Get Your PS&R Reports

The PS&R report is a tool used by Part A providers and MACs to prepare and process Medicare cost reports. Table of Contents Register to Receive the PS&R Report Instructions on How to Use Redesign Detail Reports [Return to Top] [...]

Request a Due Date Extension

It may be necessary to request an extension for your cost report due date because of an extraordinary circumstance. An example of an extraordinary circumstance would be a flood or fire that forces a provider to cease operations and transfer [...]

Request a Due Date Extension

It may be necessary to request an extension for your cost report due date because of an extraordinary circumstance. An example of an extraordinary circumstance would be a flood or fire that forces a provider to cease operations and transfer [...]

MLN Connects® Newsletter: May 9, 2024

MLN Connects® Newsletter: May 9, 2024 News HHS Releases New Data Showing Over 10 million People with Medicare Received a Free Vaccine Because of the President’s Inflation Reduction Act; Releases Draft Guidance for the Second Cycle of [...]

Submission of a Medicare Cost Report Reopening Request

Submission of a Medicare Cost Report Reopening Request In accordance with CMS policy (42 Code of Federal Regulations 405.1885 and CMS IOM Publication 15-1, The Provider Reimbursement Manual, Section 2931), a provider may request a reopening of [...]

Request an Accelerated Payment

Medicare Part A guidelines provide for accelerated payments under highly exceptional circumstances. Accelerated payment criteria and eligibility requirements are outlined in the CMS Paper-Based Manuals Publication 15-1, Medicare Provider [...]

Request an Interim Rate Adjustment

When requesting an interim rate adjustment, it's important to submit your interim financial data to National Government Services using the appropriate Interim Rate Review Documentation Request Form. These forms are designed to capture important [...]

Request an Interim Rate Adjustment

When requesting an interim rate adjustment, it's important to submit your interim financial data to National Government Services using the appropriate Interim Rate Review Documentation Request Form. These forms are designed to capture important [...]

CMS Medicare Administrative Contractor Information

CMS Medicare Administrative Contractor Information Note: Please do not include PHI such as Medicare numbers within emails. Navigation [Part A] [Part B] [DME MAC] [Federally Qualified Health Center] [Home [...]

Physicians: Are You Ordering Knee Orthosis for Your Patients?

Physicians: Are You Ordering Knee Orthosis for Your Patients? This is your opportunity to hear directly from the Medicare contractors regarding documentation required for the coverage criteria to be met. You’ll also learn how to help your [...]

Staying Up To Date on Vaccines

Staying Up To Date on Vaccines It's important to stay up to date on vaccines. Vaccines protect your patients from serious illness and can keep them out of the hospital. Talk with your patients about which vaccines may be right for them, many [...]

File an Amended Cost Report

Table of Contents File an Amended Cost Report Timeframe to Amend the Medicare Cost Report [Return to Top] File an Amended Cost Report A provider may elect to submit an amended cost report subsequent to the initial filing. The Centers [...]

File an Amended Cost Report

A provider may elect to submit an amended cost report subsequent to the initial filing. The CMS Medicare Paper-Based Manuals Publication 15-1, Provider Reimbursement Manual—Part I, Chapter 29 Section 2931.2A, allows the Medicare Administrative [...]

Prepare and Submit a Cost Report

Table of Contents Prepare and Submit a Cost Report Submit Cost Report Documentation MCReF Other Electronic Media Formats Electronic Filing Requirements and List of Vendors Approved XML IRIS Vendors Home [...]

Contacting Medicare

Contacting Medicare Medicare constituents (or People with Medicare) can have their Medicare questions answered by calling 1-800-MEDICARE (1-800-633-4227) 24-hours a day; 7-days a week. 1-800-MEDICARE users can speak to a live person either by [...]

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

Medicare’s Annual Wellness Visit in Minnesota: 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 [...]

Billing & Claim Forms

Billing & Claim Forms Medicare Authorization to Disclose Medicare Information Use this form to advise Medicare of the person or persons you have chosen to have access to your personal health information. Patient's Request for Medical [...]

Claim Data Entry

Chapter V: Claims/Attachments Submenu (02) Claim Data Entry Purpose The Claims Entry options allows the provider to enter claims and roster bills electronically into the FISS DDE Provider Online System. To initiate claim data entry [...]

FQHC and Group Therapy Services Job Aid

FQHC and Group Therapy Services Job Aid Historically, federally qualified health center’s (FQHC’s) billing instructions have been the same. However, effective 1/1/2011, the billing requirements changed for this facility type. Beginning with [...]

Revenue Codes (13)

Chapter IV: Inquiries Submenu (01) Revenue Codes (13) Purpose The purpose of the REVENUE CODES option is to provide access to details related to the revenue codes available to be reported on a claim. A revenue code is a four-digit number [...]

Determine if Medicare Will Make Payment on an MSP Claim

Table of Contents Determine if Medicare Will Make Payment on an MSP Claim Step 1: Determine if Medicare will Make an MSP Payment Step 2: Determine the Amount of Secondary Benefits Billing Reminders Which Can Affect your Medicare [...]

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

Provider Based Determinations

Table of Contents Provider Based Determinations Processing of Provider-Based Determinations MAC Provider-Based Designation Checklist Related Content [Return to Top] Provider Based Determinations On 4/18/2003, CMS issued a Program [...]

FY 2025 Occ Mix Hospital Letter Final

FY 2025 Occ Mix Hospital Letter Final CY 2022 Medicare Occupational Mix Survey Submission Section 1886(d) (3) (E) of the Social Security Act requires CMS to collect data every three years on the occupational mix of employees for each [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

Cost Report Submission Checklist

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 [...]

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 [...]

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 [...]

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

Accelerated Payments to Providers

Advance Payments to Providers

Billing Overlap/Dispute Resolution Process

Billing Overlap/Dispute Resolution Process Table of Contents Billing Overlap/Dispute Resolution Process Mailing Addresses and Fax Number JK: J6: General Inquiries JK: J6: [Return to Top] Billing Overlap/Dispute [...]

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 [...]

Overlapping Claim Tips for Resolution

Overlapping Claim Tips for Resolution Table of Contents Overlapping Claim Tips for Resolution Type of Bills Impacted Inpatient Hospital Overlap Tips Hospital Discharge Coding Hospital Overlapping with Home Health Care Hospital [...]

Medicare Beneficiary Identifier

The MBI is the patient identification number assigned to Medicare beneficiaries. Claims submitted to Medicare contractors must contain the MBI. In 2020, CMS removed the SSN based identifier from the Medicare card to protect beneficiaries and [...]

Exceptions

The official transition period for the new Medicare Number has ended. The MBI should be used for all of your transactions and inquires. CMS will continue to accept the HICN on the following data exchanges after 1/1/2020. These are the only [...]

Medicare Hospice Quick Reference Sheet

Medicare Hospice Quick Reference Sheet The codes listed below are only those most frequently applicable to hospice claims. For a complete list of codes, see the NUBC manual. The NUBC maintains the UB-04 data element specifications and revenue [...]

Education Partnership Request Form

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 [...]

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Beginning June 4th!

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Beginning June 4th! Seats are filling up quickly for our 2024 Spring/Summer Virtual Conference: Mastering Medicare- Tuesday [...]

More Medicare Resources

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

Attention All Providers, Billing Services and Clearinghouses Who Submit and Receive NGS EDI Transactions

Attention All Providers, Billing Services and Clearinghouses Who Submit and Receive NGS EDI Transactions As a reminder, when submitting the EDI Enrollment Application to National Government Services, only one form should be completed for any [...]

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 [...]

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 [...]

JK Part A Immediate Recoupment Request Form