National Correct Coding Initiative

National Correct Coding Initiative The Medicare NCCI promotes correct coding of Medicare Part B claims. Coding policies are based on coding conventions defined in the AMA’s CPT professional, national and local Medicare policies and edits, [...]

Related Resources

Related Resources MLN® Educational Tool: How to Use the Medicare National Correct Coding Initiative (NCCI) Tools Medicare National Correct Coding Initiative (NCCI) Edits National Correct Coding Initiative Policy Manual Medicare NCCI [...]

Add-on Codes

Add-on Codes Add-on codes are procedure codes that indicate additional work associated with another primary procedure. Add-on codes can be reimbursed when reported with the primary procedure code by the same practitioner. Add-on codes may be [...]

National Correct Coding Initiative

National Correct Coding Initiative We recently introduced the NCCI Lookup Tool on our Part B Tools and Calculators page. This tool is designed to assist providers in identifying codes subject to automated prepayment edits, thereby facilitating [...]

Immunization Roster Billing

Immunization Roster Billing Table of Contents Immunization Roster Billing Claim Submission Options for Roster Billing Electronic Claim Submissions Paper Claim Submissions Vaccine Billing and Coding Resources [Return to Top] [...]

Hepatitis B Virus Vaccine and Administration

Preventive Services Guide Hepatitis B Virus Vaccine and Administration Hepatitis B is a virus that can damage the liver; it is spread through contact with infected blood or body fluids and can be transmitted through sex with an infected [...]

Part A Incorrect Dialysis Payments

We have recently become aware of an issue which began on 7/15/2024 where ESRD claims with demo code 94P were finalizing with incorrect payment amounts (overpayments as well as underpayments). The incorrect payment amount is a result of FISS [...]

ASC Claim Hold Until 1/28/2025

Due to a January 2025 fee schedule pricing correction, CMS has instructed Part B MACs to hold Part B ASC claims impacted by CBSA updates until 1/28/2025. ASC claims not impacted by CBSA updates may be impacted by a 10-day hold. 

Understanding the Strength of Medical Evidence

FQHC PPS Calculator

FQHC PPS Calculator 4/1/2025-12/31/2025 1/1/2025-3/31/2025 1/1/2024-12/31/2024 2023 2022 2021 2020 2019 Revised 3/5/2025