National Government Services Proposed LCDs for Comment 9/29/2022-11/12/2022

National Government Services Proposed LCDs for Comment 9/29/2022-11/12/2022 The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from [...]

LCD Reconsideration Process

New LCD Request Process

MLN Connects® Newsletter: February 8, 2024

MLN Connects® Newsletter: February 8, 2024 News Medicare Shared Savings Program: Application Deadlines for a January 1, 2025, Start Date New Dental Specialty Codes for Medicare Hospices & Skilled Nursing Facilities: Report All [...]

National Government Services Proposed LCDs for Comment

National Government Services Proposed LCDs for Comment The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 2/8/2024 through 3/23/2024. These [...]

Reminder: Jurisdiction 6 and Jurisdiction K Providers Using Medicare Part B MSP Overpayment Request Form for Non-MSP

Reminder: Jurisdiction 6 and Jurisdiction K Providers Using Medicare Part B MSP Overpayment Request Form for Non-MSP Use the Medicare Part B MSP Overpayment Request Form for the following situations, not for non-MSP overpayments: 07–MSP [...]

National Government Services Will Be Open On President's Day

National Government Services Will Be Open On President's Day National Government Services will be open on President's Day, Monday, 2/19/2024. The PCC will be open and available to take your calls. Posted 2/14/2024

MLN Connects® Newsletter: February 15, 2024

MLN Connects® Newsletter: February 15, 2024 News CMS Roundup (Feb 9, 2024) Marriage and Family Therapists & Mental Health Counselors: New Specialty Codes for Medicare Medicare Physician Fee Schedule Database: April Update MLN [...]

Navigating Medicare Part A Insights for Providers Podcast

Navigating Medicare Part A Insights for Providers Podcast Listen to our new podcast on Spotify and Apple Podcasts! Check out our new podcast, Navigating Medicare Part A Insights for Providers, now available on Spotify and Apple Podcasts! [...]

[REVISED] Provisional Period of Enhanced Oversight for New Hospices

[REVISED] Provisional Period of Enhanced Oversight for New Hospices In an effort to reduce hospice fraud, waste and abuse, CMS is placing newly enrolling hospices located in Arizona, California, Nevada and Texas in a program called PPEO [...]

Fee Schedules Description

Fee Schedule Lookup To initiate a search, select a fee schedule type from the drop-down menu, complete all required fields, then select Search. Note: If your search does not display the fee schedule or effective date (range) you enter, [...]

Centers for Medicare & Medicaid Services Office of Legislation

Health Benefits of Quitting Smoking

Health Benefits of Quitting Smoking Help your Patients Kick the Habit! Smoking leads to multiple diseases and potentially death, but this is preventable – anyone at any age can benefit from quitting smoking. Medicare covers tobacco cessation [...]

Change to Roster Claims Information Entry in the Fiscal Intermediary Standard System Direct Data Entry

Change to Roster Claims Information Entry in the FISS DDE Effective 1/28/2013, the FISS maintainer has made a change to the way roster claims are entered. After entering the required information into the FISS DDE, providers will have to hit [...]

Common Working File (CWF) Host Dark Days for April 2024 Release

Common Working File (CWF) Host Dark Days for April 2024 Release For the upcoming April 2024 Release: For Production, CWF will be observing the Gray Day on Thursday, 3/28/2024 and Dark Days starting Friday, 3/29/2024 through Sunday, 3/31/2024 [...]

Proper Billing for Patient Supplied Drugs

Proper Billing for Patient Supplied Drugs Drugs, including biologicals, must represent an expense to the physician or legal entity billing for the services or supplies. In some instances, the patient purchases the drug or, the physician [...]

Evaluation and Management Frequently Asked Questions

Evaluation and Management Frequently Asked Questions We’ve expanded our E/M FAQs for the Complex and Chronic Care – HCPCS code G2211 category to include answers to common questions we’ve received about this add-on code. Visit this page for the [...]

MLN Connects® Newsletter: February 22, 2024

MLN Connects® Newsletter: February 22, 2024 News CMS Issues Additional Guidance on Program to Allow People with Medicare to Pay Out-of-Pocket Prescription Drug Costs in Monthly Payments Compliance Medical Services Authorized by the [...]

Correct or Reopen a Claim Due to an MSP-Related Issue

Table of Contents Correct or Reopen a Claim Due to an MSP-Related Issue Identify the Finalized Status of the Claim and Take the Appropriate Action Depending on the Type of Denial/Correction That Needs to be Made Step 1 Claim Denied as [...]

Prolonged Services Timeline 2024

Prolonged Services Timeline 2024 We’ve updated the Prolonged Services Timetable with 2024 HCPCS and CPT codes, time requirements and date spans. We encourage providers to view this information to ensure you’re billing claims for prolonged [...]

Medicare Part B Overpayments

Medicare Part B Overpayments We developed the Medicare Part B Overpayments Tip Sheet to provide instructions for reporting various overpayment situations. Topics include responding to a demand letter, viewing outstanding overpayments, [...]

Overpayments Right Hand

Resources Medicare Part B Overpayments Tip Sheet Form(s) you'll need: Financial Contact Submissions All Forms

Overpayments Right Hand

Resources Medicare Part B Overpayments Tip Sheet Form(s) you'll need: Financial Contact Submissions All Forms

Ambulance Duplicate Claim Denials

Sample TPE Notification Letter

Sample TPE Notification Letter Mail Date Provider Name Provider Address City, State, Zip Casefolder ID: Casefolder ID Provider Number PTAN: PTAN (Provider Transaction Access Number) Provider Number NPI: NPI (National Provider Identifier) [...]

Sample TPE Notification Letter

Sample TPE Notification Letter Mail Date Provider Name Provider Address City, State, Zip Casefolder ID: Casefolder ID Provider Number PTAN: PTAN (Provider Transaction Access Number) Provider Number NPI: NPI (National [...]

