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Posting Date: 07/28/2025
Method II CAH Claims Not Paying Professional Services with Revenue Codes 096x-098x
Certain CAH claims (TOB 85X) with professional service revenue codes 096x – 098X did not process for payment because the fee amount was not correctly retrieved during processing. The affected claims have receipt/processed dates in October 2024.
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Posting Date: 07/24/2025
Prolonged Services
Prolonged Services Note: View the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.6.15.2 and Section 30.6.15.3 for CPT codes [...]
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Posting Date: 07/28/2025
Submit Medicare Secondary Payer Claims Correctly the First Time!
Submit Medicare Secondary Payer Claims Correctly the First Time! If you're facing challenges related to MSP claim submissions for Medicare Part B, then this information is important for you. Ensuring that claims are submitted correctly the [...]
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Posting Date: 07/28/2025
View our Educational Frequently Asked Questions
View our Educational Frequently Asked Questions Our educational FAQs have been reviewed and updated. Please visit the Help and FAQs page under the Education section of our website to explore topics such as: ASCA Appeals CAR T-cell Therapy [...]
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Posting Date: 07/29/2025
Learning Medicare Secondary Payer Interactively
Join us for an interactive learning webinar where you can engage and have fun at the same time! It’s all about learning the Part B Medicare Secondary Payer (MSP) provisions with live case scenarios. Providers will understand their [...]
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Posting Date: 02/26/2024
Ambulance Duplicate Claim Denials
Ambulance Duplicate Claim Denials Duplicate trips may be reported on the same claim if the ZIP code for the point of pick-up for both trips is the same. If separate claims are submitted for the same beneficiary on the same day with the same [...]
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Posting Date: 03/27/2025
Ambulance Services and the Advance Beneficiary Notice of Noncoverage
Ambulance Services and the Advance Beneficiary Notice of Noncoverage To follow are Medicare’s guidelines regarding the use of an ABN for ambulance services. Per the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) [...]
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Posting Date: 01/31/2015
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 [...]
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Posting Date: 04/15/2022
Ambulance Physician Certification Statement Guidelines
Ambulance Physician Certification Statement Guidelines Certification Type Certification Required? Yes/No Who May Sign the Certification Timeframe Other Information /Resources Nonemergency, scheduled, [...]
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Posting Date: 10/27/2022
Coverage of Rural Air Ambulance Services
Coverage of Rural Air Ambulance Services Section 415 of the Medicare Modernization Act of 2003 provides coverage for rural air ambulance services that are reasonable and necessary and ordered by qualified personnel. Medicare considers the [...]
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