Two Weeks to Prepare to use NGSConnex for Beneficiary Eligibility Information

Two Weeks to Prepare to use NGSConnex for Beneficiary Eligibility Information As we’ve communicated, beginning 11/18/2024, Beneficiary Eligibility information will not be offered on the IVR. This includes all beneficiary eligibility [...]

Additional Events Links

Resources Education Partnership Request Form Five Steps to Webinar Success Provider Outreach and Education Reminders

Additional Events Links

Resources Education Partnership Request Form Five Steps to Webinar Success Provider Outreach and Education Reminders

Additional Events Links

Resources Education Partnership Request Form Five Steps to Webinar Success Provider Outreach and Education Reminders

Additional Events Links

Resources Education Partnership Request Form Five Steps to Webinar Success Provider Outreach and Education Reminders

Instructions for Unfinished PECOS Enrollment Application(s)

Table of Contents Instructions for Unfinished PECOS Enrollment Application(s) Instructions for Unfinished PECOS Application(s) Instructions for Application Status “Pending E-Signature” Submitted Enrollment Application(s) on Behalf of an [...]

Skilled Nursing Facility Billing Basics

This session will focus on the basics of skilled nursing facility (SNF) inpatient and outpatient billing, including consolidated billing guidelines. Learn about the required fields on SNF claims, timeframes for claim submission and how proper [...]

Report a Change of Information

Report change of enrollment information timely. Changes can be either submitted electronically via PECOS or by mail with the paper CMS-855A and/or CMS-588 EFT agreement. A change in the Tax ID with no ownership change will need to submit [...]

Report a Change of Information

Report change of enrollment information timely. Changes can be either submitted electronically via PECOS or by mail with the paper CMS-855A and/or CMS-588 EFT agreement. A change in the Tax ID with no ownership change will need to submit [...]

Report a Change of Information

Table of Contents Report a Change of Information PECOS Submission Related Content Paper Submission Related Content [Return to Top] Report a Change of Information Report change of enrollment information [...]

Coming Soon ‒ The CY 2025 Medicare Physician Fee Schedule

Coming Soon ‒ The CY 2025 Medicare Physician Fee Schedule The CY 2025 MPFS will soon be available on the Fee Schedule Lookup tool located on NGSMedicare.com, after the CY 2025 physician fee schedule regulation is put on display. Once the Fee [...]

Ambulance Transports Included in SNF Consolidated Billing

Ambulance Transports Included in SNF Consolidated Billing Transport Description Medical Necessity Met Ambulance Billing Modifiers and Other Considerations Who is Responsible for Payment? Reference(s) SNF to [...]

Ambulance Transports Excluded from SNF Consolidated Billing

Ambulance Transports Excluded from SNF Consolidated Billing When a Medicare beneficiary is a resident in a SNF under a Part A stay, not all ambulance transports are included in the PPS (prospective payment system) payment for a SNF. SNF [...]

Ambulance Medical Necessity Reminder for ESRD Patients

Ambulance Medical Necessity Reminder for ESRD Patients National Government Services receives a significant amount of dialysis facility ambulance transports that do not meet medical necessity criteria. Documentation must explicitly describe the [...]

Related Content

Related Content Ambulance Services Center MLN® Booklet: Medicare Ambulance Transports Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-02, Medicare Benefit Policy Manual, Chapter 10, [...]

Billing for A0426 or A0428

Billing for A0426 or A0428 National Government Services has been receiving electronic claims with the 2300 REF segment (G1 qualifier) for prior authorization, however, the value entered in REF02 is a ZIP code. This segment is intended for the [...]

Medical Necessity of Ambulance Services

Medical Necessity of Ambulance Services Table of Contents Medical Necessity of Ambulance Services What You Can Do Nearest Appropriate Facility: GY Modifier What You Can Do Related Content [Return to Top] Medical [...]

Prior Authorization of Repetitive Scheduled Non-Emergent Ambulance Transport

Ambulance Medical Necessity

Ambulance Medical Necessity According to the Centers for Medicare & Medicaid Services’ (CMS) Internet Only Manual (IOM) 100-02, Medicare Benefit Policy Manual, Chapter 10, Ambulance Services; (400 KB) 10.2 - Necessity and Reasonableness [...]

Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity

Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity Recent National Government Services educational efforts have highlighted an issue between facilities and the ambulance [...]

Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports

Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports The CMS implemented the prior authorization of RSNAT. NGS J6 states Illinois, Minnesota, and Wisconsin were added to the RSNAT Model effective with dates [...]

