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Posting Date: 10/20/2022
Claim Billing Guidance
Claim Billing Guidance With the end of the PHE, as of 5/11/2023, this information no longer applies. We will keep the information available for PHE-related services that occurred prior to the expiration date that have not yet been billed. [...]
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Posting Date: 12/16/2024
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG)
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG) L39189 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39189 A58921 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58921 A59900 [...]
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Posting Date: 12/17/2024
Method II CAH Claims Not Paying Professional Services with Revenue Codes 096x-098x
Certain CAH claims (TOB 85X) with professional service revenue codes 096x – 098X did not process for payment because the fee amount was not correctly retrieved during processing. The affected claims have receipt/processed dates in October 2024.
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Posting Date: 12/18/2024
Provider Enrollment Application Fee Amount for CY 2025
Provider Enrollment Application Fee Amount for CY 2025 The provider enrollment application fee for CY 2025 is $730. For more information, view MLN Connects® Newsletter: December 12, 2024. Posted 12/18/2024
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Posting Date: 09/29/2022
Helpful Resources
Helpful Resources The absence of a local coverage determination (LCD) or Medical Policy Article does not indicate noncoverage, it means that currently, National Government Services (NGS) has not identified the service requires an associated [...]
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Posting Date: 03/21/2024
Medicare Part B Drug Coverage
Medicare Part B Drug Coverage Medicare Part B may provide coverage for medically necessary drugs/biologicals that are furnished “incident to” a physician’s service. This coverage does not apply to drugs that are usually [...]
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Posting Date: 03/21/2024
Allergen Immunotherapy: Coding and Billing CPT 95165
Allergen Immunotherapy: Coding and Billing CPT 95165 CPT 95165 is defined as “Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of [...]
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Posting Date: 12/18/2024
[REVISED UPDATE] Hospice Claims Rejected with Reason Code 17729
Claim rejections for TOB 081X and 082X with RC 17729 have occurred due to a file error. These claims did comply with CMS-required entry of the correct certifying physician in the “Attending” field, which did match the PECOS Enrolled [...]
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Posting Date: 12/31/2024
Description of Application Fee
The application fee is imposed on institutional providers and suppliers to cover enrollment costs. The application fee for calendar year 2025 is $730. Related Content Federal Register Notice ‒ information about how the fee was calculated [...]
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Posting Date: 12/31/2024
Who Needs to Pay Application Fees
Institutional providers or suppliers must submit an application fee or hardship exception when initially enrolling, revalidating their enrollment or adding a new Medicare practice location. Physicians, nonphysician practitioners, physician [...]
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Posting Date: 12/31/2024
How to Pay the Application Fee
The application fee must be paid electronically. Important: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee using the Provider Enrollment, [...]
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Posting Date: 12/19/2024
Reminder for Correcting Hospice Edits for Certifying Physicians (17729, 17730)
Reminder for Correcting Hospice Edits for Certifying Physicians (17729, 17730) Reason Codes 17729 and 17730: Refer to specific hospice claim edits related to certifying physicians. Adjustments: Should be submitted for correcting input [...]
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Posting Date: 04/20/2022
Who Needs to Pay Application Fees
Who Needs to Pay Application Fees Institutional providers or suppliers must submit an application fee or hardship exception when initially enrolling, revalidating their enrollment or adding a new Medicare practice location. Physicians, [...]
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Posting Date: 04/20/2022
Who Needs to Pay Application Fees
Who Needs to Pay Application Fees Institutional providers and certain suppliers must pay an application fee or submit a hardship exception when initially enrolling, revalidating their enrollment or adding a new Medicare practice location. [...]
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Posting Date: 04/20/2022
Who Needs to Pay Application Fees
Who Needs to Pay Application Fees Institutional providers and certain suppliers must pay an application fee or submit a hardship exception when initially enrolling, revalidating their enrollment or adding a new Medicare practice location. [...]
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Posting Date: 01/05/2021
Description of Application Fee
Description of Application Fee The application fee is imposed on institutional providers and suppliers to cover enrollment costs. The application fee for calendar year 2025 is $730. Related Content Federal Register Notice ‒ information [...]
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Posting Date: 01/05/2021
Description of Application Fee
Description of Application Fee The application fee is imposed on institutional providers and suppliers to cover enrollment costs. The application fee for calendar year 2025 is $730. Related Content Federal Register Notice ‒ information [...]
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Posting Date: 01/05/2021
Description of Application Fee
Description of Application Fee The application fee is imposed on institutional providers and suppliers to cover enrollment costs. The application fee for calendar year 2025 is $730. Related Content Federal Register Notice ‒ information [...]
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Posting Date: 01/05/2021
How to Pay the Application Fee
How to Pay the Application Fee The application fee must be paid electronically. Important: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee [...]
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Posting Date: 01/05/2021
How to Pay the Application Fee
How to Pay the Application Fee The application fee must be paid electronically. IMPORTANT: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee [...]
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