Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted Retroactive Medicare Entitlement

Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted Retroactive Medicare Entitlement Table of Contents Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted [...]

MLN Connects® Newsletter: May 23, 2024

MLN Connects® Newsletter: May 23, 2024 News Medicare Shared Savings Program: Apply by June 17 for January 1 Start Date Medicare Providers: Deadlines for Joining an Accountable Care Organization Institutional Providers: Medicare Enrollment [...]

Billing G-Codes for Therapy and Skilled Nursing Services

Billing G-Codes for Therapy and Skilled Nursing Services Table of Contents Billing G-Codes for Therapy and Skilled Nursing Services What You Need to Know to Bill Physical Therapy Occupational Therapy Speech Language Pathology [...]

Create an Account - Standard

Create an Account – Standard Table of Contents Create an Account – Standard Step 1 – Account Step 2 – Individual Step 3 – Business [Return to Top] Create an Account – Standard An NGSConnex Standard Account holder will [...]

More Medicare Resources

More Medicare Resources Medicare.gov Your online Medicare resource Replace Your Medicare Card Learn how to replace your Medicare card

CPT 99459 Pelvic Examination Billing for Medicare

CPT 99459 Pelvic Examination Billing for Medicare National Government Services has received several inquiries regarding the use of CPT 99459, which was added to CPT coding for 2024 as an add-on code service. This means the code is only payable [...]

Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77

Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77 Table of Contents Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77 Example of the Proper Use of OC 27 Example of the Proper Use of OC 27 with OSC 77 [...]

Upcoming Annual Logon ID Recertification

Upcoming Annual Logon ID Recertification Upcoming Annual Logon ID Recertification for Maine, Massachusetts, New Hampshire, Vermont, Rhode Island Regions Beginning the week of 05/06/2024, the Maine, Massachusetts, New Hampshire, Vermont, Rhode [...]

Upcoming Annual Logon ID Recertification

Upcoming Annual Logon ID Recertification Upcoming Annual Logon ID Recertification for Maine, Massachusetts, New Hampshire, Vermont, Rhode Island Regions Beginning the week of 5/6/2024, the Maine, Massachusetts, New Hampshire, Vermont, Rhode [...]

CHOPD Accelerated Payments to Providers

CHOPD Advance Payments to Providers

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today!

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today! We’ve dedicated Tuesdays for the month of June to deliver valuable educational topics that will help our provider [...]

A/B DME MAC Collaborative Webinar: Nebulizers and Nebulizer Drugs

A/B DME MAC Collaborative Webinar: Nebulizers and Nebulizer Drugs Physicians/Practitioners! Are you Ordering Nebulizers and Nebulizer Drugs for your Patients? This is your opportunity to hear directly from the Medicare contractors regarding [...]

MLN Connects® Newsletter: May 16, 2024

MLN Connects® Newsletter: May 16, 2024 News Administration Acts to Improve Access to Kidney Transplants DMEPOS: Updated List of Items Potentially Subject to Conditions of Payment Lymphedema Compression Treatment Items: New [...]

CR13566 - Outlier Reconciliation and Cost-to-Charge Ratio (CCR) Updates for the Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS

CR13566 - Outlier Reconciliation and Cost-to-Charge Ratio (CCR) Updates for the Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Posted 5/16/2024

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS Enrollment Forms

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS Enrollment Forms To reduce requests for additional information, National Government Services offers several provider enrollment topics, helpful tips and [...]

Helpful Resources Change of Address Find & Compare Doctors, Plans, Hospitals, Suppliers, & Other Providers Beneficiary Fact Sheets for Medicare Coverage and Cost Medicare.gov Sign into Medicare.gov

Helpful Resources Change of Address Find & Compare Doctors, Plans, Hospitals, Suppliers, & Other Providers Beneficiary Fact Sheets for Medicare Coverage and Cost Medicare & You Handbook Medicare.gov Sign into Medicare.gov

Helpful Resources Change of Address Find & Compare Doctors, Plans, Hospitals, Suppliers, & Other Providers Beneficiary Fact Sheets for Medicare Coverage and Cost Medicare & You Handbook Medicare.gov Sign into Medicare.gov

Helpful Resources Change of Address Find & Compare Doctors, Plans, Hospitals, Suppliers, & Other Providers Beneficiary Fact Sheets for Medicare Coverage and Cost Medicare & You Handbook Medicare.gov Sign into Medicare.gov

Helpful Resources Change of Address Find & Compare Doctors, Plans, Hospitals, Suppliers, & Other Providers Beneficiary Fact Sheets for Medicare Coverage and Cost Medicare & You Handbook Medicare.gov Sign into Medicare.gov

Medicare’s Annual Wellness Visit in Illinois: Understanding the Benefit and Preventing Denials

Medicare’s Annual Wellness Visit in Illinois: Understanding the Benefit and Preventing Denials National Government Services Jurisdiction 6 MAC by Michael J. Dorris; Carolyn S. Henson, CPC , CAC, CACO, CPC-I, AAPC I-10 Instructor; and Nathan [...]

