Billing for A0426 or A0428

Billing for A0426 or A0428 National Government Services has been receiving electronic claims with the 2300 REF segment (G1 qualifier) for prior authorization, however, the value entered in REF02 is a ZIP code. This segment is intended for the [...]

Medical Necessity of Ambulance Services

Medical Necessity of Ambulance Services Table of Contents Medical Necessity of Ambulance Services What You Can Do Nearest Appropriate Facility: GY Modifier What You Can Do Related Content [Return to Top] Medical [...]

Prior Authorization of Repetitive Scheduled Non-Emergent Ambulance Transport

Ambulance Medical Necessity

Ambulance Medical Necessity According to the Centers for Medicare & Medicaid Services’ (CMS) Internet Only Manual (IOM) 100-02, Medicare Benefit Policy Manual, Chapter 10, Ambulance Services; (400 KB) 10.2 - Necessity and Reasonableness [...]

Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity

Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity Recent National Government Services educational efforts have highlighted an issue between facilities and the ambulance [...]

Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports

Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports The CMS implemented the prior authorization of RSNAT. NGS J6 states Illinois, Minnesota, and Wisconsin were added to the RSNAT Model effective with dates [...]

Membership Rosters

Membership Rosters Member Lists JK Part A J6 Part A Federally Qualified Health Center (All States) Revised 11/4/2024