via e-mail. Please do not include any PHI/PII. The EDI Support Services team does not need this information to assist with 5010, 999, 277CA, and [...]

OverpaymentResults-Part A

Immediate Recoupment Request Form - Electronic/E-mail Automatic Response Thank you for using the National Government Services Immediate Recoupment Request Form - Electronic/E-mail. Your request has been received and will be processed within [...]

Overpayment-Home Health and Hospice

Immediate Recoupment Request Form - Electronic/E-mail Complete this online form to initiate a request for immediate recoupment of overpayment(s). All fields are required and the form must be completed in its entirety prior to submitting [...]

Overpayment Results-Durable Medical Equipment

Immediate Recoupment Request Form - Electronic/E-mail Automatic Response Thank you for using the National Government Services Immediate Recoupment Request Form - Electronic/E-mail. Your request has been received and will be processed within [...]

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Note: While the above information covers general revalidation instructions, additional information or documentation may be requested depending on the applicant’s specific situation. The analyst may develop for additional information via email, [...]

Email Updates

Email Updates--> Welcome to the National Government Services email updates page! Here you can join electronic mail groups/lists and manage your subscriptions. To get started, join the desired electronic mail group(s) and create your profile [...]

DME Mobile Application Registration and Download Form - Top

DME Mobile Application Registration & Download Form “NGS Info to GO” is the new DME mobile application; an innovative approach to deliver education to the supplier community! Our DME mobile application is free and can be downloaded at [...]

E-mail Password Reminder Header

E-mail Password Submit a registered e-mail address below and the password will be e-mailed to you.

Clinical Social Worker Resources

Psychiatric Services Calculator

Dental Codes Billed As Principal Diagnosis Code Cause Claim Rejections

Claims Submitted With Dental Codes As Principal Diagnosis Will RejectOn 1/3/2021, EDI added a new edit to the EDI Front-End. If an 837I claim contains principal diagnosis code 2300 HI with qualifier ABK (principal diagnosis) that is a dental [...]

Adjustment of Claims with Automated Medical Review Denials

Adjustment of Claims with Automated Medical Review Denials National Government Services would like to provide clarification to providers receiving automatic denials on claims. In certain circumstances it may be necessary to correct a billing [...]

Skilled Nursing Facility Medicare Part A Benefit Quick Reference Fact Sheet

Skilled Nursing Facility Medicare Part A Benefit Quick Reference Fact Sheet Beneficiary must have Medicare Part A with days left in their 100 day benefit period. A medically necessary inpatient hospital stay of at least three consecutive days [...]

Appropriate Use Criteria Program

MDS Calendar

Incident to Job Aid for Place of Service Office

“Incident to” Job Aid for Place of Service Office Employed by the same entity - The person supervising and person performing the service must be employed by the same entity. They may be an employee, leased employee, or independent [...]

Overpayments

Medicare Participating Physicians Directory (MEDPARD)

MSP Post-Pay Adjustments

If you have received an overpayment because Medicare paid as the primary insurer and another insurance carrier should be the primary payer, follow the instructions on the Part A Overpayment Recovery Unit Voluntary Refund Form. A separate [...]

MSP Post-Pay Adjustments

If you have received an overpayment because Medicare paid as the primary insurer and another insurance carrier should be the primary payer, follow the instructions on the voluntary refund form. A separate refund form is needed for each date [...]

Medical Policy Contact Information

Fee-for-Service Expedited Determination Notices

EDI E-mail Inquiry Form

PC-ACE

Administrative Simplification Compliance Act

Provider Request for PS&R Form

USA.gov

Claims

Electronic Data Interchange Help Desk E-mail Terms of Service_ALOB

Electronic Data Interchange Help Desk Email Terms of Service Any entity sending information/requests to the National Government Services EDI Help Desk via email agrees to the following guidelines and any underlying guidelines of National [...]

MLN Connects® Special Edition for Wednesday, June 9, 2021

MLN Connects® Special Edition for Wednesday, June 9, 2021 Biden Administration Continues Efforts to Increase Vaccinations by Bolstering Payments for At-Home COVID-19 Vaccinations for Medicare Beneficiaries As part of President Biden’s [...]

MLN Connects® Special Edition for Monday, March 15, 2021

MLN Connects® Special Edition for Monday, March 15, 2021 Biden-Harris Administration Increases Medicare Payment for Life-Saving COVID-19 Vaccine On March 15, CMS increased the Medicare payment amount for administering the COVID-19 vaccine. [...]

Medicare Compliance

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Appeals Decision Tree

Appeals Decision Tree Part B Bottom

Appeals Decision Tree Part B Top

Appeals Decision Tree

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Behavioral Health Integration Services for Primary Care Providers

Behavioral Health Integration Services for Primary Care Providers Medicare BHI service for your patients that do not require the use of a behavioral health care team. Primary care physicians who are treating Medicare patients with [...]

CMS Helpful Links

CMS Helpful Links

CMS Helpful Links