Jurisdiction 6 State Licensing and Certification Websites

Jurisdiction K State Licensing and Certification Websites

Jurisdiction 6 State Licensing and Certification Websites

Jurisdiction K State Licensing and Certification Websites

Provider Enrollment: Obtaining and Verifying State License

Provider Enrollment: Obtaining and Verifying State License Providers must contact their State agency when initially enrolling or making a change to a current Medicare enrollment for certification materials for their provider/supplier type. For [...]

Certified Provider and State Survey Agency

Certified Provider and State Survey Agency

MLN Connects® Newsletter for Thursday, August 4, 2022

MLN Connects® Newsletter for Thursday, August 4, 2022 ICD-10-CM Code Files: Fiscal Year 2023 News Hospices: Volunteer to Test Hospice Outcomes & Patient Evaluation Instrument Immunization: Protect Your Patients Claims, Pricers, [...]

Modifier 52 Claim Submission Billing Reminder

Modifier 52 Claim Submission Billing Reminder National Government Services found that on many occasions, providers are billing for reduced services with modifier 52 appended to the CPT code; however, they are billing the regular charged amount [...]

Comprehensive Error Rate Testing Redetermination Deadline 9/27/2022

Comprehensive Error Rate Testing Redetermination Deadline 9/27/2022 The CERT RY 2022 is quickly coming to an end. The deadline for redetermination completion is 9/27/2022 to be considered for the CERT RY. National Government Services requests [...]

Comprehensive Error Rate Testing Documentation Deadline 8/22/2022

Comprehensive Error Rate Testing Documentation Deadline 8/22/2022 The CERT RY 2022 is quickly coming to an end. In order to give sufficient time for the CERT RC to complete the review of your claims, all documentation and additional [...]

October 2022 Release "Dark Days" for the Common Working File Hosts

October 2022 Release "Dark Days" for the Common Working File Hosts For the upcoming October 2022 Release: For Production, CWF will be observing the Gray Day on Thursday, September 29th and Dark Days starting Friday, September 30th through [...]

MLN Connects® Newsletter for Thursday, August 11, 2022

MLN Connects® Newsletter for Thursday, August 11, 2022 Monkeypox & Smallpox Vaccines: New Product Codes News Monkeypox & Smallpox Vaccines: New Product Codes Payment Allowance Update for COVID-19 Monoclonal Antibody Therapy [...]

CMS Identifies National System Issue

CMS Identifies National System Issue CMS identified a national system issue, which may have inadvertently adjusted previously processed Part B claims with dates of service (DOS) on or after January 1, 2021. These adjustments processed on July [...]

National Government Services Medicare Spring 2022 Virtual Conference

National Government Services Medicare Spring 2022 Virtual Conference Medicare For You Wednesday, 5/11/2022 – Thursday, 5/12/2022 The NGS Provider Outreach and Education Team is holding our latest bi-annual virtual conference on Wednesday, [...]

Log Out

Log Out You will be logged out of NGSConnex automatically after 30-minutes of inactivity. This is a CMS - security requirement to protect provider and beneficiary information. When you are ready to exit the system, click Log Out icon located [...]

Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow!

Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow! Medicare for You offers valuable information that is fundamental for you, as a provider, to submit claims with the needed information so you realize the [...]

Submit an Adjustment to Correct Claims Partially Denied by Automated LCD-NCD Denials

Submit an Adjustment to Correct Claims Partially Denied by Automated LCD-NCD Denials NGS would like to remind providers that using adjustment reason code “LN” to submit adjusted claims (xx7, xxQ), where changes were made to an LCD/NCD denied [...]

Screen Movements

  Chapter III: Navigating the Online System Screen Movements Purpose To move within the FISS/DDE Provider Online System, providers will perform several different screen movements. The following chart outlines the various screen [...]

Credit Balance Report - CMS 838 (R3)

Chapter VII: Online Reports View Submenu (04) Credit Balance Report - CMS 838 (R3) Purpose Credit balance reporting is used to certify whether you have any outstanding monies owed to the Medicare Program. Part A providers submit credit [...]

MLN Connects® Newsletter for Thursday, August 18, 2022

MLN Connects® Newsletter for Thursday, August 18, 2022 Discontinuing Use of Certificates of Medical Necessity & Durable Medical Equipment Information Forms    News CMS Discontinuing the Use of Certificates of Medical [...]

