Site Visit Failure

Site Visit Failure CMS reserves the right, when deemed necessary, to perform onsite review of a provider or supplier to verify that the enrollment information submitted to CMS or its agents is accurate and to determine compliance with Medicare [...]

Failure to Report Address Changes

Failure to Report Address Changes Providers who fail to report an address change will result in suspension of Medicare payment.   All Medicare providers are responsible for providing their Medicare contractor with their current and [...]

Failure to Report a Change in Bank Account Information

Failure to Report a Change in Bank Account Information Providers who fail to report a change in bank account information will result in suspension of Medicare payment and termination of Medicare billing privileges. All changes initiated by [...]

Revocation

Revocation CMS may revoke a currently enrolled provider or supplier's Medicare billing privileges and any corresponding provider or supplier agreement for the following reasons: Abuse of billing privileges Failure to document or provide [...]

Failure to Report a Critical Change

Failure to Report a Critical Change Providers and suppliers enrolled in Medicare are required to ensure strict compliance with Medicare regulations by submitting updates and changes to enrollment information in accordance with specified [...]

Failure to Complete Revalidation

Failure to Complete Revalidation Avoid claims being rejected or termination of Medicare billing privileges by responding: by the revalidation due date timely to additional information requested Related Content Medicare Revalidation [...]

Global Period Services - HCPCS Code G0559

Global Period Services - HCPCS Code G0559 As of 1/1/2025, CMS has implemented HCPCS Code G0559 to capture work performed by a provider other than the performing surgeon during the global period associated with most surgical procedures. The [...]

Jurisdiction K State Licensing and Certification Websites

State Licensing and Certification Websites The following list contains helpful links to websites of some organizations within JK that can be used to verify your status. Table of Contents Connecticut Maine Massachusetts New [...]

Deactivation of Billing Privileges/Suspension of Payment

Reasons for Deactivation of Medicare Billing Privileges/Suspension of Payment (not all inclusive) Inactivity Failure to complete revalidation within required time frame Unreported provider address and/or bank information Inactivity [...]

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