P.O. Box Mailing Addresses

P.O. Box Mailing Addresses Business Function Mailing Address Additional Development Requests National Government Services, Inc. Attn: Medical Review P.O. Box 6474 Indianapolis, IN 46206-6474 ASCA [...]

P.O. Box Mailing Addresses

P.O. Box Mailing Addresses Business Function State Mailing Address Administration Simplification Compliance Act Waiver Request Forms All states National Government Services, Inc. Attn: ASCA P.O. Box 7022 [...]

P.O. Box Mailing Addresses

P.O. Box Mailing Addresses Business Function Mailing Address Additional Development Requests National Government Services, Inc. Attn: Medical Review P.O. Box 6474 Indianapolis, IN 46206-6474 ASCA [...]

P.O. Box Mailing Addresses

P.O. Box Mailing Addresses Business Function State Mailing Address Additional Documentation Requests CT, MA, ME, NH, NY, RI, VT National Government Services, Inc. P.O. Box 7108 Indianapolis, IN [...]

P.O. Box Mailing Addresses

P.O. Box Mailing Addresses Business Function State Mailing Address Additional Documentation Requests CT, MA, ME, NH, NY, RI, VT National Government Services, Inc. P.O. Box 7108 Indianapolis, IN [...]

MLN Connects® Newsletter: May 22, 2025

MLN Connects® Newsletter: May 22, 2025 Departments of Labor, Health and Human Services, Treasury Announce Move to Strengthen Healthcare Price Transparency Trump administration issues request for information, guidance to expand access to real [...]

Part A Summit Let’s Chat: Prior Authorization for Certain Hospital Outpatient Department Services

This Let’s Chat session focuses on Prior Authorization for certain hospital outpatient department (OPD) services and is an informal opportunity for you to chat with our staff about the selected topic. During the session, you may ask us [...]

Medically Unlikely Edits

Claim ADRs

Claim Additional Development Requests Types include: Origins Facts Identification NOC and unlisted codes. Modifiers: AS, 22, 52, 53, 62, 66, 80, 81, 82. PWK initiated and records are not [...]

CMS Medically Unlikely Edits

Medically Unlikely Edits and Related Billing Clarifications

Medically Unlikely Edits and Related Billing Clarifications An MUE is the maximum number of UOS allowable under most circumstances for a single HCPCS/CPT code billed by a provider for a particular date of service for a single beneficiary. [...]

Rural Emergency Hospital Basics

Do you know what a Rural Emergency Hospital (REH) is and what services can be provided? Part A facilities, including Critical Access Hospitals and small rural hospitals, are eligible to enroll as a REH. Join this session to learn more about the [...]

Medical Review Targeted Probe and Educate ADRs

Medical Review Targeted Probe and Educate Additional Development Requests Origins Facts Identification CMS’ TPE program is provider specific education that will focus on improving issues without allowing other [...]

Other Audit Contractor ADRs

Other Audit Contractor Additional Development Requests Origins Facts Identification Comprehensive Error Rate Testing (CERT) Office of Inspector General (OIG) Recovery Auditor Contractors (RAC) [...]

General Information

General Information National Government Services or other CMS contractors may need to request additional information for Medicare claims to assess compliance with Medicare rules. These requests are ADRs. An ADR is a notification/letter [...]

Related Resources

Related Resources MLN® Educational Tool: How to Use the Medicare National Correct Coding Initiative (NCCI) Tools Medicare National Correct Coding Initiative (NCCI) Edits Medicare NCCI Medically Unlikely Edits (MUEs) National Correct [...]

The National Correct Coding Initiative Lookup Tool

The National Correct Coding Initiative Lookup Tool The National Correct Coding Initiative Lookup Tool is designed to help providers identify when certain codes are subject to the automated code pair edits. Search for coding pairs by entering a [...]

Ways to Respond to ADRs

Ways to Respond to ADRs When you are ready to submit, refer to the ADR for the specific submission methods available. NGS offers multiple ways for providers to submit their documentation in response to an ADR. CMS audit contractors notate in [...]

