Refunds Due to Beneficiaries by Providers

Refunds Due to Beneficiaries by Providers In some situations providers are responsible for refunding monies to beneficiaries that have paid for services that providers have determined to be noncovered and nonpayable by Medicare. When an ABN [...]

There’s Still Time to Register – National Government Services Preventive Service Week

There’s Still Time to Register – National Government Services Preventive Service Week National Government Services Provider Outreach and Education Team is holding a Special Virtual Conference on Medicare Preventive Services. Join us on [...]

Testosterone Pellet Dosage

Testosterone Pellet Dosage The dosage approved by the US Food and Drug Administration for testosterone pellet replacement therapy in androgen-deficient males is 150 mg to 450 mg subcutaneously every 3-6 months. Effective for dates of [...]

Register for EDI

Medicare Quality Improvement Organization

Medicare Quality Improvement Organization Questions or complaints regarding quality of care and patient rights for a Medicare-covered service, please contact 1-800-MEDICARE (1-800-633-4227) to locate each state’s QIO.       [...]

DME National Supplier Clearinghouse

DME National Supplier Clearinghouse The primary role of the National Supplier Clearinghouse is to process the Medicare enrollment application from a DME supplier in order to be eligible to receive Medicare payment for covered services [...]

Railroad Retirees Part B Questions

Railroad Retirees Part B Questions Palmetto GBA processes all Railroad Retirement Part B (medical) coverage claims and handles all inquiries for Railroad Retirees on a national basis. Railroad Retirees can call 877-772-5772 for their Part [...]

About Medicare

About Medicare Part A Hospital Services Part A (hospital insurance) provides coverage of inpatient hospital, limited skilled nursing facility, home health & hospice care, and health care center services. National Government Services [...]

CMS National Training Program

CMS National Training Program Access to the Centers for Medicare & Medicaid Services National Training Program Resources  

Membership Rosters

Membership Rosters Jurisdiction K Connecticut Maine, Massachusetts, New Hampshire, Rhode Island, Vermont New York Jurisdiction 6 Illinois, Minnesota, Wisconsin

Temporary Holding for Some Part B Claims

An issue has been identified resulting in the need to hold a segment of claims until the appropriate system fix can be installed.

06/21 B MMR: Evaluation and Management Coding: Medical Decision Making Moderate Point Scoring for Data Elements

Evaluation and Management Coding: Medical Decision Making Moderate Point Scoring for Data Elements On 1/1/2021, CMS approved and issued modifications to E/M coding guidelines that were originally developed and adopted by the AMA. This change [...]

Review for codes 0207T and 0563T

Review for codes 0207T and 0563T Services for CPT 0207T (Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral), and CPT 0563T (Evacuation of meibomian glands, automated, using heat delivered through [...]

Medicare Learning Network Articles, Medicare Monthly Review

Sample Results Letter

Sample Results Letter MAIL DATE PROVIDER NAME PROVIDER ADDRESS CITY, STATE, ZIP Provider PTAN/NPI Number: XXXXXXXX RE:Notice of Review - Targeted Probe and Education Results (Round X) Case Number: XXXXXX Dear Medicare Provider, Supplier [...]

Botox Chemodenervation Administration Codes

The above-described administration codes are billed on the Part B claim without the corresponding drug J0585, J0586, J0587 or J0588 and the claim rejects with messages CO16 N56 MA130. The article A52848 indicates the drug should be billed on [...]

End-Stage Renal Disease

NGSMedicare Videos

Nephrology

Eligibility