Need Answers? The Options to Consider Before Calling or Writing Into Medicare

National Government Services self-service options and other channels can answer most of provider’s questions. During this session, we will show you how to effectively utilize these tools.

Description of Application Fee

The application fee is imposed on institutional providers and suppliers to cover enrollment costs. The application fee for calendar year 2025 is $730. Related Content Federal Register Notice ‒ information about how the fee was calculated [...]

Description of Application Fee

Description of Application Fee The application fee is imposed on institutional providers and suppliers to cover enrollment costs. The application fee for calendar year 2025 is $730. Related Content Federal Register Notice ‒ information [...]

Description of Application Fee

Description of Application Fee The application fee is imposed on institutional providers and suppliers to cover enrollment costs. The application fee for calendar year 2025 is $730. Related Content Federal Register Notice ‒ information [...]

Description of Application Fee

Description of Application Fee The application fee is imposed on institutional providers and suppliers to cover enrollment costs. The application fee for calendar year 2025 is $730. Related Content Federal Register Notice ‒ information [...]

How to Submit a Hardship Request

How to Submit a Hardship Request To request a hardship consideration, submit with a letter and any supporting documentation describing the hardship and why it justifies the exception for your application. Your hardship request will not be [...]

How to Submit a Hardship Request

How to Submit a Hardship Request To request a hardship consideration, submit with a letter and any supporting documentation describing the hardship and why it justifies the exception for your application. Your hardship request will not be [...]

How to Submit a Hardship Request

How to Submit a Hardship Request To request a hardship consideration, submit with a letter and any supporting documentation describing the hardship and why it justifies the exception for your application. Your hardship request will not be [...]

How to Submit a Hardship Request

To request a hardship consideration, submit with a letter and any supporting documentation describing the hardship and why it justifies the exception for your application. Your hardship request will not be considered if it is received [...]

Observance of Fourth of July 2025

Observance of Fourth of July 2025 In observance of the Fourth of July 2025, National Government Services offices will be closed on Friday, 7/4/2025. Please note: EDI claim files transmitted after 4:00 p.m. central time/5:00 p.m. eastern time [...]

CAH, FQHC and RHC Quarterly Top Claim Errors

Do you struggle with your claim denials, rejections and return to provider (RTP) claims? Do you want to be proactive in preventing unnecessary errors? Join us in a review of top claim errors for your provider type based on recent data analysis [...]

Hospital, CMHC, CORF/ORF and ESRD Facilities Quarterly Top Claim Errors

Do you struggle with your claim denials, rejections and return to provider (RTP) claims? Do you want to be proactive in preventing unnecessary errors? Join us in a review of top claim errors for your provider type based on recent data analysis [...]

National Government Services Important Update

National Government Services Important Update ALERT: Medicare Fraud Scheme Involving Phishing Fax Requests National Government Services wants to share with our providers an urgent issue that has been identified by CMS. CMS has been flooded [...]

How to Pay the Application Fee

The application fee must be paid electronically. Important: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee using the Provider Enrollment, [...]

How to Pay the Application Fee

How to Pay the Application Fee The application fee must be paid electronically. IMPORTANT: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee [...]

How to Pay the Application Fee

How to Pay the Application Fee The application fee must be paid electronically. Important: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee [...]

How to Pay the Application Fee

How to Pay the Application Fee The application fee must be paid electronically. Important: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee [...]

Who Needs to Pay Application Fees

Who Needs to Pay Application Fees Institutional providers or suppliers must submit an application fee or hardship exception when initially enrolling, revalidating their enrollment or adding a new Medicare practice location. Physicians, [...]

Who Needs to Pay Application Fees

Institutional providers or suppliers must submit an application fee or hardship exception when initially enrolling, revalidating their enrollment or adding a new Medicare practice location. Physicians, nonphysician practitioners, physician [...]

Who Needs to Pay Application Fees

Who Needs to Pay Application Fees Institutional providers or suppliers must submit an application fee or hardship exception when initially enrolling, revalidating their enrollment or adding a new Medicare practice location. Physicians, [...]

Who Needs to Pay Application Fees

Who Needs to Pay Application Fees Institutional providers or suppliers must submit an application fee or hardship exception when initially enrolling, revalidating their enrollment or adding a new Medicare practice location. Physicians, [...]

LCD and Billing and Coding Article Updates – 2025

LCD and Billing and Coding Article Updates – 2025 January Psychiatric Partial Hospitalization Programs L33626 Effective 1/1/2024, in the Coverage Indications, Limitations and/or Medical Necessity section, the third list under Limitations has [...]

Fee Schedule Assistance

Fee Schedule Assistance Connecticut Illinois Locality/Area and County Information Maine, Massachusetts, New Hampshire, Rhode Island, Vermont Locality/Area and County Information New York Locality/Area and County Information Locate and [...]

