Diabetes Self-Management Training, Diabetes Screening Tests, and Medical Nutrition Therapy

During this webinar, we'll review the coverage, coding and billing guidelines for diabetes screening tests, diabetes self-management training, and medical nutrition therapy.

Bone Mass Measurements, Colorectal and Prostate Cancer Screenings

During this webinar, we'll review the coverage, coding and billing guidelines for bone mass measurements, colorectal and prostate cancer screenings.

Counseling to Prevent Tobacco Use and Lung Cancer Screening

During this webinar, we'll review the coverage, coding and billing guidelines for the Medicare preventive services benefits of counseling to prevent tobacco use.

Flu, COVID-19 and PPV Vaccines

During this webinar, we'll review the coverage, coding and billing guidelines for influenza, pneumococcal and COVID-19 vaccine administration and billing.

Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2025

Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2025 Table of Contents Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2025 Advantages of Being a Medicare-Participating [...]

Medicare Participating Physician or Supplier Agreement Form (CMS-460)

Next Week - 2024 Preventive Services Virtual Conference!

Next Week – 2024 Preventive Services Virtual Conference! We hope you’re as excited as we are about the upcoming National Government Services Medicare Part B 2024 Preventive Services Virtual Conference, taking place on December 9th to 11th! [...]

Get Help with Rejected/Denied Enrollment Application

Table of Contents Get Help with Rejected/Denied Enrollment Application Determine the Application Status Understand Rejection or Denial Related Content [Return to Top] Get Help with Rejected/Denied Enrollment Application The CMS IOM [...]

Get Help with Rejected/Denied Enrollment Application

Table of Contents Get Help with Rejected/Denied Enrollment Application Determine the Application Status Understand Rejection or Denial Related Content  Get Help with Rejected/Denied Enrollment Application The CMS IOM Publication [...]

Get Help with Rejected/Denied Enrollment Application

Table of  Contents   Get Help with Rejected/Denied Enrollment Application Determine the Application Status Understand Rejection or Denial Related Content Get Help with Rejected/Denied Enrollment Application The CMS IOM [...]

Requests for Additional Information

Table of Contents Requests for Additional Information Paper Application Submissions PECOS Application Submissions [Return to Top] Requests for Additional Information While processing the application(s), National Government [...]

Introduction

Medicare Part B 101 Manual: Introduction Medicare Program for Part B Providers Table of Contents Introduction Medicare Administrative Contractors Medicare Contracting Reform Providers Responsible for Knowing Guidelines Medicare Part A [...]

Interactive Voice Response System

Interactive Voice Response System State IVR Number Hours Available* Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont 877-567-7205 Monday–Friday: 6:00 a.m.–7:00 p.m. ET [...]

Interactive Voice Response System

Interactive Voice Response System State IVR Hours Available* Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont 877-869-6504 Monday–Friday: 6:00 a.m.–7:00 p.m. ET Saturday: [...]

Interactive Voice Response System

Interactive Voice Response System State IVR Number Hours Available* Alaska, Arizona, California, Hawaii, Idaho, Nevada, Oregon, Washington, American Samoa, Guam, Northern Mariana Island 866-277-7287 [...]

Interactive Voice Response System

Interactive Voice Response System Toll-Free Number 877-309-4290 Hours Available* Monday–Friday: 6:00 a.m.–7:00 p.m. ET Saturday: 7:00 a.m.–3:00 p.m. ET *IVR hours represent general availability for access to all menu options. The IVR is [...]

MLN Connects® Newsletter: December 5, 2024

MLN Connects® Newsletter: December 5, 2024 News Clinical Laboratory Fee Schedule: CY 2025 Final Payment Determinations CMS Roundup (November 29, 2024) Advanced Primary Care Management Services: Get Information about Billing Medicare Flu [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Written Correspondence and Inquiries [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Written Correspondence and Inquiries [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Written Correspondence and Inquiries [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Written Correspondence and Inquiries [...]

Common Working File (CWF) Host Dark Days for January 2025 Release

Common Working File (CWF) Host Dark Days for January 2025 Release  For Production, 1/1/2025 – Observe Holiday – No Cycle, CWF will be observing the Gray Day on Thursday, 1/2/2025 and Dark Days starting Friday, 1/3/2025 through Sunday, [...]