Medicare’s Annual Wellness Visit in Wisconsin: Understanding the Benefit and Preventing Denials

Medicare’s Annual Wellness Visit in Wisconsin: Understanding the Benefit and Preventing Denials National Government Services Jurisdiction 6 MAC by Michael J. Dorris; Carolyn S. Henson, CPC , CAC, CACO, CPC-I, AAPC I-10 Instructor; and Nathan [...]

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS-855A Application

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS-855A Application To reduce requests for additional information, National Government Services offers several provider enrollment topics, helpful tips and [...]

Cost Report Submission Checklist

Billing Fascia Iliaca Blocks with 64999

Billing Fascia Iliaca Blocks with 64999 National Government Services is receiving information that does not provide the documentation necessary to process claims for Fascia Iliaca Blocks when billed with CPT 64999. Since this is an unlisted [...]

Registration Is Open for the Medicare Part B 2024 Spring/Summer Virtual Conference! Mastering Medicare: Tuesday Tutorials for Part B Providers

Registration is Open for the Medicare Part B 2024 Spring/Summer Virtual Conference! Mastering Medicare: Tuesday Tutorials for Part B Providers We’ve devoted Tuesdays in June to host a series of educational webinars focused on evaluation and [...]

Self-Administered Drug Exclusion

Self-Administered Drug Exclusion Medications that are self-administered more than 50% of the time for all Medicare beneficiaries are excluded from Medicare Part B coverage.  At the direction of CMS, each MAC shall create an article that [...]

LCD and Article Updates May/June 2024

LCD and Article Updates May/June 2024 Billing and Coding Articles L37485 Prostate Rectal Spacers This policy is retired and is no longer in effect for services rendered on or after 5/1/2024. A52863 Billing and Coding: Pain Management - [...]

A/B and DME Collaborative YouTube Video

A/B and DME Collaborative YouTube Video The A/B DME MACs are offering a YouTube video on General Documentation Requirements. This video provides guidance to assist providers and suppliers with a better understanding of the requirements for [...]

Standard Companion Guides

Standard Companion Guides Standard Companion Guide Trading Partner Information (275) Standard Companion Guide Trading Partner Information (277) Standard Companion Guide Trading Partner Information (278/275) Standard Companion Guide Health [...]

JK Part A Immediate Recoupment Request Form

Hospice Change of Ownership

Hospice Change of Ownership Table of Contents Hospice Change of Ownership What is Not a CHOW The Provider Enrollment Process Purchase Agreement Merger/Acquisition [Return to Top] Hospice Change of Ownership CHOW is defined [...]

Filing an Electronic Notice of Cancelation (Type of Bill 8XD)

Filing an Electronic Notice of Cancelation (Type of Bill 8XD) Table of Contents Filing an Electronic Notice of Cancelation (Type of Bill 8XD) Steps to Cancel a NOE Steps to Cancel a Benefit Period Submitting the 8XD Related Content [...]

Filing an Electronic Notice of Transfer (Type of Bill 8XC)

Filing an Electronic Notice of Transfer (Type of Bill 8XC) Table of Contents Filing an Electronic Notice of Transfer (Type of Bill 8XC) Correcting the Transfer Date on a Previous Submitted Notice of Transfer Related Content [Return to [...]

Hospice Site of Service Codes

Hospice Site of Service Codes Table of Contents Hospice Site of Service Codes HCPCS Codes Site of Service Location Notes Edits Related Content [Return to Top] Hospice Site of Service Codes Hospice agencies must report an HCPCS [...]

Reporting Hospice Discharges, Revocations and Transfers

Reporting Hospice Discharges, Revocations and Transfers Medicare regulations at 42 CFR 418.26 outline three reasons for discharge from hospice care: The beneficiary moves out of the hospice’s service area or transfers to another [...]

Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims

Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims Once a hospice chooses to admit a Medicare beneficiary, it may not automatically or routinely discharge the beneficiary at its discretion, even if the care promises [...]

Professional Services During a Patient Hospice Election

Professional Services During a Patient Hospice Election Table of Contents Article Overview Hospice Election Medicare Payment During Hospice Election Determining the Correct Entity to Bill Separately Payable Part B Services [...]

National Government Services: Raising Awareness About Care Management

National Government Services: Raising Awareness about Care Management According to the Center for Disease Control, six in ten adults in the U.S. have a chronic disease and four in ten adults have two or more. As your MAC for Jurisdiction 6 [...]