Medicare Preventive Services

Medicare Preventive Services Medicare covers many preventive services to help keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain [...]

LCD and Billing and Coding Article Updates for February/March 2024

LCD and Billing and Coding Article Updates for February/March 2024 Local Coverage Determinations Biomarker Testing for Prostate Cancer Diagnosis (L37733) This LCD has been retired and will no longer be in effect for services performed after [...]

Date of Service on CMS-1500 Billing

Date of Service on CMS-1500 Billing Overview Radiology Services Surgical and Anatomical Pathology Chronic Care Management Care Plan Oversight Home Health Certification and Recertification Physician End-Stage Renal Disease Services [...]

[REVISED] 2024 Gapfill Request

[REVISED] 2024 Gapfill Request National Government Services, the MAC for JK and J6 is in receipt of the new laboratory test codes identified by the CMS to be gap-fill priced for 2024. The PAMA regulations instruct the MACs to establish local [...]

Change Healthcare Security Incident

Change Healthcare Security Incident The CMS and National Government Services are aware that Change Healthcare recently suffered a cyber-attack. Change Healthcare is a clearinghouse vendor that connects providers with insurance payers and has [...]

MLN Connects® Newsletter: February 29, 2024

MLN Connects® Newsletter: February 29, 2024 Events ICD-10 Coordination & Maintenance Committee Meeting — March 19–20 MLN Matters® Articles Appropriate Use Criteria for Advanced Diagnostic Imaging: CY 2024 Update Clinical [...]

Tobacco Counseling via Telehealth

Tobacco Counseling via Telehealth Tobacco use is the leading cause of preventable disease, disability and death in the United States. Each year, nearly half a million Americans die prematurely of smoking or exposure to secondhand smoke. [...]

You Asked, We Listened: Redesigned Events Page Coming Soon

You Asked, We Listened: Redesigned Events Page Coming Soon We’re always looking for and appreciate feedback from our providers. Your ideas and recommendations help drive improvements to our website. Providers suggested that we display the [...]

March 2024

In This Issue National Government Services Articles for Part A and Part B Providers Common Working File (CWF) Host Dark Days for April 2024 Release Health Benefits of Quitting Smoking 2024 Gapfill Request Correct Coding of Molecular [...]

CMS Rural Health Resources

CMS Rural Health Clinics Center

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport CMS implemented the prior authorization program for RSNAT to reduce expenditures while maintaining and/or improving quality of care. This program applies to [...]

Appeals

Appeals State MAC Appeals Address Qualified Independent Contractor Address CT, MA, ME, NH, NY, RI, VT National Government Services, Inc. Appeals Department P.O. Box 7111 Indianapolis, IN 46207-7111 [...]

Claim Status <2>

table, td, th table { border-collapse: collapse; width: 50%; } Claim Status <2> If you are part of a group, remember to use the group NPI, PTAN and TIN for authentication purposes. When Claim Status is selected, the IVR will [...]

Investigational Device Exemption Requests ‒ Renewals and Modifications

Investigational Device Exemption Requests ‒ Renewals and Modifications Effective for Category A and B IDE studies approved by the FDA on or after 1/1/2015, interested parties (i.e. study sponsors) seeking Medicare coverage must submit a [...]

NGSMedicare.com Scheduled Maintenance: 3/9/2024-3/10/2024

NGSMedicare.com Scheduled Maintenance Due to scheduled maintenance, NGSMedicare.com will be inaccessible beginning Saturday, 3/9/2024 through Sunday, 3/10/2024. We apologize for any inconvenience this may cause. Posted 3/7/2024

MLN Connects® Newsletter: March 7, 2024

MLN Connects® Newsletter: March 7, 2024 News HHS Statement Regarding the Cyberattack on Change Healthcare Final Guidance to Help People with Medicare Prescription Drug Coverage Manage Prescription Drug Costs Current Status of Blood [...]

Levels of Appeals and Time Limits for Filing

Home Infusion Therapy

Modifiers

National Government Services Part A Medical Review Newsletter June 2021

National Government Services Part A Medical Review Newsletter June 2021The National Government Services MR Department would like to welcome you to our newest service; a regular newsletter. It is our hope that you will find this newsletter [...]

Article Updates for July 2021

Article Updates for July 2021Billing and Coding: Complex Drug Administration Coding (A58620)Under Article Text - Route of Administration Modifier revised the first sentence to read, “The use of the JA and JB modifiers is required for drugs [...]

Financial Contact Information Form

Immediate Recoupment Request Form – Electronic/E-mail

Credit Balance Report Reminders

Credit Balance Report RemindersFor the quarter ending 6/30/2021, CBRs can be submitted starting 7/1/2021 and must be submitted within 30 days to be considered timely.FISS/DDE users who submit the 838 detail page directly over the FISS/DDE [...]

Provider Enrollment: Understand the Process to Opt Out of Medicare

Provider Enrollment: Understand the Process to Opt Out of MedicareProviders that render services to a Medicare beneficiary must enroll with Medicare and submit a claim on behalf of the beneficiary. However, select providers can stay in [...]

July 2021 Release "Dark Days" for the Common Working File Hosts

July 2021 Release "Dark Days" for the Common Working File HostsFor the upcoming July 2021 Release:For Production, CWF will be observing the Gray Day on Thursday, July 1st and Dark Days starting Friday, July 2nd through Sunday, July 4th to [...]

National Government Services Part B Medical Review Newsletter June 2021

National Government Services Part B Medical Review Newsletter June 2021We hope you are enjoying our newest service; a regular newsletter. Our goal is to help you stay up-to-date on the on the MR activities performed here at National Government [...]