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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...

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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, Manageme...

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Posting Date: 09/17/2024
National Government Services Contractor Advisory Committee Meeting

National Government Services Contractor Advisory Committee Meeting There will be a multi-jurisdictional CAC meeting held on Thursday 10/17/2024 at 3:00-5:00 p.m. ET, 2:00-4:00 p.m. CT. Meeting details...

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Posting Date: 09/16/2024
Third Quarter Top Ten EDI Institutional Edits

Third Quarter Top Ten EDI Institutional Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the third quarter. Visit Quarterly Top Ten EDI Institutional Edits to view the edits and thei...

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Posting Date: 09/16/2024
Third Quarter Top Ten EDI Part B Edits

Third Quarter Top Ten EDI Part B Edits Using data analysis we’ve updated the Top Ten EDI Edits for the third quarter. Visit Quarterly Top Ten EDI Part B Edits to view the edits and their description, ...

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Posting Date: 09/13/2024
Credit Balance Reporting Reminder: Submissions for Quarter Ending 9/30/2024 Start Soon!

Credit Balance Reporting Reminder: Submissions for Quarter Ending 9/30/2024 Start Soon! CBR submissions can be submitted starting on 10/1/2024 and are due within 30 days to be considered timely. Remem...

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Posting Date: 09/12/2024
MLN Connects® Newsletter: September 12, 2024

MLN Connects® Newsletter: September 12, 2024 News COVID-19: Updated Vaccines for 2024–2025 Season Rural Emergency Hospital Provisions, Conversion Process, & Conditions of Participation: Revised Guidan...

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Posting Date: 09/12/2024
National Government Services Medicare Part B Care Management Services September Series

National Government Services Medicare Part B Care Management Services September Series According to the CDC, six in ten adults in the U.S. have a chronic disease and four in ten adults have two or mor...

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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...

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Posting Date: 09/09/2024
Psychotherapy Services and Targeted Probe and Educate

Psychotherapy Services and Targeted Probe and Educate We’ve added a new section to our website for Psychotherapy Services. Visit this page for informative instruction about completing a psychotherapy ...

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Posting Date: 09/09/2024
Common Working File (CWF) Host Dark Days for October 2024 Release

Common Working File Host Dark Days for October 2024 Release For the upcoming October 2024 Release: For Production, CWF will be observing the Gray Day on Thursday, 10/3/2024, and Dark Days starting Fri...

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Posting Date: 09/06/2024
LCD and Article Updates for August/September 2024

LCD and Article Updates for August/September 2024 Local Coverage Determinations Facet Joint Interventions for Pain Management L35936 Effective 8/1/2024 - Updated "Coverage Indications, Limitations and...

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Posting Date: 09/05/2024
MLN Connects® Newsletter: September 5, 2024

MLN Connects® Newsletter: September 5, 2024 News Osteogenesis Stimulators: Prior Authorization Requirements Suspended Hospice Benefit: Expanding Prepayment Review in 4 States Skilled Nursing Facility ...

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Posting Date: 08/29/2024
MLN Connects® Newsletter: August 29, 2024

MLN Connects® Newsletter: August 29, 2024 News CMS Roundup (August 23, 2024) Physicians, Teaching Hospitals, & Non-Physician Practitioners: Review Your Open Payment Data by December 31 Claims, Pricers...

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Posting Date: 08/22/2024
MLN Connects® Newsletter: August 22, 2024

MLN Connects® Newsletter: August 22, 2024 News Commemorating the 2nd Anniversary of the Lower Cost Prescription Drug Law MolDx Local Coverage Determination Statement Hospital Price Transparency: Get R...

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Posting Date: 08/20/2024
Electronically Submitted Claims that Exceed $99,999.99 Reminder

Electronically Submitted Claims that Exceed $99,999.99 Reminder Electronically submitted claims containing a dollar amount in excess of 99,999.99 will be rejected as a front-end EDI edit. The Standard...

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Posting Date: 08/15/2024
Additional Development Requests for Part A Claims for CPT J9299

Additional Development Requests for Part A Claims for CPT J9299 A system error on 7/25/2024 caused ADR letters to be issued in error on Part A claims for CPT J9299 with DOS on or after 3/1/2024. The i...

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Posting Date: 08/15/2024
MLN Connects® Newsletter: August 15, 2024

MLN Connects® Newsletter: August 15, 2024 News Negotiating for Lower Drug Prices Works, Saves Billions Resources & Flexibilities to Assist with the Public Health Emergency in Florida, Georgia, and Sou...

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Posting Date: 08/08/2024
MLN Connects® Newsletter: August 8, 2024

MLN Connects® Newsletter: August 8, 2024 Final Payment Rule Hospital Inpatient Prospective Payment System & Long-Term Care Hospital Prospective Payment System FY 2025 Final Rule News Transitional Cove...

