Update on proposed LCD for Transesophageal Echocardiography

Update on proposed LCD for Transesophageal Echocardiography The LCD for Transesophageal Echocardiography (TEE) was published for comment and presented at an Open Meeting in July 2023. NGS is continuing to assess the provisions in this LCD and [...]

MLN Connects® Newsletter: October 6, 2023

MLN Connects® Newsletter: October 6, 2023     News COVID-19: Updated Novavax COVID-19 Vaccine, Adjuvanted for Patients 12 & Older Posted 10/6/2023

Cognitive Assessment and Care Plan Services CPT Code 99483

Cognitive Assessment and Care Plan Services CPT Code 99483 Effective 1/1/2021, Medicare increased payment for these services to $282 (may be geographically adjusted) when provided in an office setting, added these services to the definition of [...]

Mental Health Crisis Help

Mental Health Crisis Help Anyone experiencing a mental health crisis, including substance use crisis or thoughts of suicide, can get confidential support 24/7 by calling 988 or visiting the 988 Suicide & Crisis Lifeline website. View the [...]

Notification of the 2024 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review

Notification of the 2024 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review The amount that must remain in controversy for ALJ hearing requests filed on or [...]

MLN Connects® Newsletter: October 12, 2023

MLN Connects® Newsletter: October 12, 2023     News CMS Roundup (Oct 6, 2023) Protect Your Patients: Give Them a Flu Shot Publications Direct Data Entry: 10-Digit Screen Expansion Medicare Preventive Services — [...]

Let’s Get Ready for The Great American Smokeout on 11/16/2023!

Let’s Get Ready for The Great American Smokeout on 11/16/2023! For more than 40 years, the American Cancer Society has hosted the Great American Smokeout on the third Thursday of November. This yearly event is a call for action, not just for [...]

Electronic Funds Transfer Form and Instructions

Electronic Funds Transfer

Improving Customer Experience in 2021

Improving Customer Experience in 2021We are committed to improving your experience. Each day, we review comments from providers who submit surveys to let us know what is working well and how we can improve. We appreciate your feedback. This is [...]

May is National Mental Health Awareness Month

May is National Mental Health Awareness MonthAlthough May is the month of national focus on mental health awareness, it is a daily focus for many dealing with mental health conditions. Integrating behavioral health care with primary care [...]

Reminder: Medicare Part B Voluntary Refunds

Reminder: Medicare Part B Voluntary RefundsProviders submitting voluntary refunds need to be aware that when completing the Part B Voluntary Overpayment Refund Form, additional claim data is required:Complete the Part B Voluntary Overpayment [...]

Cognitive Assessment and Care Plan Services (CPT 99483)

Cognitive Assessment and Care Plan Services (CPT 99483)Medicare covers a separate visit for a cognitive assessment if your patient shows signs of cognitive impairment at their annual wellness visit or a routine visit. The cognitive assessment [...]

MACs to Host Multi-Jurisdictional CAC Meeting Regarding Facet Joint and Medial Nerve Branch Procedures

MACs to Host Multi-Jurisdictional CAC Meeting Regarding Facet Joint and Medial Nerve Branch ProceduresThe MACs will host a multi-jurisdictional CAC via Teleconference on 5/28/2020 from 1:00 p.m.‒4:00 p.m. CDT, 2:00 p.m.‒5:00 p.m. [...]

MAC Customer Experience Survey

MAC Customer Experience SurveyWe often receive feedback from our website users who get frustrated because our MCE survey displays before they are done visiting our website. We understand that it’s better for you to finish your visit before you [...]

Hospice Cap Self-Reporting Reminder

Hospice Cap Self-Reporting ReminderThe Hospice Cap Self-Reporting for the 2020 Cap Year (10/1/2019-9/30/2020) is due no later than 3/1/2021. Hospice providers should submit the pro-forma calculation along with supporting documentation and a [...]

New PC-ACE Version Will Soon Be Available

New PC-ACE Version Will Soon Be AvailableA new version PC-ACE Version 4.6.0.100 will be available 6/2/2020 for download from our website. This new PC-ACE version has been updated to include new HCPCS and ICD-10 diagnosis codes for COVID-19. [...]

There's Still Time to Register for the National Government Services Spring 2021 Virtual Conference

There's Still Time to Register for the National Government Services Spring 2021 Virtual ConferenceMedicare 2021: A Journey to a Healthier Future and PartnershipThe National Government Services POE Team's bi-annual virtual conference is [...]

MCReF/PS&R Official Supported Browser to Change on 6/21/2021

MCReF / PS&R Official Supported Browser to Change on 6/21/2021Beginning, Monday, 6/21/2021, the supported browser for MCReF system and PS&R system is changing from IE to Google Chrome. With this change, MCReF and PS&R will no longer [...]

Multi-Jurisdictional CAC Meeting on Amniotic Product Injections for Musculoskeletal Indications, Non-Wound

Multi-Jurisdictional CAC Meeting on Amniotic Product Injections for Musculoskeletal Indications, Non-WoundNoridian Healthcare Solutions along with CGS Administrators, First Coast Services Options, National Government Services, Novitas [...]

