MLN Connects® for Thursday, September 24, 2020

MLN Connects® for Thursday, September 24, 2020 Need Help Checking Medicare Eligibility? MLN Connects® for Thursday, September 24, 2020 View this edition as a PDF News CMS to Expand Successful Ambulance Program [...]

MLN Connects® for Thursday, September 17, 2020

MLN Connects® for Thursday, September 17, 2020 MLN Connects® for Thursday, September 17, 2020 View this edition as a PDF News SNF Healthcare-Associated Infections Measure: Submit Comments by October 14 Participate in Medical [...]

MLN Connects® for Thursday, September 10, 2020

MLN Connects® for Thursday, September 10, 2020 CMS Care Compare Empowers Patients MLN Connects® for Thursday, September 10, 2020 View this edition as a PDF News CMS Care Compare Empowers Patients When Making Important Health [...]

MLN Connects® for Thursday, October 8, 2020

MLN Connects® for Thursday, October 8, 2020 17 Provider Compliance Tips Fact Sheets MLN Connects® for Thursday, October 8, 2020 View this edition as a:  Webpage | PDF  News Hospice Quality Reporting [...]

MLN Connects® for Thursday, October 29, 2020

MLN Connects® for Thursday, October 29, 2020 Quality Payment Program APMs: Update Billing Information to Get Paid MLN Connects® for Thursday, October 29, 2020 View this edition as a: Webpage | PDF News Quality Payment Program [...]

MLN Connects® for Thursday, October 22, 2020

MLN Connects® for Thursday, October 22, 2020 Medicare Coverage for Opioid Use Disorder Treatment MLN Connects® for Thursday, October 22, 2020 View this edition as a: Webpage | PDF News Opioid Use Disorder Treatment: Medicare [...]

MLN Connects® for Thursday, October 15, 2020

MLN Connects® for Thursday, October 15, 2020 COVID-19 Testing: Protecting Integrity MLN Connects® for Thursday, October 15, 2020 View this edition as a: Webpage | PDF News CMS Takes Action to Protect Integrity of COVID-19 [...]

MLN Connects® for Thursday, October 1, 2020

MLN Connects® for Thursday, October 1, 2020 Hospital Price Transparency: Requirements Effective January 1 MLN Connects® for Thursday, October 1, 2020 View this edition as a: Webpage | PDF Editor’s Note: This edition includes a [...]

MLN Connects® for Thursday, November 5, 2020

MLN Connects® for Thursday, November 5, 2020 COVID-19 Vaccine: Find Out How to Prepare MLN Connects® for Thursday, November 5, 2020 View this edition as a: Webpage | PDF News COVID-19 Vaccine: Find Out How to Prepare Hospital [...]

MLN Connects® for Thursday, November 19, 2020

MLN Connects® for Thursday, November 19, 2020 Nursing Homes: Take COVID-19 Training MLN Connects® for Thursday, November 19, 2020 View this edition as a: Webpage | PDF News CMS Releases Nursing Home COVID-19 Training Data with [...]

MLN Connects® for Thursday, November 12, 2020

MLN Connects® for Thursday, November 12, 2020 COVID-19: Non-Physician Practitioner Billing for Audio Services MLN Connects® for Thursday, November 12, 2020 View this edition as a: Webpage | PDF News Critical Care: Comparative [...]

Notification of the 2020 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review

Notification of the 2020 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 [...]

New Version of PC-ACE: April 2020

New Version of PC-ACE:  April 2020 PC-ACE Version 4.6 contains several CMS mandates and product enhancements including but not limited to the items listed below. CR 11353 - New Medicare Provider Specialty Code (D5) and Billing Codes [...]

New Uniform Thresholds for Determining Low Medicare Utilization Providers

New Uniform Thresholds for Determining Low Medicare Utilization Providers Effective for all cost reports received on or after 6/19/2020, the MACs are instructed to use the following defined “Low Medicare Utilization Thresholds” compared to [...]

New NGS Part A Redetermination Request Form

New NGS Part A Redetermination Request Form Save time and money by using of the following options instead of mailing a written redetermination request form: Initiate an adjustment in the FISS DDE for fully covered or rejected claims Use [...]

National Government Services and the Public Health Emergency

National Government Services and the Public Health Emergency The health and well-being of our beneficiaries, providers, associates and communities is our top priority. We understand the uncertainty and concerns you may be experiencing during [...]

National Government Services Provider Enrollment Appeals Mailbox Reminder

National Government Services Provider Enrollment Appeals Mailbox Reminder National Government Services, Inc. has seen an increase in submissions to the PE appeals mailbox (NGS-PE-Appeals@Anthem.com) that are not appropriate. The NGS PE appeals [...]

National Government Services Accepting and Processing Claims for Expanded Coverage of Telehealth Services as of 3/6/2020

National Government Services Accepting and Processing Claims for Expanded Coverage of Telehealth Services as of 3/6/2020 On 3/17/2020, CMS issued MLN Connects® Special Edition for Tuesday, March 17, 2020, President Trump Expands Telehealth [...]

