Ambulatory Surgical Center Approved HCPCS Codes and Payment Rates

Beneficiary Notices Initiatives

Medicare Monthly Review

Sign up for Email Updates

Helpful Contacts

Medicare Helpful Contacts and Partner Resources Medicare Helpful Contacts Medicare Partner Resources

Submit an Appeal Electronically via esMD

Submit an Appeal Electronically via esMD CMS developed a mechanism for contractors to receive first level appeals electronically from providers via a secure gateway known as Electronic Submission of Medical Documentation, or esMD. Some [...]

Submit an Appeal Electronically via esMD

Submit an Appeal Electronically via esMD CMS developed a mechanism for contractors to receive first level appeals electronically from providers via a secure gateway known as Electronic Submission of Medical Documentation, or esMD. Some [...]

Submit an Appeal Electronically via esMD

Submit an Appeal Electronically via esMD CMS developed a mechanism for contractors to receive first level appeals electronically from providers via a secure gateway known as Electronic Submission of Medical Documentation, or esMD. Some [...]

September 2023

In This Issue National Government Services Articles for Part A and Part B Providers Introducing PECOS 2.0 Duplicate Claim Editing Information Two Interactive Voice Response System Features Ending 9/30/2023 October 2023 Release "Dark [...]

August 2023

In This Issue National Government Services Articles for Part A and Part B Providers CR13220 - Technical Revisions Only to the National Coverage Determination (NCD) Manual, Publication (Pub) 100-03 Tip Sheet for Medicare Providers on [...]

Outpatient Department Prior Authorization UTN Alert

Each UTN is Valid for One-Time Use The National Government Services Medical Review Department initiated prior authorization reviews for the following outpatient department procedures: Panniculectomy, Rhinoplasty, Vein Ablation, Blepharoplasty [...]

Outpatient Department Prior Authorization Type of Bill Alert

Providers Who Submit a Type of Bill 13X Are Required to Submit a Prior Authorization Request for the OPD PA Services The National Government Services Medical Review Department initiated prior authorization reviews for the following outpatient [...]

UTN Alert: Implanted Spinal Neurostimulator Trial and Permanent UTN

UTN Alert: Implanted Spinal Neurostimulator Trial and Permanent UTN The National Government Services Medical Review Department initiated prior authorization reviews for the following outpatient department procedures: Panniculectomy, [...]

Type of Bill Code is a Requirement for All Prior Authorization Requests

Type of Bill Code is a Requirement for All Prior Authorization Requests The National Government Services PA Department has seen an increase in cases that are submitted without a TOB code. PA staff conducts outreach to obtain this code; [...]

Outpatient Department Prior Authorization Implanted Spinal Neurostimulators Alert

Outpatient Department Prior Authorization Implanted Spinal Neurostimulators Alert Implanted Spinal Neurostimulator Prior Authorization National Government Services Medical Review initiated a prior authorization review outpatient department [...]

MLN Connects® Newsletter: September 14, 2023

MLN Connects® Newsletter: September 14, 2023     News Inflation Reduction Act Continues to Lower Out-of-Pocket Prescription Drug Costs for Drugs with Price Increases Above Inflation CMS Roundup (Sept 8, 2023) New Provider [...]

Billing for Originating Site

Billing for Originating Site Originating Site An originating site is the location of an eligible Medicare beneficiary at the time the telehealth services is being furnished via a telecommunications system. Medicare beneficiaries are eligible [...]

Distant Site

Distant Site The term “distant site” means the site where the physician or practitioner providing the professional service is located at the time the service is provided via a telecommunications system. Medicare distant site practitioners who [...]

General Information

General InformationTelehealth services require use of an interactive audio and video telecommunications system that permits real-time communication between the provider at the distant site and the Medicare beneficiary at the originating [...]

Originating Site

Originating Site An originating site is the location of an eligible Medicare beneficiary at the time the telehealth services is being furnished via a telecommunications system. Medicare beneficiaries are eligible for telehealth services only [...]

Facility Fee for Originating Site

Facility Fee for Originating Site The originating site facility fee is a separately billable Part B payment. The payment amount to the originating site is the lesser of 80 percent of the actual charge or 80 percent of the originating site [...]