Method II CAH Claims Not Paying Professional Services with Revenue Codes 096x-098x

Certain CAH claims (TOB 85X) with professional service revenue codes 096x – 098X did not process for payment because the fee amount was not correctly retrieved during processing. The affected claims have receipt/processed dates in October 2024.

Billing Protections for Qualified Medicare Beneficiaries

Screening Mammography, Pap Test and Pelvic Exam

Ensure that your patients obtain the preventive services they are eligible for by knowing the Medicare coverage, coding and billing guidelines for screening mammograms, pap tests and pelvic examinations, as well as where to find more [...]

Incarcerated or Unlawfully present in the US claim rejections (U538H, U538Q)

Incarcerated or Unlawfully Present in the U.S. Claim Rejections (U538H, U538Q) This stringent claim editing process helps ensure that Medicare does not make payments for services rendered to beneficiaries who are not eligible due to being [...]

Annual Logon ID Recertification for New York/Connecticut Regions

All users who access the FISS DDE system are required by the CMS to recertify their access annually. National Government Services will designate one state at a time to complete the annual logon recertification. To complete the recertification [...]

January 2025 EDI Front End Quarterly Release

January 2025 EDI Front End Quarterly Release Please be advised that while the Centers for Medicare & Medicaid Services mandated release for January 2025 will be installed the weekend of 1/5/2025, the code set updates included with this [...]

U5233

Avoiding/Correcting This Error Verify the admission date, from, and through dates on the claim and compare the dates to the MAO/HMO entitlement dates. Outpatient facilities and IPPS and IRF hospitals, or LTCH billing services within an [...]

Correct a Beneficiary's MSP Record

Table of Contents Background Step 1: Provider Receives Information Indicating Medicare Is the Primary Payer for a Beneficiary's Services Step 2: Prepare and Submit a Medicare Primary Claim With the Reason Medicare Is the Primary Payer [...]

Ambulance Services and Establishing Medical Necessity for Part B Providers

This webinar will help the ambulance community understand the importance of medical necessity as it pertains to Medicare’s coverage guidelines.

Certified Provider and State Survey Agency

Certified Provider and State Survey Agency Table of Contents Certified Provider and State Survey Agency Certified Providers/Suppliers Certified Providers and Certified Suppliers That Enroll Via the Form CMS-855A Certified Suppliers That [...]

34963

Avoiding/Correcting This Error Verify billing and, if appropriate correct and return the claim. Online providers should press PF9 to restore the claim. Related Content New Fiscal Intermediary Shared System Consistency Edit to Validate [...]

34963

Avoiding/Correcting This Error Verify billing and, if appropriate correct and return the claim. Online providers should press PF9 to restore the claim. Related Content New Fiscal Intermediary Shared System Consistency Edit to Validate [...]

Overcoming Barriers to Tobacco Counseling

Overcoming Barriers to Tobacco Counseling Healthcare providers may face different challenges when implementing tobacco cessation counseling into a clinical practice routine. These various factors influence the healthcare professionals’ [...]

34963

Avoiding/Correcting This Error Verify billing and, if appropriate correct and return the claim. Online providers should press PF9 to restore the claim. Related Content New Fiscal Intermediary Shared System Consistency Edit to Validate [...]

Understanding the Approval Recommendation Process for Certified Providers

The certified provider completes and submits a CMS-855 enrollment application and all supporting documentation to its MAC, including any state require documentation and certifications according to the supplier type. The MAC reviews the [...]

Certified Provider and State Survey Agency

Certified Provider and State Survey Agency Table of Contents Certified Provider and State Survey Agency Certified Providers/Suppliers Certified Providers and Certified Suppliers That Enroll Via the Form CMS-855A Certified Suppliers [...]

Understanding the Approval Recommendation Process for Certified Providers

Understanding the Approval Recommendation Process for Certified Providers The certified provider completes and submits a CMS-855 enrollment application and all supporting documentation to its MAC, including any state require documentation [...]