Relocation of the Medically Unlikely Edit Webpage Information

Relocation of the Medically Unlikely Edit Webpage Information National Government Services would like to inform you of an important change regarding the placement of the MUE section on our website. The MUE information has been relocated and is [...]

National Correct Coding Initiative and Medically Unlikely Edits

Quarterly Version Update Changes

Quarterly Version Update Changes CMS posts changes to each of its NCCI PTP published edit files on a quarterly basis. This includes additions, deletions and modifier indicator quarterly changes to PTP column one/column two correct coding edits [...]

Procedure to Procedure Edits

Procedure to Procedure Edits The NCCI contains one table of edits for physicians/practitioners and one table of edits for outpatient hospital services. Hospital PTP edits apply to types of bills subject to the outpatient code editor for the [...]

Add-on Codes

Add-on Codes Add-on codes are specific types of HCPCS/CPT codes intended to describe services that can only be reported in conjunction with a primary procedure. They represent additional work performed during the primary procedure and [...]

Smoking Cessation Tools and Resources - You Can Help Your Patients Quit Tobacco Use

Smoking Cessation Tools and Resources - You Can Help Your Patients Quit Tobacco Use Smokefree.gov Centers for Disease Control and Prevention: Tips from Former Smokers campaign Centers for Disease Control and Prevention: Office on Smoking [...]

Medicare Physician Fee Schedule Database

Medicare offers several tools to help providers bill their services. Many questions you have can be answered by learning how to access and use the Medicare Physician Fee Schedule Database. We hope you'll join us for an overview of this database.

Steps to Claim Corrections

This webinar includes the top continuous errors we find at National Government Services with claim submissions. Join us to learn how to correct your claims. We will also include an interactive segment on the different claim scenarios that cause [...]

Proper Part B Claim Submissions

This webinar is intended to educate providers and office staff members on how to complete a clean claim to avoid claim rejections, developments or denials. We will guide you through the CMS-1500 claim form and the electronic equivalent loops [...]

U537I

Avoiding/Correcting This Error All dates of service reported on a period of care claim must be on or after the date of admission. Verify the from and through dates billed and all line-item dates of service to ensure the dates are within the [...]

Being Compliant by Avoiding Claim Denials, Reopenings and Redeterminations

National Government Services is committed to reducing provider burden associated with Medicare claim denials, reopenings and appeals. Don’t wait until you receive the claim denials that will increase your time, effort, and cost to have the [...]

Laboratory Part B Billing

During this webinar, we'll review the Centers for Medicare & Medicaid Services billing requirements for laboratory and pathology services and includes appropriate modifier usage when submitting claims for laboratory/pathology services. [...]

Reducing Unprocessable Claims

When claims are submitted with invalid, incomplete or incorrect information, our claims processing system will detect these errors and will reject claims as unprocessable. Our goal is to assist our providers in submitting claims correctly the [...]

Repetitive Scheduled Non-Emergent Ambulance Transports Prior Authorization

Attention All Independent Ambulance Suppliers! If you are providing repetitive, scheduled, non-emergent ambulance transports (RSNAT), you'll want to attend this webinar. Join us to learn everything you need to know about the RSNAT program.

Medically Unlikely Edits

Medically Unlikely Edits An MUE is the maximum number of UOS allowable under most circumstances for a single HCPCS/CPT code billed by a provider for a particular date of service for a single beneficiary. All claims submitted by physicians [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Freedom of Information Act (FOIA) [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Freedom of Information Act (FOIA) [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Freedom of Information Act (FOIA) [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Freedom of Information Act (FOIA) [...]

Using NGSConnex to Prevent Eligibility Denials and Rejections

During this webinar, we'll examine common eligibility denials and rejections for National Government Services Part B claims and provide strategies from NGSConnex to prevent them in future submissions. There will be time following the [...]

Medical Necessity and the Advance Beneficiary Notice

Register for this webinar and learn how to properly administer the Advance Beneficiary Notice of Noncoverage (ABN) within the office setting. If you are a physician, nonphysician practitioner or office staff member and interested in learning [...]