Accessibility Statement

Accessibility Features of the National Government Services Website The NGSMedicare.com website employs many features to make information more accessible. If you have comments or suggestions, please use our Site Feedback mechanism to let us [...]

MLN Connects® Special Edition for Thursday, August 18, 2022

MLN Connects® Special Edition for Thursday, August 18, 2022 Creating a Roadmap for the End of the COVID-19 Public Health Emergency News Creating a Roadmap for the End of the COVID-19 Public Health Emergency Health Care System Resiliency [...]

New Enrollment Articles Added to Authorization and Accreditation

New Enrollment Articles Added to Authorization and Accreditation We’ve added Eligible Institutional Providers and Eligible Method II Providers articles to our website to provide clarification of Institutional Providers that submit the [...]

Part A Prior Authorization Status Update Requests

Part A Prior Authorization Status Update Requests NGS has noticed an increase in calls to the NGS Provider Customer Service Department requesting an update on the status of a prior authorization request that was made within the last few days. [...]

Email Verification Requirement

How to Register

How to Use Multi-Factor Authentication

NGSConnex Security Requirements

NGSConnex Security Requirements We frequently receive suggestions to improve NGSConnex by implementing less restrictive or eliminating some of our security requirements. Although we understand these security requirements often feel excessive, [...]

What to Expect After Registering

What to Expect After Registering Once you have registered with NGSConnex, you will need to request access for the screens in NGSConnex. To do this, you will need to log into NGSConnex with your User name and password you selected during the [...]

What to Expect After Registering

What to Expect After Registering Once you have registered with NGSConnex, you will need to request access for the screens in NGSConnex. To do this, you will need to log into NGSConnex with your User name and password you selected during the [...]

Provider Enrollment: Description of NPI and Link to NPPES Registry

Provider Enrollment: Description of NPI and Link to NPPES Registry We’ve added Description of NPI and a Link to NPPES Registry in the enrollment section of our website to assist with clarification of the NPI. Posted 8/24/2022

New YouTube Video: Medical Documentation: A/B and DME Collaborative Presentation Now Available

New YouTube Video: Medical Documentation: A/B and DME Collaborative Presentation Now Available The A/B and DME MACs YouTube Video: Medical Documentation: A/B and DME Collaborative Presentation is available. This video offers providers and [...]

MLN Connects® Newsletter for Thursday, August 25, 2022

MLN Connects® Newsletter for Thursday, August 25, 2022 Medicare Secondary Payer: Manual Updates News Interns and Residents Information System XML Format: Updated Vendor List Claims, Pricers, & Codes Integrated Outpatient [...]

Treatment Plans for Cardiac Rehabilitation Services

Treatment Plans for Cardiac Rehabilitation Services ​​​​​​​In order for cardiac rehabilitation services to be covered under Medicare, an individualized treatment plan is required. The individualized treatment plan is a written plan tailored to [...]

Mental Health Crisis Help

Appropriate Use Criteria Program

Capable Recipients for the Advance Beneficiary Notice of Noncoverage

Capable Recipients for the Advance Beneficiary Notice of Noncoverage The purpose of the ABN is to inform a Medicare beneficiary before he or she receives specified items or services that, in this circumstance, Medicare certainly or probably [...]

Medicare Advance Written Notices of Noncoverage Booklet

Provider Compliance Tips for Polysomnography (Sleep Studies)

August and September 2022 LCD, Billing and Coding Article Updates

August and September 2022 LCD, Billing and Coding Article Updates Routine Foot Care and Debridement of Nails – L33636 Under the Limitations section, the active care requirement for systemic conditions has been revised to remove “qualified [...]

Prepare and Submit a Cost Report

MLN Connects® Newsletter for Thursday, June 30, 2022

MLN Connects® Newsletter for Thursday, June 30, 2022 No Surprises Act: Fact Sheets for Your Patients News CMS Issues Significant Updates to Improve the Safety and Quality Care for Long-Term Care Residents & Calls for Reducing Room [...]

MLN Connects® Special Edition for Wednesday, July 27, 2022

MLN Connects® Special Edition for Wednesday, July 27, 2022 3 Final FY 2023 Payment Rules: Hospices, Inpatient Psychiatric Facilities, & Inpatient Rehabilitation Hospices: Learn What’s New for Fiscal Year 2023 Inpatient Psychiatric [...]