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Posting Date: 08/08/2024
Supplemental Security Income Ratio Realignment for Cost Reporting Periods Starting Before 10/1/2013

Supplemental Security Income Ratio Realignment for Cost Reporting Periods Starting Before 10/1/2013 On 6/9/2023, in response to the Supreme Court’s ruling in Azar v. Allina Health Services, 139 S. Ct....

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Posting Date: 08/07/2024
Unnecessary Adjustments for Part B Claims

Unnecessary Adjustments for Part B Claims A recent transition process at the Medicare Part B system maintainer has resulted in unnecessary and inappropriate Part B claim adjustments, impacting all MAC...

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Posting Date: 08/05/2024
Telehealth Place of Service 02 and 10 Clarification

Telehealth Place of Service 02 and 10 Clarification National Government Services has been receiving inquiries from providers in regard to POS 02 and POS 10 for telehealth service reporting. We’ve crea...

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Posting Date: 08/02/2024
Introducing the All-New Medicare University!

  Introducing the All-New Medicare University! We encourage you to visit the new Medicare University and explore these exciting enhancements. Simply follow the directions below to check it out. Loggin...

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Posting Date: 08/01/2024
MLN Connects® Newsletter: August 1, 2024

MLN Connects® Newsletter: August 1, 2024 Final Payment Rules Skilled Nursing Facility FY 2025 Final Rule Inpatient Rehabilitation Facility FY 2025 Final Rule Inpatient Psychiatric Facility FY 2025 Fin...

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Posting Date: 07/31/2024
CLIA Number Processing Issue

CLIA Number Processing Issue National Government Services has been made aware of an issue with CLIA lab claims processing. CLIA numbers were not loaded through CWF, resulting in claim denials as CLIA ...

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Posting Date: 07/29/2024
LCD and Article Updates for August 2024

LCD and Article Updates for August 2024 Articles L33394/A52423 – Drugs and Biologicals Provided off-label coverage of Infliximab for microscopic colitis and retirement of Bortezomib article, effective...

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Posting Date: 07/25/2024
MLN Connects® Newsletter: July 25, 2024

MLN Connects® Newsletter: July 25, 2024 News CMS Announces Resources & Flexibilities to Assist with Public Health Emergency in Texas CMS Oral Health Cross-Cutting Initiative Fact Sheet Doctors & Clini...

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Posting Date: 07/25/2024
National Government Services Will Send Email Updates from a New Email Address Beginning 8/7/2024

National Government Services Will Send Email Updates from a New Email Address Beginning 8/7/2024 Starting 8/7/2024, National Government Services will send email updates to you from a new email address...

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Posting Date: 07/24/2024
Health Benefits of Quitting Smoking and Helping Your Patients Kick the Habit

Health Benefits of Quitting Smoking and Helping Your Patients Kick the Habit Smoking leads to multiple diseases and potentially death, but it is preventable! Anyone at any age can benefit from quittin...

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Posting Date: 07/18/2024
A/B DME MAC Collaborative Webinar: Positive Airway Pressure Devices

A/B DME MAC Collaborative Webinar: Positive Airway Pressure Devices Physicians/Practitioners! Are you Ordering PAP Devices for Your Patients? This is your opportunity to hear directly from the Medicar...

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Posting Date: 07/18/2024
MLN Connects® Newsletter: July 18, 2024

MLN Connects® Newsletter: July 18, 2024 News Final Part Two Guidance to Help People with Medicare Prescription Drug Coverage Manage Prescription Drug Costs Medicare Ground Ambulance Data Collection Sy...

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Posting Date: 07/18/2024
“Payer Only” Codes Submitted on Part A Medicare Claims

“Payer Only” Codes Submitted on Part A Medicare Claims This article is to inform Part A providers of an editing change impacting claims submitted with “payer only” codes. As of 7/3/2024, new edits cau...

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Posting Date: 07/16/2024
Hospice Quality Reporting Letters

Hospice Quality Reporting Letters CMS notified MACs of hospice providers that either chose not to participate in the Hospice QRP or failed to meet the Hospice QRP reporting requirements for the data c...

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Posting Date: 07/11/2024
MLN Connects® Newsletter: July 11, 2024

MLN Connects® Newsletter: July 11, 2024 Proposed Rules Physician Fee Schedule CY 2025 Proposed Rule Hospital Outpatient Prospective Payment System & Ambulatory Surgical Center Payment System CY 2025 P...

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Posting Date: 07/11/2024
Part B Top Claim Errors Updated

Part B Top Claim Errors Updated Using data analysis, we update the Top Claim Errors on a quarterly basis and provide: the error reason code; a description of the error; the error type; details that in...

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Posting Date: 07/03/2024
MLN Connects® Newsletter: July 3, 2024

MLN Connects Newsletter: July 3, 2024 News ESRD Prospective Payment System CY 2025 Proposed Rule — Submit Comments by August 26 CMS Roundup (June 28, 2024) Improve Your Search Results for CMS Content ...

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Posting Date: 07/01/2024
2024 CMS Health Equity Services

2024 CMS Health Equity Services The 2024 Physician Fee Schedule Final Rule expanded Medicare coverage by adding four services to the Medicare program for coverage. These services are to help further a...