Membership Rosters

Membership Rosters Member Lists JK Part A J6 Part A Federally Qualified Health Center (All States) Revised 11/4/2024

Introduction to Medicare Part I

Are you new to the Medicare Program? Attend our Introduction to Medicare Part I and II Webinars! Each session will be 1 hour with 15 minutes of Q&A. Part I will focus on: Jurisdictions, NGS Website/Medicare Education, Medicare Enrollment [...]

Billing Medicare Part A When Veteran’s Administration Eligible Medicare Beneficiaries Receive Services in Non-VA Facilities

Billing Medicare Part A When Veteran’s Administration Eligible Medicare Beneficiaries Receive Services in Non-VA Facilities Table of Contents Background Beneficiary Chooses to Use Medicare Beneficiary Chooses to Use VA Benefits VA [...]

New Provider Center

New Provider Center National Government Services: A Medicare Administrative Contractor – Who Are We? A MAC is a private health care insurer to whom the CMS has awarded geographic jurisdiction to process FFS Medicare claims for beneficiaries [...]

New Provider Center

New Provider Center National Government Services: A Medicare Administrative Contractor Who Are We? A MAC is a private health care insurer to whom the CMS has awarded geographic jurisdiction to process FFS Medicare claims for beneficiaries [...]

New Provider Center

New Provider Center National Government Services: A Medicare Administrative Contractor – Who Are We? A MAC is a private health care insurer to whom the CMS has awarded geographic jurisdiction to process FFS Medicare claims for beneficiaries [...]

New Provider Center

New Provider Center National Government Services: A Medicare Administrative Contractor – Who Are We? A MAC is a private health care insurer to whom the CMS has awarded geographic jurisdiction to process FFS Medicare claims for beneficiaries [...]

November is Lung Cancer Awareness Month

November is Lung Cancer Awareness Month Lung cancer is the leading cause of cancer death in the United States and worldwide. Although education, research and treatment options for lung cancer have dramatically improved in recent years, lung [...]

Submitting Revalidation via PECOS

During this webinar, we’ll provide an understanding of how to utilize the Centers for Medicare & Medicaid Services (CMS) Internet-based Provider Enrollment Chain & Ownership System (PECOS) to be comfortable in navigating the system to submit a [...]

Submitting Revalidation via PECOS

During this webinar, we’ll provide an understanding of how to utilize the Centers for Medicare & Medicaid Services (CMS) Internet-based Provider Enrollment Chain & Ownership System (PECOS) to be comfortable in navigating the system to submit a [...]

PECOS: View and Manage Reassignments through Group Enrollment

During this webinar, we’ll provide an understanding of how to view and manage reassignments through the group enrollment in Provider Enrollment, Chain and Ownership System (PECOS), including to add or terminate reassignments. Individual [...]

Provider Enrollment: Completing the CMS-855B Paper Application

During this webinar, we'll provide an understanding of how to complete the CMS-855B provider enrollment paper application for a clinic, group, or supplier.

PECOS: Manage Signatures and Additional Information Requests

During this webinar, we’ll give direction for the Provider Enrollment, Chain and Ownership System (PECOS) application on understanding how to manage signatures and respond to additional information request from submitted applications.

Registration Now Open for the 2024 Preventive Services Virtual Conference!

Registration Now Open for the 2024 Preventive Services Virtual Conference! We are thrilled to announce that registration is now open for the National Government Services Medicare Part B 2024 Preventive Services Virtual Conference, taking place [...]

Intensive Outpatient Program

Intensive Outpatient Program Table of Contents IOP vs. Partial Hospitalization Program Provider Types Eligible to Provide IOP Medicare Beneficiary Eligible for IOP Services Active Treatment and Treatment Plan Covered IOP Services [...]

Let’s Chat about Medicare Secondary Payer for Part A Providers

This Let’s Chat session will focus on questions our Part A providers have regarding the topic of Medicare Secondary Payer (MSP). Let's Chat sessions are informal opportunities for our providers to chat with our Provider Outreach and [...]

Introduction

Section 1: Introduction Introduction Disclaimer National Government Services produced this material as an informational reference for providers furnishing services in our contract jurisdiction. NGS employees, agents and staff make no [...]

Federal Government Administration

Section 1: Introduction Table of Contents Federal Government Administration Who Is CMS? CMS' Goals Program Objectives Access to Quality Care Services to Beneficiaries Program Administration CMS Structure CMS [...]