MLN Connects® Special Edition for Friday, July 29, 2022

MLN Connects® Special Edition for Friday, July 29, 2022 Skilled Nursing Facilities: Final FY 2023 Payment Rule Skilled Nursing Facilities: Learn What’s New for Fiscal Year 2023 CMS Seeks Public Feedback to Improve Medicare Advantage [...]

MLN Connects® Newsletter for Thursday, September 1, 2022

MLN Connects® Newsletter for Thursday, September 1, 2022 Payment Allowances for Influenza Vaccine News CORRECTION: Monkeypox & Smallpox Vaccines: Include Product Code on Claims COVID-19: Novavax Vaccine Authorized for Patients [...]

Prior Authorization Exemption Status Inquiry Tool Alert

Prior Authorization Exemption Status Inquiry Tool Alert National Government Services continues to see PARs submitted by exempt providers. In an effort to prevent unnecessary submission, NGS has developed a self-service inquiry tool that can [...]

Prior Authorization Exemption Status Inquiry Tool Alert

Prior Authorization Exemption Status Inquiry Tool Alert National Government Services continues to see PARs submitted by exempt providers. In an effort to prevent unnecessary submission, NGS has developed a self-service inquiry tool that can [...]

Seasonal Influenza Vaccines Pricing

Seasonal Influenza Vaccines Pricing For Medicare billing purposes, the flu season runs from August to July of the following year. Medicare Part B covers one flu shot per flu season, if medically necessary, more than one per season may be [...]

Billing for Qutenza Administration (REVISED)

Billing for Qutenza Administration (REVISED) Qutenza is topical high concentration (8%) capsaicin which is administered by a physician. The FDA approved this treatment for neuropathic pain associated with PHN in 2009 and for neuropathic pain [...]

Prior Authorization Exemption Status Inquiry Tool

MLN Connects® Special Edition for Monday, September 12, 2022

MLN Connects® Special Edition for Monday, September 12, 2022 News Updated COVID-19 Vaccines Providing Protection Against Omicron Variant Available at No Cost Posted 9/12/2022

MLN Connects® Newsletter for Thursday, September 15, 2022

MLN Connects® Newsletter for Thursday, September 15, 2022 Make Your Voice Heard News Make Your Voice Heard Request for Information Seeks Public Comment to Promote Efficiency, Reduce Burden, & Advance Equity within CMS Programs [...]

Password Reset Requirements Checklist

Password Reset Requirements Checklist The following information will assist you in successfully resetting your password and eliminate any unnecessary disconnects. You should note that passwords expire every 60 days and can be reset prior to [...]

Changing Your EDI Password

Changing Your EDI Password EDI passwords have to be regularly changed or reset to maintain data security. You should note that passwords expire every 60 days and can be changed or reset prior to expiration. Follow these steps to change your [...]

EDI Self-Service Gateway Password Portal

EDI Self-Service Gateway Password Portal The EDI Gateway Self-Service Password Portal is a simple/secure, web-based process for changing or resetting passwords for EDI Trading Partners. There are differences in the steps for these password [...]

MLN Connects® Newsletter for Thursday, September 22, 2022

MLN Connects® Newsletter for Thursday, September 22, 2022 Encourage Preferred Flu Vaccines for Patients 65+ News Flu Shot: Encourage Preferred Vaccines for Patients 65+ Cataract Surgery: Comparative Billing Report Do You Only Order or [...]

Notice Regarding Targeted Probe and Educate Topic: Breast Ultrasound

Notice Regarding Targeted Probe and Educate Topic: Breast Ultrasound National Government Services has received approval from CMS to deny related claims (modifier 26 and/or TC) in accordance to the CMS IOM Publication 100-08, Medicare Program [...]

Billing and Coding and Medical Policy Article Updates September/October 2022

Billing and Coding and Medical Policy Article Updates September/October 2022 Billing and Coding: Bevacizumab and biosimilars (A52370) Based on Transmittal 11594, (CR 12885) October 2022 Update of the Hospital OPPS, HCPCS code C9142 has been [...]

Reminder: Documenting Physical Therapy Services

Reminder: Documenting Physical Therapy Services Insufficient documentation causes most improper payments. Visit our CERT Alerts webpage for Topic specific articles that provide instructions and resources for submitting appropriate [...]