Medicare Usage of CPT 99072

Medicare Usage of CPT 99072 National Government Services has received many questions regarding CPT 99072 for Medicare usage since the AMA announced the code on 9/8/2020. Many providers have been asking if CMS will cover this code for Medicare [...]

Chiropractors Billing Medicare for Therapy Services

Chiropractors Billing Medicare for Therapy Services Chiropractors in the Medicare fee-for-service realm are only allowed to be considered for spinal manipulation via submission of CPT codes 98940‒98942. Medicare pays for these services when [...]

Top Reasons for Unprocessable Claims

Top Reasons for Unprocessable Claims National Government Services has composed a list of the top reasons for returning claims as unprocessable; due to missing, incomplete, insufficient or invalid claim information. An unprocessable claim is [...]

What Part B Providers Need to Know About the Prior Authorization Program for Certain Medicare Services Performed in the Hospital Outpatient Department

What Part B Providers Need to Know About the Prior Authorization Program for Certain Medicare Services Performed in the Hospital Outpatient Department Hospitals submitting claims for certain outpatient department services will be required to [...]

Reminder: 2020 New Codes for Care Management

Reminder: 2020 New Codes for Care Management We are reminding you that the 2020 final rule with regard to the new care management codes is not policy at this time. CMS is considering these changes identified in the final rule. If CMS decides [...]

Proper Billing for Opioid Treatment Program Weekly Bundles for HCPCS Codes G2067-G2075

Proper Billing for Opioid Treatment Program Weekly Bundles for HCPCS Codes G2067-G2075 Medicare introduced the OTP as a covered Part B benefit beginning with dates of service on and after 1/1/2020. Payment is made to Medicare-enrolled OTP [...]

Prior Authorization: Part B Physician Implications

Prior Authorization: Part B Physician Implications For dates of service on and after 7/1/2020, CMS has implemented a prior authorization program for certain hospital OPD services. This has been done to ensure that Medicare beneficiaries [...]

Fee Schedule Adjustments Reminder for 99441-99443

Fee Schedule Adjustments Reminder for 99441-99443 National Government Services has received several inquiries from providers regarding the adjustment of CPT codes 99441-99443. When CMS announced that they were changing the fee schedule [...]

Chiropractors Billing Medicare for Therapy Services

Chiropractors Billing Medicare for Therapy Services Chiropractors in the Medicare fee-for-service realm are only allowed to be considered for spinal manipulation via submission of CPT codes 98940‒98942. Medicare pays for these services when [...]

2021 E/M Prolonged Service Billing Changes for Medicare

2021 E/M Prolonged Service Billing Changes for Medicare National Government Services has received several inquiries regarding changes to office or other outpatient prolonged service coding effective 1/1/2021. When the AMA released the changes [...]

Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement

Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement  The CMS-588 Electronic Funds Transfer Authorization Agreement is to be submitted for billing providers upon initial enrollment, change in bank information and [...]

Social Security Income Ratios

Social Security Income Ratios Attention All Part A Inpatient Prospective Payment System Hospitals, Inpatient Rehabilitation Facilities and Long-Term Care Hospitals The federal fiscal year 2018 SSI ratios for IPPS hospitals, IRFs and LTCHs [...]

New EDI Service Offering for the Part A/FQHC/HHH 276/277 Claim Status Inquiry and Response

New EDI Service Offering for the Part A/FQHC/HHH 276/277 Claim Status Inquiry and Response National Government Services is pleased to announce the availability of a ‘near’ real time response to claim status inquiries submitted to EDI with the [...]

Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement

Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement The CMS-588 Electronic Funds Transfer Authorization Agreement is to be submitted for billing providers upon initial enrollment, change in bank information and during [...]

Opioid Treatment Add-on Code G2078 and G2079 MUE Values

Opioid Treatment Add-on Code G2078 and G2079 MUE Values The July 2020 quarterly update for the NCCI added an MUE value of one for OTP HCPCS codes G2067-G2075 and G2078 and G2079. It was later determined by CMS that the incorrect MUE value was [...]

Maximum Payment Limits for Rural Health Centers

Maximum Payment Limits for Rural Health Centers Payment Limit Annual Adjustment Period Covered $190.00 TBD 1/1/2028–12/31/2028 $178.00 TBD 1/1/2027–12/31/2027 $165.00 TBD [...]

2024 Medicare Cost Report Due Dates

2024 Medicare Cost Report Due Dates FYE 12/31/2023 cost reports are due by 5/31/2024. We strongly encourange early filing of the cost report. Early-filed cost reports that are rejected will receive a grace period to re-submit prior to [...]

Vaccines

Vaccines Medicare covers some preventive vaccines at no cost to the beneficiary. CMS and National Government Services provide detailed educational and billing information for providers. Medicare also covers vaccines that are directly related [...]

EDI Guided Enrollment Form

MLN Connects® Newsletter: May 2, 2024

MLN Connects® Newsletter: May 2, 2024 News CMS Statement on Proposed Local Coverage Determination for Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers Quality in [...]