-
Posting Date: 06/27/2017
Ambulance Medical Necessity
Ambulance Medical Necessity According to the Centers for Medicare & Medicaid Services’ (CMS) Internet Only Manual (IOM) 100-02, Medicare Benefit Policy Manual, Chapter 10, Ambulance Services; (400 KB) 10.2 - Necessity and Reasonableness [...]
Read More -
Posting Date: 06/27/2022
Billing for A0426 or A0428
Billing for A0426 or A0428 National Government Services has been receiving electronic claims with the 2300 REF segment (G1 qualifier) for prior authorization, however, the value entered in REF02 is a ZIP code. This segment is intended for the [...]
Read More -
Posting Date: 08/06/2015
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 [...]
Read More -
Posting Date: 04/29/2022
Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports
Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports The CMS implemented the prior authorization of RSNAT. NGS J6 states Illinois, Minnesota, and Wisconsin were added to the RSNAT Model effective with dates [...]
Read More -
Posting Date: 11/12/2020
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 [...]
Read More -
Posting Date: 06/03/2022
Network Service Vendors
Network Service Vendors National Government Services requires connectivity to the EDI Gateway for exchange of EDI data through select NSVs. In addition to connectivity to the EDI Gateway for the exchange of HIPPAA transactions, these vendors [...]
Read More -
Posting Date: 07/29/2025
Automated CMS System for Tracking Audit and Reimbursement Calculated Tentative
Automated CMS System for Tracking Audit and Reimbursement Calculated Tentative Beginning with cost reports received on or after 7/14/2025, all hospital cost reports will process through the automated CMS STAR Calculated Tentative. With this [...]
Read More -
Posting Date: 07/29/2025
Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating
Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating Did you know that tobacco cessation counseling is a covered Medicare service? Brief tobacco counseling provides substantial health benefits while producing cost savings. [...]
Read More -
Posting Date: 06/01/2020
New York State Ambulance Services in Rural Areas (for JK providers only)
New York State Ambulance Services in Rural Areas NYS has unique requirements for the payment of paramedic intercept services when an ambulance company can provide only BLS services. Paramedic intercept services can be approved in counties and [...]
Read More