DME MAC Jurisdiction A

DME MAC Jurisdiction B

DME MAC Jurisdiction C

DME MAC Jurisdiction D

NPPES

Remittance Advice Codes

USA.gov

American Medical Association

Prepare and Submit an MSP Conditional Claim 

Maximum Payment Limits for Rural Health Centers

Coverage of Rural Air Ambulance Services

Federally Qualified Health Center Payment Limits

New York State Ambulance Services in Rural Areas

Health Professional Shortage Area

FISS/DDE Provider Online Guide: Chapter IV - ZIP Code File (19)

Submit Supporting Documentation

Ambulance Rural ZIP Code Search

Fundamentals of Medicare: Skilled Nursing Facility Inpatient Care

Get Help Submitting an Appeal Hard Copy

Get Help Submitting an Appeal Hard Copy All levels of appeals may be submitted by mail. The only types of appeals submitted to National Government Services are reopening and redetermination requests. For information on other types of appeals, [...]

Get Help Submitting an Appeal Hard Copy

Get Help Submitting an Appeal Hard Copy All levels of appeals may be submitted by mail. The only types of appeals submitted to National Government Services are reopening and redetermination requests. For information on other types of appeals, [...]

Request a Redetermination

Request a Redetermination The first level of appeal is the redetermination and is carried out by the MAC. Time limit to initiate = 120 days from date of receipt of the initial determination notice Time limit to complete the [...]

PC-ACE Roster Billing Guide

PC-ACE Roster Billing Guide Roster billing is a feature of PC-ACE that allows the provider to create many nearly identical claims for flu and pneumonia vaccines quickly. PC-ACE is now equipped for COVID-19 vaccine roster billing as well. [...]

Appeals Decision Tree

Appeals Decision Tree

Complete a Voluntary Refund

A voluntary refund is when you have self-identified you have been overpaid and you need to refund the excess funds to Medicare. All checks are made payable to National Government Services. Whenever possible the refund to Medicare should be [...]

Complete a Voluntary Refund

A voluntary refund is when you have self-identified you have been overpaid and you need to refund the excess funds to Medicare. All checks are made payable to National Government Services. All checks are made payable to National Government [...]

5010 Top Page for Part B

EDI Front End Rejection Code Lookup Tool To view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code [...]

Person(s) with Medicare

Person(s) with Medicare  Home Contacts & Resources Coverage & Billing Education Medicare Plans News

Cardiac Positron Emission Tomography Pricing Change

Cardiac Positron Emission Tomography Pricing Change Effective 1/1/2020 there nine CPT codes that describe PET as noted in the lists below. Of the nine listed codes, six (group 1) are new for 2020 and are contractor priced codes for the TC and [...]

Site Map

I Am Not Yet Enrolled in Medicare

You can only begin set up with EDI if you are a participating provider in the Medicare program.  If you have not submitted an application to enroll in Medicare, please visit our Enrollment section of the site for guidelines.If you have a [...]

Hospice Billing

Hospice Documentation

Accessing Eligibility for MDPP in NGSConnex

5010 top page

5010 277CA Reject Code Lookup ToolTo view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code [...]

5010 top page for Durable Medical Equipment

5010 277CA Reject Code Lookup ToolTo view easy-to-understand descriptions associated with the edit code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code information [...]

ASP Drug Form Description

ASP Drug Resources

Note: Codes that have a $0 (zero) fee schedule amount will not display a search result.Locality/Area and County Information for IllinoisLocality/AreaCounties12Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. [...]

Ambulance Form Description

Ambulance Resources

Note: Codes that have a $0 (zero) fee schedule amount will not display a search result.Locality/Area and County Information for IllinoisLocality/AreaCounties12Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. [...]

Ambulatory Form Description

Ambulatory Resources

Note: Codes that have a $0 (zero) fee schedule amount will not display a search result.Locality/Area and County Information for IllinoisLocality/AreaCounties12Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. [...]

Levels of Appeals and Time Limits for Filing

Home Infusion Therapy

Modifiers

National Government Services Part A Medical Review Newsletter June 2021

National Government Services Part A Medical Review Newsletter June 2021The National Government Services MR Department would like to welcome you to our newest service; a regular newsletter. It is our hope that you will find this newsletter [...]

Article Updates for July 2021

Article Updates for July 2021Billing and Coding: Complex Drug Administration Coding (A58620)Under Article Text - Route of Administration Modifier revised the first sentence to read, “The use of the JA and JB modifiers is required for drugs [...]

Financial Contact Information Form

Immediate Recoupment Request Form – Electronic/E-mail

Credit Balance Report Reminders

Credit Balance Report RemindersFor the quarter ending 6/30/2021, CBRs can be submitted starting 7/1/2021 and must be submitted within 30 days to be considered timely.FISS/DDE users who submit the 838 detail page directly over the FISS/DDE [...]

Provider Enrollment: Understand the Process to Opt Out of Medicare

Provider Enrollment: Understand the Process to Opt Out of MedicareProviders that render services to a Medicare beneficiary must enroll with Medicare and submit a claim on behalf of the beneficiary. However, select providers can stay in [...]

July 2021 Release "Dark Days" for the Common Working File Hosts

July 2021 Release "Dark Days" for the Common Working File HostsFor the upcoming July 2021 Release:For Production, CWF will be observing the Gray Day on Thursday, July 1st and Dark Days starting Friday, July 2nd through Sunday, July 4th to [...]

National Government Services Part B Medical Review Newsletter June 2021

National Government Services Part B Medical Review Newsletter June 2021We hope you are enjoying our newest service; a regular newsletter. Our goal is to help you stay up-to-date on the on the MR activities performed here at National Government [...]

National Government Services: Raising Awareness about Care Management

National Government Services: Raising Awareness about Care ManagementAccording to the Center for Disease Control (CDC), an estimated 117 million adults have one or more chronic health conditions, and one in four adults have two or more chronic [...]

Medicare Telehealth versus Telemedicine

Medicare Telehealth versus TelemedicineWe have received many questions that have indicated confusion between telehealth and telemedicine, and which rules apply to which services within these two benefit categories. While there is a perceived [...]

Billing Tip for COVID-19 Vaccine as a Mass Immunizer Roster Biller - Use the Taxonomy Code

Billing Tip for COVID-19 Vaccine as a Mass Immunizer Roster Biller - Use the Taxonomy CodeNational Government Services highly recommends that Part B providers who are credentialed as a Mass Immunizer (specialty 73) and have multiple PTANs [...]

Annual Security Training/Certifying Access

Annual Security Training/Certifying AccessEvery 365 days NGSConnex LSOs and users are required to review the annual Security Awareness Training, including the rules of behavior and acknowledge access still is required. NGSConnex will display [...]

Use NGSConnex to Submit Quarterly Credit Balance Reports

Use NGSConnex to Submit Quarterly Credit Balance ReportsWe recently posted a news article that explained the process and benefits of using NGSConnex to submit quarterly credit balance reports. Today’s article contains the resolutions for common [...]

Reminder: General Anesthesia and Conscious Sedation is Not Medically Necessary for Facet Joint Interventions

Reminder: General Anesthesia and Conscious Sedation is Not Medically Necessary for Facet Joint InterventionsOn 4/25/2021 National Government Services revised the Local Coverage Determination L35936 “Facet Joint Interventions for Pain [...]