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Posting Date: 10/15/2021
Physician Dialysis Services
Physician Dialysis Services Table of Contents Physician Dialysis Services Monthly Capitation Payment Coding Claim Submission Tips Billing for a Partial Month Documentation Requirements Related Content [...]
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Posting Date: 11/23/2021
Oncology Care Model
Oncology Care Model Note: If you did not register for the CMS OCM during the open application and selection period, then you are not a part of this program. The names of those practices and payers participating in OCM can be found on the OCM [...]
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Posting Date: 11/29/2021
Spinraza (nusinersen) Billing
Spinraza (nusinersen) billing Spinraza (nusinersen) is a medication that was approved in December 2016 by the U.S. FDA for the treatment of all forms of SMA. HCPCS code J2326 - Inj, nusinersen, 0.1mg should be used to report Spinraza. [...]
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Posting Date: 02/22/2023
Chimeric Antigen Receptor (CAR) T-cell Therapy
Chimeric Antigen Receptor (CAR) T-cell Therapy Table of Contents NCD 110.24: Chimeric Antigen Receptor (CAR) T-cell therapy: Billing Instructions Overview Billing and coding CAR T-cell therapy for inpatient services Clinical [...]
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Posting Date: 09/19/2024
MLN Connects® Newsletter: September 19, 2024
MLN Connects® Newsletter: September 19, 2024 News Resources & Flexibilities to Assist with the Public Health Emergency in Louisiana Skilled Nursing Facilities: Report Your Expanded Ownership, Management, & Related Party Data [...]
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Posting Date: 09/19/2024
Billing Errors on 2024/2025 Influenza Season Claims
Billing Errors on 2024/2025 Influenza Season Claims The influenza season runs from August 1st of each year until July 31st the following year. Every influenza vaccine is assigned a new NDC each season. This season, some codes no longer have a [...]
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Posting Date: 01/19/2022
Learn About MDPP
Learn About MDPP The MDPP expanded model includes an evidence-based set of services aimed to help prevent the onset of type 2 diabetes among Medicare beneficiaries with an indication of prediabetes. MDPP services is available to eligible [...]
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Posting Date: 01/19/2022
Framework for Prevention and Goals
Framework for Prevention and Goals CMS along with the CDC provides a framework for diabetes prevention efforts. It brings together partners from the public and private sectors to prevent or delay type 2 diabetes. The MDPP is structured [...]
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Posting Date: 01/19/2022
Delivering a Lifestyle Change for Medicare Beneficiaries
Delivering a Lifestyle Change for Medicare Beneficiaries Providers play a vital role in beneficiary referrals. Although a referral is not required, a provider’s assessment during the AWV or the IPPE is strongly recommended by NGS. Providers [...]
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Posting Date: 01/19/2022
Receiving CDC Recognition and Medicare Enrollment
Receiving CDC Recognition and Medicare Enrollment Organizations who wish to furnish MDPP services to beneficiaries and bill Medicare for those services must enroll in Medicare as an MDPP supplier. To become a Medicare-enrolled MDPP supplier, [...]
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Posting Date: 01/19/2022
MDPP Codes and Payment Amounts 2023
MDPP Codes and Payment Amounts 2023 HCPCS G-codes are used when submitting claims to bill Medicare for payment. MDPP HCPCS G-codes may be used only one time per eligible beneficiary (except for G9890 and G9891). The initial session (G9873) [...]
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Posting Date: 02/06/2024
MDPP Codes and Payment Amounts 2024
MDPP Codes and Payment Amounts 2024 Medicare pays up to 22 visits billed with codes G9886 and G9887, combined, in a 12-month period: Months 1–6: one in-person/distance learning visit every week (up to 16) Months 7–12: one [...]
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Posting Date: 01/19/2022
MDPP Billing Information
MDPP Billing Information In addition to the usual information that needs to be completed to file a claim for a Medicare Part B service to your MAC, you will need to complete the following items of the CMS-1500 form or electronic equivalent [...]
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Posting Date: 01/19/2022
Contact Information and Resources
Contact Information and Resources Inquiry Type Examples Help Desk Contact Information Process of MDPP CDC Recognition Credential via CDC, check status of application for CDC recognition or submitting [...]
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Posting Date: 11/15/2021
Prevent Revalidation Processing Delays
Prevent Revalidation Processing Delays When National Government Services receives a revalidation application, we often determine additional information is needed to process the application. In those cases, a request for additional information [...]
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Posting Date: 08/01/2024
Medicare University
Medicare University National Government Services offers a variety of teleconferences, webinars and face-to-face educational sessions on Medicare-related topics including rules and regulations throughout the year. Medicare University (MU), our [...]
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Posting Date: 09/10/2024
Expected Timeframes for Therapy Services
Expected Timeframes for Therapy Services CMS and CPT guidelines for provider time spent and documented on therapy services may vary, depending on the definition of the service and the context in which it is performed. Therapy services [...]
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Posting Date: 06/22/2022
Standard Companion Guide Trading Partner Information
Standard Companion Guide Trading Partner Information Instructions Related to the X12 277 Health Care Claim Request for Additional Information Version 6020 Companion Guide Version Number: 6.0 Revised: October 2019 Preface Companion Guides [...]
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Posting Date: 04/20/2022
Standard Companion Guide Trading Partner Information
Standard Companion Guide Trading Partner Information Instructions Related to the X12 278 and 275 Prior Authorization Transactions Companion Guide Version Number: 1.0 Created: April, 2022 Preface Companion Guides (CG) may contain two types of [...]
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Posting Date: 06/15/2022
Creating a 276 Claim Status Request in PC-ACE
Creating a 276 Claim Status Request in PC-ACE Claim Status Request Files must be prepared and transmitted using communication software. Select INST or PROF from the PC-ACE Claims Processing System main menu. Select List Claims [...]
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