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  • Posting Date: 02/04/2022
    Notice of Admission Questions and Answers

    Notice of Admission Questions and Answers Medicare requires HHAs to submit a one-time NOA instead of RAPs for new admissions starting on or after 1/1/2022. HHAs shall no longer submit RAPs, TOB 0322 for any HH periods of care with a “From” [...]

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  • Posting Date: 12/30/2022
    Telehealth Home Health Services

    Telehealth Home Health Services Prior to 1/1/2023, data on telecommunications technology used during a 30-day period of care at the patient level was not collected on HH claims. On 7/1/2023 reporting telecommunications G codes became [...]

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  • Posting Date: 07/21/2022
    Late Notice of Admission - The Exception Process

    Late Notice of Admission - The Exception Process Table of Contents Timeliness of the NOA and the Penalty Requirements for Submission of the NOA Exception Process Canceling a Timely NOA to Correct an Error Reasons Not to Cancel an NOA [...]

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  • Posting Date: 05/19/2022
    Home Health Demand Billing

    Home Health Demand Billing Table of Contents Background What is a Demand Bill? Requirements for Submission How to Submit a Demand Bil Claim Page 1: Claim Page 2: Covered and Noncovered Charges Claim Page 2: All Noncovered Charges [...]

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  • Posting Date: 12/05/2017
    Disposable Negative Pressure Wound Therapy Services Under Home Health

    Disposable Negative Pressure Wound Therapy Services Under Home Health Effective for services furnished on or after 1/1/2017, Medicare will make separate payment to HHAs for dNPWT services for patients under the home health benefit. NPWT [...]

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  • Posting Date: 05/09/2022
    Home Health Agency Transfer and Dispute Protocol

    Home Health Agency Transfer and Dispute Protocol Specific protocol and steps must be followed prior to opening an admission period for a new patient. Step One: Verify the patient’s eligibility You must ensure the patient is not [...]

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  • Posting Date: 12/20/2016
    Reporting Site of Service Codes for Home Health Care

    Reporting Site of Service Codes for Home Health Care HH PPS claim payments are based on the site of the beneficiary’s care. In order for Medicare to accurately capture where home health services are provided, HHAs are required to report the [...]

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  • Posting Date: 04/11/2017
    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 [...]

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  • Posting Date: 05/08/2023
    Home Health Billing When a New MBI is Assigned

    Home Health Billing When a New MBI is Assigned A patient’s MBI number is required on all home health billing submitted to Medicare. CMS will issue a new MBI when an original MBI may have been, or has been compromised. There are times a home [...]

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  • Posting Date: 01/13/2022
    Billing the Home Health Notice of Admission Electronically

    Billing the Home Health Notice of Admission Electronically Table of Contents Billing the Home Health Notice of Admission Electronically NOA Claim Page 1 NOA Claim Page 2 NOA Claim Page 3 NOA Claim Page 4 NOA Claim Page 5 [...]

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  • Posting Date: 09/23/2015
    Completing the Advance Beneficiary Notice for Home Health Agency Demand Claims

    Completing the Advance Beneficiary Notice of Noncoverage for Home Health Agency Demand Claims The purpose of the ABN is to appropriately notify a Medicare beneficiary of services that the HHA believes Medicare will not cover. In order for the [...]

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  • Posting Date: 12/16/2020
    The Medicare Home Infusion Therapy Benefit and Home Health Agencies

    The Medicare Home Infusion Therapy Benefit and Home Health Agencies If you are a HHA that wants to provide and bill Medicare HIT professional services starting in CY 2021, you are required to enroll with the Part B Medicare Administrative [...]

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  • Posting Date: 07/24/2017
    Home Health Therapy Billing

    Home Health Therapy Billing Table of Contents Home Health Therapy Billing 32X TOB: Billing Therapy Under a Home Health Plan of Care Discipline Revenue Codes (UB-04 FLs 42-43) Discipline HCPCS Codes (UB-04 FL 44) Service Units [...]

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  • Posting Date: 08/13/2020
    How to Get Started - Five Easy Steps

    How To Get Started – Five Easy Steps Contact your vendor, clearinghouse or billing service to ensure they support the electronic attachment program which includes the following: 6020 version of the 275 transaction; HL7 CDA R2 [...]

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  • Posting Date: 07/09/2020
    Participating Clearinghouses and Vendors

    Participating Clearinghouses and Vendors The following entities support electronic attachments with NGS. Any of these entities can assist you with implementing electronic attachments and participating in the NGS Attachment Program. [...]

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  • Posting Date: 03/01/2022
    Benefits of Electronic Remittance Advice

    Benefits of Electronic Remittance Advice Table of Contents Benefits of Electronic Remittance Advice There Are Several Benefits to Choosing ERA Versus SPR Help Interpreting the ERA Is Available [Return to Top] Benefits of Electronic [...]

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  • Posting Date: 08/10/2023
    Duplicate Claim Editing Information

    Duplicate Claim Editing Information National Government Services implemented a Part A duplicate claim edit in our EDI front-end processing system. Providers are notified that a claim is a duplicate upon receipt of the 277 Claims [...]

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  • Posting Date: 03/08/2021
    Related Content

    Related Content WPC Health Care Code Lists Health Care Payment and Remittance Advice: Provides information on ERA and companion documents for assistance with receiving the Transaction 835. CMS IOM Publication, Medicare Claims Processing [...]

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  • Posting Date: 02/17/2022
    How to Get Started

    How to Get Started Making the change is easy. If you use a clearinghouse to submit claims, contact your clearinghouse to ask how to enroll for the electronic remittance service. If you currently have a claim submission software program, [...]

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  • Posting Date: 09/19/2022
    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 [...]

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