-
Posting Date: 10/31/2019
GT Modifier
GT Modifier Effective 10/01/2018, the GT modifier (via interactive audio and video telecommunications systems) is only required on institutional claims for distant site services billed under CAH Method II (claim type 085X). The GT modifier is [...]
Read More -
Posting Date: 10/31/2019
Clarification of Telehealth for DSMT
Clarification of Telehealth for DSMT Individual and group DSMT services may be paid as a Medicare telehealth service. Effective for claims with dates of service on and after 1/1/2019, Medicare allows all ten hours of the initial DSMT training [...]
Read More -
Posting Date: 10/31/2019
ESRD-Related Services as a Telehealth Service
ESRD-Related Services as a Telehealth Service Effective for DOS on/after 1/1/2019, renal dialysis facilities and the homes of ESRD beneficiaries receiving home dialysis may be originating sites and will not apply originating site geographic [...]
Read More -
Posting Date: 04/19/2022
Ambulatory Surgical Center Pass-Through Devices
Ambulatory Surgical Center Pass-Through Devices What is a Pass-Through Device? Pass-through status is determined for newly FDA-approved drug and device products on an individual basis. Drugs and devices qualifying for pass-through status [...]
Read More -
Posting Date: 09/14/2023
MLN Connects® Newsletter: COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older – September 14, 2023
MLN Connects® Newsletter: COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older – September 14, 2023 News COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older Posted 9/14/2023
Read More -
Posting Date: 09/15/2023
New YouTube Video: Surgical Dressings and Supplies: Part A/B and DME Collaborative Presentation
New YouTube Video: Surgical Dressings and Supplies: Part A/B and DME Collaborative Presentation The Part A/B and DME MACs are offering a YouTube video on Surgical Dressings and Supplies. This video offers information on the coverage criteria [...]
Read More -
Posting Date: 12/09/2022
Interested in Becoming a Home Health or Hospice Provider Outreach and Education Advisory Group Member?
Interested in Becoming a Home Health or Hospice Provider Outreach and Education Advisory Group Member? Are you someone who would be interested in helping shape the education provided by your MAC? We want to hear from you! Join us to [...]
Read More -
Posting Date: 09/08/2023
Don’t Let Your Flu Vaccination Claims Deny!
Don’t Let Your Flu Vaccination Claims Deny! The 2023-2024 flu vaccine season has begun. At the beginning of each flu season, National Government Services sees an increase in claim denial volume for flu vaccinations. This notice is being [...]
Read More -
Posting Date: 09/14/2023
Save the Dates! National Government Services Fall 2023 Virtual Conference for Part B Providers
Save the Dates! National Government Services Fall 2023 Virtual Conference for Part B Providers Understanding Medicare Compliance 11/6/2023-11/8/2023 We’re excited to announce our Medicare Part B 2023 Fall Virtual Conference! This three-day [...]
Read More -
Posting Date: 07/25/2023
Attention all OPPS Providers: Provider-Based Department Edits Being Implemented on/after 8/1/2023
Attention All OPPS Providers: Provider-Based Department Table of Contents Edits Being Implemented on/after 8/1/2023 Reason Code 34977: Practice address issue Reason Code 34978: PO and/or PN modifier missing Reason Code 34984: ER [...]
Read More -
Posting Date: 07/07/2023
URGENT: Billing Reminders for OPPS Providers with Multiple Service Locations
URGENT: Billing Reminders for OPPS Providers with Multiple Service Locations Table of Contents Urgent: Provider Compliance Required Effective 8/1/2023 Requirements Claim Filing Requirements Final Reminders Related Content [Return to [...]
Read More -
Posting Date: 12/17/2019
ESRD Facilities: Clarification for Providing Dialysis Services to Patients Acute Kidney Injury
ESRD Facilities: Clarifications for Providing Dialysis Services to Patients Acute Kidney Injury Effective 1/1/2017. ESRD facilities (hospital-based and freestanding) may furnish renal dialysis services to beneficiaries with AKI (both adult and [...]
Read More -
Posting Date: 09/12/2017
JK: Medicare Paid Hospital Providers Twice for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient IPPS Hospital Stays
Medicare Paid Hospital Providers Twice for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient IPPS Hospital Stays Table of Contents Provider Action Payment Window Policy and Under Arrangement Policy [...]
Read More -
Posting Date: 12/22/2020
Professional Services During a Patient Hospice Election
Professional Services during a Patient Hospice Election Table of Contents Article Overview Hospice Election Medicare Payment During Hospice Election Determining the Correct Entity to Bill Separately Payable Part B Services Hospice and [...]
Read More -
Posting Date: 09/18/2023
Direct Data Entry Users May Need to Adjust Screen Size
Direct Data Entry Users May Need to Adjust Screen Size CMS recently issued Change Request 13138 “Implementation to Expand Monetary Amount Fields Related to Billing and Payment to Accommodate 10-Digits in Length ($99,999,999.99) - Phase 1”. [...]
Read More -
Posting Date: 10/14/2021
Drugs and Biologicals - Coverage and Billing
Drugs and Biologicals – Coverage and Billing Medicare Part B will provide coverage for drugs that are furnished “incident to” a physician’s service. Coverage applies to drugs are not usually self-administered by the patients who take them. In [...]
Read More -
Posting Date: 02/10/2015
Outpatient Therapy Functional Reporting
Outpatient Therapy Functional Reporting Table of Contents Outpatient Therapy Functional Reporting Reporting Episode - similar to the therapy episode of care Required Functional Reporting Discharge Reporting Unique Functional Reporting [...]
Read More -
Posting Date: 01/12/2021
Home Health Referrals
Home Health Referrals The certifying physician or allowed nonphysician practitioner, and/or the acute/post-acute care facility referring the patient for home care must ensure that the medical record justifies the referral for Medicare home [...]
Read More -
Posting Date: 06/02/2020
Modifier CS and COVID-19 Billing
Modifier CS and COVID-19 Billing How should the CS modifier, which removes application of beneficiary cost-sharing (deductible and co-payment), be applied to telehealth services and/or E/M visits? The CS modifier should be applied for certain [...]
Read More -
Posting Date: 09/21/2023
MLN Connects® Newsletter: September 21, 2023
MLN Connects® Newsletter: September 21, 2023 News CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Georgia Organ Transplantation Affinity Group: Strengthening [...]
Read More