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Posting Date: 06/28/2024
National Government Services Proposed LCDs for Comment - July 18, 2024

National Government Services Proposed LCDs for Comment - July 18, 2024 The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment...

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Posting Date: 06/27/2024
LCD and Article Updates for June/July 2024

LCD and Article Updates for June/July 2024 Articles Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms A56867 Due to the quarterly CPT/HCPCS code update, PLA code 0204U was de...

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Posting Date: 06/27/2024
MLN Connects® Newsletter: June 27, 2024

MLN Connects Newsletter: June 27, 2024 News CY 2025 Home Health Prospective Payment System Proposed Rule PrEP Using Antiretroviral Therapy to Prevent HIV Infection: Technical FAQs for Pharmacies Claim...

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Posting Date: 06/24/2024
Common Working File (CWF) Host Dark Days for July 2024 Release

Common Working File (CWF) Host Dark Days for July 2024 Release For the upcoming July 2024 Release: For Production, CWF will be observing the Gray Day on Thursday, 6/27/2024 and Dark Days starting Frid...

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Posting Date: 06/20/2024
MLN Connects® Newsletter: June 20, 2024

MLN Connects Newsletter: June 20, 2024 News CMS Preparing to Close Program that Addressed Medicare Funding Issues Resulting from Change Healthcare Cyber-Attack Federal Study Examines Care Following No...

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Posting Date: 06/18/2024
Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today for June 25th Sessions!

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today for June 25th Sessions! We’re wrapping up our Medicare Part B 2024 Sprin...

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Posting Date: 06/17/2024
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 u...

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Posting Date: 06/17/2024
Credit Balance Reminder: Submissions For Quarter Ending 6/30/2024 Start Soon!

Credit Balance Reminder: Submissions For Quarter Ending 6/30/2024 Start Soon! CBR submissions can be submitted starting on 7/1/2024 and are due within 30 days to be considered timely. Remember, even i...

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Posting Date: 06/13/2024
MLN Connects® Newsletter: June 13, 2024

MLN Connects® Newsletter: June 13, 2024 News Medicare Shared Savings Program: Apply for January 1 Start Date by June 17 Men’s Health: Encourage Your Patients to Prioritize Their Health Compliance Hosp...

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Posting Date: 06/12/2024
Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today for June 18th Sessions!

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today for June 18th Sessions! Our third in the series of Medicare Part B 2024 ...

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Posting Date: 06/06/2024
MLN Connects® Newsletter: June 6, 2024

MLN Connects® Newsletter: June 6, 2024 News CMS Roundup (May 31, 2024) Quality Payment Program: 2022 Performance Information on Medicare.gov Compare Tool Skilled Nursing Facility Value-Based Purchasin...

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Posting Date: 06/04/2024
Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today for June 11th Sessions!

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today for June 11th Sessions! We’re gearing up for our second in the series of...

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Posting Date: 06/04/2024
Accelerated Payment Program Available for Providers Impacted by the Ascension Health Cyber Related Incident (CRI)

Accelerated Payment Program Available for Providers Impacted by the Ascension Health Cyber Related Incident Part A Providers experiencing cash flow problems related to Ascension Health CRI, which bega...

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Posting Date: 05/31/2024
National Government Services Proposed LCDs for Comment

National Government Services Proposed LCDs for Comment The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends ...

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Posting Date: 05/30/2024
MLN Connects® Newsletter: May 30, 2024

MLN Connects® Newsletter: May 30, 2024 News Hospice Interdisciplinary Team: Addition of Marriage and Family Therapists & Mental Health Counselors Revised Part B Inflation Rebate Guidance: Using the 34...

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Posting Date: 05/30/2024
Attention Illinois, Massachusetts and Rhode Island Providers: Senior Medicare Patrol Can Assist Medicare Providers!

Attention Illinois, Massachusetts and Rhode Island Providers: Senior Medicare Patrol Can Assist Medicare Providers! National Government Services is proud to announce a special project to assist our pr...

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Posting Date: 05/29/2024
Recovery Audit Contractor Reminders

Recovery Audit Contractor Reminders Did you know that Performant is now the RAC for all of National Government Services Part A and Part B lines of business in Jurisdiction 6 and Jurisdiction K? As par...

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Posting Date: 05/28/2024
Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers on Tuesday, June 4th

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers on Tuesday, June 4th! Our first in our series of Medicare Part B 2024 Spring/Summer Vir...

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Posting Date: 05/23/2024
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, ...

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Posting Date: 05/23/2024
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 s...

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Posting Date: 05/23/2024
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 Instit...

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Posting Date: 05/23/2024
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 bette...

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Posting Date: 05/23/2024
LCD and Article Updates May/June 2024

LCD and Article Updates May/June 2024 Billing and Coding Articles L37485 Prostate Rectal Spacers This policy is retired and is no longer in effect for services rendered on or after 5/1/2024. A52863 Bi...

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