Self-Administered Drug Exclusion (J6 and JK)

Self-Administered Drug Exclusion Update (J6 and JK) Medications that are self-administered more than 50% of the time for all Medicare beneficiaries are excluded from Medicare Part B coverage.  At the direction of CMS, each MAC shall [...]

Ambulance Transports Included in SNF Consolidated Billing

Ambulance Transports Included in SNF Consolidated Billing Transport Description Medical Necessity Met Ambulance Billing Modifiers and Other Considerations Who is Responsible for Payment? Reference(s) SNF to [...]

Hospital-Based Ambulance Basic Billing Guidelines

Hospital-Based Ambulance Basic Billing Guidelines For hospital-based ambulance billing under Medicare, services should be billed on the UB-04 form using the ambulance service-specific NPI, not the acute hospital NPI, and claims for inpatient [...]

National AB Medicare Administrative Contractor Ambulance Provider/Supplier Coalition

National AB Medicare Administrative Contractor Ambulance Provider/Supplier Coalition Attention Ambulance Providers In response to numerous and continued requests from the ambulance community, the AB MACs have put together a National AB MAC [...]

Medical Necessity of Ambulance Services

Medical Necessity of Ambulance Services Table of Contents Medical Necessity of Ambulance Services What You Can Do Nearest Appropriate Facility: GY Modifier What You Can Do Related Content [Return to Top] Medical [...]

Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity

Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity Recent National Government Services educational efforts have highlighted an issue between facilities and the ambulance [...]

MLN Connects® Newsletter: June 26, 2025

MLN Connects® Newsletter: June 26, 2025 News Alert: Medicare Fraud Scheme Involving Phishing Fax Requests Medicare Diabetes Prevention Program: CY 2025 Payment Rates Compliance Commodes, Bed Pans & Urinals: Prevent Claim Denials [...]

The Incident To Provision for Medicare

Do you have nonphysician practitioners that are, or could be, providing services incident to the physicians in the practice? Are you following the Centers for Medicare & Medicaid Services (CMS) regulations for this program? Staying [...]

Learn Over Lunch – NGSConnex Inquiries

Effective 5/27/2025, National Government Services will no longer accept inquiries submitted through the postal service to any of our P.O. Boxes or faxed to any of our fax lines. Are you prepared? Join this session to learn how to efficiently [...]

Lets Chat about Federally Qualified Health Center Billing and Reimbursement

Need answers on FQHC billing and reimbursement without attending a full training? Join our 30-minute "Let's Chat" session. This informal discussion allows providers to engage with our Provider Outreach and Education team. You are [...]

Lets Chat about Federally Qualified Health Center Billing and Reimbursement

Need answers on FQHC billing and reimbursement without attending a full training? Join our 30-minute "Let's Chat" session. This informal discussion allows providers to engage with our Provider Outreach and Education team. You are [...]

Electronic Funds Transfer

Electronic Funds Transfer EFT allows for claim payments to be electronically transferred to your bank in place of a hard copy check mailed to the facility. Medicare payments due a provider or supplier of services may be sent to a bank (or [...]

Electronic Funds Transfer

EFT allows for claim payments to be electronically transferred to your bank in place of a hard copy check mailed to the facility. Medicare payments due a provider or supplier of services may be sent to a bank (or similar financial institution) [...]

Eligible Method II Providers

Eligible Method II Providers If a CAH wants to become a Method II biller, email the request to A&R at ngsreimbursement@anthem.com.  Suppliers who can enroll as a Method II Biller Reassignment. Doctor of Medicine (MD) Doctor of [...]

Verify Bank Account Information

National Government Services receives numerous electronic funds transfer banking rejections each year due to frozen or closed bank accounts. To prevent interruption in Medicare payment, billing providers verify an active bank account is [...]

Verify Bank Account Information

Verify Bank Account Information National Government Services receives numerous electronic funds transfer banking rejections each year due to frozen or closed bank accounts. To prevent interruption in Medicare payment, billing providers verify [...]

Electronic Funds Transfer Form and Instructions

Table of Contents Electronic Funds Transfer Form and Instructions CMS-588 EFT Completion Tips for Sole Proprietors, Sole Owners, Clinic/Groups, Organizations, Providers and Suppliers [Return to Top] Electronic Funds Transfer Form and [...]

Electronic Funds Transfer Form and Instructions

Electronic Funds Transfer Form and Instructions Table of Contents Electronic Funds Transfer Form and Instructions  CMS-588 EFT Completion Tips for Sole Proprietors, Sole Owners, Clinic/Groups, Organizations, Providers and Suppliers [...]