Filing an Electronic Notice of Change of Ownership (TOB 8XE)

Filing an Electronic Notice of Change of Ownership (TOB 8XE) The Notice of Change of Ownership (TOB 8XE) is submitted when the hospice has a change of ownership that results in a change of the PTAN. Please refer to the Hospice Change of [...]

Hospice Quality Reporting Program

Hospice Quality Reporting Program Along with the other MACs, National Government Services has received several requests from new hospice providers, as well as national and state hospice associations, regarding training and assistance for [...]

Filing an Electronic Notice of Election (Type of Bill 8XA)

Filing an Electronic Notice of Election (Type of Bill 8XA) The NOE, TOB 8XA, is submitted when the hospice receives a signed election statement from the beneficiary acknowledging that he/she wishes to enroll in the Medicare hospice benefit. [...]

Proper Medicare Part B Claim Submissions Due to the Change Healthcare Security Incident

Proper Medicare Part B Claim Submissions Due to the Change Healthcare Security Incident With many providers submitting paper claims due to the Change Healthcare security incident, it is important to submit your claims correctly. Failure to do [...]

MLN Connects® Newsletter: April 25, 2024 (UPDATE)

MLN Connects® Newsletter: April 25, 2024 (UPDATE) Editor's Note: CMS updated a message because we delayed the effective date that physicians who certify hospice services must enroll in or opt-out of Medicare until 6/3/2024. You may have to [...]

SNFs: Missing Medicare Health Insurance Claim Number on Minimum Data Set Can Cause Potential Claim Denials

SNFs: Missing Medicare Health Insurance Claim Number on Minimum Data Set Can Cause Potential Claim Denials Our Medical Review department has noted many cases where the HIC number is missing from the MDS that is in the repository. MDS Overview [...]

Billing Reminder: When a Skilled Nursing Facility Payment Ban is in Effect

Billing Reminder: When a Skilled Nursing Facility Payment Ban is in Effect CMS may impose a DPNA against the SNF when the facility is not in compliance with the requirements of participation under the Social Security Act at Sections 1819(h) [...]

Save the Dates! National Government Services 2024 Spring/Summer Virtual Conference

Save the Dates! National Government Services 2024 Spring/Summer Virtual Conference Mastering Medicare: Tuesday Tutorials for Part B Providers Coming to you soon on 6/4/2024, 6/11/2024, 6/18/2024 and 6/25/2024, four full days of virtual [...]

Save the Dates! CMS National Provider Enrollment Conference in San Diego: 8/28/2024-8/29/2024

Save the Dates! CMS National Provider Enrollment Conference in San Diego: 8/28/2024-8/29/2024 Wednesday, 8/28/2024 and Thursday, 8/29/2024 from 8:00 a.m.–5:00 p.m. PT Register for the CMS National Provider Enrollment Conference at the San [...]

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 [...]

Join Us for ‘Real Time” with CMS Chicago

Join Us for ‘Real Time' with CMS Chicago The CMS Chicago LEA would like to invite you to our “Real Time” with CMS Chicago, a bi- weekly webinar that occurs on the 2nd & 4th Wednesday of every Month at 9 a.m. CT. These 30-minute calls are [...]

Reminders for the New Hospice Certifying Physician Claim Edit Effective 5/1/2024

Reminders for the New Hospice Certifying Physician Claim Edit Effective 5/1/2024 Effective for hospice claim "From" dates on or after 5/1/2024, CMS implemented edits to enforce a new rule that would deny hospice claims if the certifying [...]

Top Claim Errors Have Been Reviewed and Updated

Top Claim Errors Have Been Reviewed and Updated Our top claim errors are updated on a quarterly basis to reflect current information. Visit Top Claim Errors under Resources > Claims and Appeals to learn what you can do to avoid claim [...]

Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex

Table of Contents Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex What are the benefits? [Return to Top] Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex National Government [...]

Home Office Cost Statements

A home office of a chain organization is a related organization to its participating providers. Home offices usually furnish central management and administrative services, e.g., centralized accounting, purchasing, personnel services, [...]

What is NGSConnex?

What is NGSConnex? NGSConnex is a free, secure, web-based application developed by National Government Services just for you! NGSConnex provides access to a wide array of self-service functions that save you time and money, such as: Obtain [...]

LCD and Article Updates for April/May 2024

LCD and Article Updates for April/May 2024 Billing and Coding Articles Billing and Coding: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or T-cell Origin (A59311) [...]

National Government Services Proposed LCDs for Comment (4/25/2024-6/8/2024)

National Government Services Proposed LCDs for Comment (4/25/2024-6/8/2024) The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 4/25/2024 through [...]

Best Practices for a Successful Targeted Probe and Educate Review