Accelerated and Advanced Payment Nettings/Offsets Across Organization Affiliations

Accelerated and Advanced Payment Nettings/Offsets Across Organization AffiliationsWe are receiving an influx of calls to our Provider Contact Center with regard to recoupment of AAPs with providers questioning recoupments on funds they believe [...]

Outpatient Prospective Payment System Part B Drug Payment and Status Indicator Change for Healthcare Common Procedure Coding System Q5122

Outpatient Prospective Payment System Part B Drug Payment and Status Indicator Change for Healthcare Common Procedure Coding System Q5122The following instructions have been provided by CMS to National Government Services for HCPCS code Q5122. [...]

LCD and Article Updates for April and May 2021

LCD and Article Updates for April and May 2021April 2021 Medical Policy Article UpdatesBilling and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography (A52849)This article has been updated due to a provider request to [...]

Clinicians Ordering Oxygen and Oxygen Equipment – COVID-19 PHE Reference Guide

Clinicians Ordering Oxygen and Oxygen Equipment – COVID-19 PHE Reference GuideAs a result of the COVID-19 PHE, CMS has issued waivers and flexibilities to assist Medicare beneficiaries in obtaining the services they need and allowing [...]

Responding to an Additional Documentation Request

Responding to an Additional Documentation RequestMost recently, National Government Services has experienced an increasing volume of 56900 denials: medical records not submitted upon receipt of an ADR. In response to the lack of submission of [...]

CGI Hosting an Upcoming Session on “Easier File Uploads for E-Filing in MCReF”

CGI Hosting an Upcoming Session on “Easier File Uploads for E-Filing in MCReF”Medicare Part A Cost Report: Easier File Uploads for e-Filing in MCReF Webcast:Date: Thursday 4/29/2021Time: 1:00–2:30 p.m. ETRegister today DescriptionMedicare [...]

Behavioral Health Integration Services: Psychiatric Collaborative Care Model

Behavioral Health Integration Services: Psychiatric Collaborative Care ModelIntegrating behavioral health care with primary care (“behavioral health integration” or “BHI”) is an effective strategy for improving outcomes for the millions of [...]

Checking the Status of Your Accelerated or Advanced Overpayment

Checking the Status of Your Accelerated or Advanced OverpaymentIf you requested an accelerated or advanced payment (AAP), then the overpayment amount is right at your fingertips. We would like to share some great tips on managing your accounts [...]

COVID-19 Lump Sum Payments for RHCs and FQHCs

COVID-19 Lump Sum Payments for RHCs and FQHCsRHCs and FQHCs may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS, through your MAC, will pay you up front for COVID-19 vaccines and [...]

Medicare Diabetes Maintenance Programs

Medicare Diabetes Maintenance ProgramsDiabetes management is an important topic to National Government Services. Patients diagnosed with diabetes may experience challenges with managing their diabetes and are more likely to experience many [...]

Provider Enrollment: Submitting Claims Before the Effective Date

Provider Enrollment: Submitting Claims Before the Effective DateNational Government Services has noticed an increase of Part B claim submissions from Medicare enrolled group practices for rendering providers prior to receiving their approval [...]

LCD and Article Updates for April 2021

LCD and Article Updates for April 2021New LCDs/ArticlesColon Capsule Endoscopy (CCE) (L38571)CCE is a noninvasive procedure that does not require air inflation or sedation and allows for minimally invasive and painless colonic evaluation. It is [...]

About Appeals

About AppealsProviders and beneficiaries have the right to appeal claim determinations made by National Government Services. The purpose of the appeals process is to ensure the correct adjudication of claims. Appeals activities conducted by NGS [...]

New Documentation Requirements for Filing Medicare Cost Reports

New Documentation Requirements for Filing Medicare Cost ReportsAttention: The FY 2019 Medicare IPPS final rule changed the required supporting documentation that must be submitted with the Medicare cost report. CMS also published MLN Matters [...]

Provider Enrollment: Change in Practice Location

Provider Enrollment: Change in Practice LocationThe fastest way to update a provider enrollment record is through PECOS for the individual (NPI Type 1) or entity/group (NPI Type 2). PECOS allows you to edit, add and delete information according [...]

COVID-19 Accelerated/Advance Payment Revised Repayment Terms

COVID-19 Accelerated/Advance Payment Revised Repayment TermsThe recently enacted Continuing Appropriations Act, 2021 and Other Extensions Act amended the repayment terms for the COVID-19 accelerated/advance payments. The changes to the [...]

COVID-19: RHC and FQHC Lump Sum Payments

COVID-19: RHC and FQHC Lump Sum PaymentsRural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS will pay you for [...]

Responding to a Hospice ADR

Responding to a Hospice ADRNational Government Services performs medical review audits of services billed to Medicare to validate that the documentation supports coverage and level of services billed.When you receive an ADR, it is important to [...]

Updated Billing Requirements for Home Infusion Therapy (HIT) Services on or After 1/1/2021

Updated Billing Requirements for Home Infusion Therapy (HIT) Services on or After 1/1/2021CR12108Posted 3/29/2021

Update to Rural Health Clinic (RHC) Payment Limits

Update to Rural Health Clinic (RHC) Payment LimitsCR12185Posted 3/29/2021