SNF and Swing Bed Quarterly Top Claim Errors

Do you struggle with your claim denials, rejections and return to provider (RTP) claims? Do you want to be proactive in preventing unnecessary errors? Join us in a review of top claim errors for your provider type based on recent data analysis [...]

Long-Term Care Hospitals: Preparing and Submitting Compliant Inpatient Claims

In this webinar, we will review Medicare's general inpatient billing requirements for Long-Term Care Hospitals including bill types, billing frequency, interim billing, benefits exhaust billing, billing when claims are paid by Medicare [...]

Medicare Secondary Payer: A Review of the End-Stage Renal Disease with an Employer Group Health Plan Provision – Part 1

This is a two-part webinar; we suggest you attend both parts. In Part 1 on 7/29/2025, we will review the End-Stage Renal Disease with an EGHP Medicare Secondary Payer provision as it applies to patients eligible for Medicare based solely on [...]

Medicare Secondary Payer: A Review of the End-Stage Renal Disease with an Employer Group Health Plan Provision – Part 2

This is a two-part webinar; we suggest you attend both parts. In Part 1 on 7/29/2025, we will review the End-Stage Renal Disease with an EGHP Medicare Secondary Payer provision as it applies to patients eligible for Medicare based solely on [...]

Improving Customer Experience

Improving Customer Experience We are committed to improving your experience. Please watch this two-minute video that explains how each day we review comments from providers who submit surveys to let us know what is working well and how we can [...]

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.

Bone Mass Measurement: Promoting Good Health Through Disease Prevention and Detection

Medicare covers many preventive services to keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain diseases. Register today for an [...]

EDI Enrollment J6

Helpful Resources Approved Entities Network Service Vendors EDI Application Status Search Tool NPI/PTAN Crosswalk Contact the EDI Help Desk: 877-273-4334 Available by phone or email Monday–Friday* 8:00 a.m.–5:00 p.m. ET 7:00 a.m.–4:00 p.m. [...]

EDI Enrollment JK

Helpful Resources Approved Entities Network Service Vendors EDI Application Status Search Tool NPI/PTAN Crosswalk Contact the EDI Help Desk: 888-379-9132 Available by phone or email Monday–Friday* 8:00 a.m.–5:00 p.m. ET 7:00 a.m.–4:00 p.m. [...]

ASCA Requirements for Paper Claim Submissions

Table of Contents ASCA Requirements for Paper Claim Submissions Submitting Electronic Claims Submitting Paper Claims ASCA Exception Criteria Related Content [Return to Top] ASCA Requirements for Paper Claim Submissions [...]

Using the Medicare Coverage Database: How to Find Important Medicare Coverage Information

Are you responsible for looking up whether a service is covered in the Medicare program at your facility but you're not sure where to look for the most relevant information? As a health care provider, you are responsible for understanding [...]

The National Correct Coding Initiatives Procedure-to-Procedure and Medically Unlikely Edits

Centers for Medicare & Medicaid Services developed the National Correct Coding Initiative (NCCI) program to promote national correct coding. Incorrect coding often leads to improper payment and increases the paid claims error rate. If you [...]

Radiopharmaceutical Reimbursement National Government Services has reviewed the radiopharmaceutical pricing methodology set forth in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Section 303(h) which states that [...]

Administrative Simplification Compliance Act Waiver Request Form

July 2025 Release "Dark Days" for the Common Working File Hosts

July 2025 Release "Dark Days" for the Common Working File Hosts For the Upcoming July 2025 Release: For Production, CWF will be observing the Gray Day on Wednesday, 7/2/2025 and Dark Days starting Thursday, 7/3/2025 (including July 4th [...]

The Medicare Appeals Process: What You Need to Know

This informative session will help you navigate Medicare’s appeals process by providing information on what an appeal is, how to determine if a claim can be appealed, who may file an appeal, the appeal levels, timeframes and documentation [...]

July 2025 EDI Front End Quarterly Release

July 2025 EDI Front End Quarterly Release Please be advised that while the CMS mandated release for July 2025 will be installed the weekend of 7/6/2025, the code set updates included with this release will not be effective in the EDI Front-End [...]

July 2025 EDI Front End Quarterly Release

July 2025 EDI Front End Quarterly Release Please be advised that while the CMS mandated release for July 2025 will be installed the weekend of 7/6/2025, the code set updates included with this release will not be effective in the EDI Front-End [...]

Claim Denials for Medically Unnecessary Ambulance Transports: Avoiding Reason Code 55B10

Claim Denials for Medically Unnecessary Ambulance Transports Table of Contents Claim Denials for Medically Unnecessary Ambulance Transports Medical Necessity and Coverage Guidelines for Ambulance Transport Avoiding Reason Code 55B10 [...]