Overview of Evaluation and Management Services

Note: Maximum registration has been reached for this webinar. We've scheduled a repeat session on 6/25/2025. View the events page to register. We've seen major changes to the evaluation and management code set over the last few years. [...]

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments Each year, National Government Services experiences numerous EFT rejections due to inactive or closed bank accounts. To ensure continuous Medicare [...]

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments Each year, National Government Services experiences numerous EFT rejections due to inactive or closed bank accounts. To ensure continuous Medicare [...]

Local Coverage Determination Open Meeting

Local Coverage Determination Open Meeting National Government Services is hosting a Local Coverage Determination Open Meeting on 6/25/2025.  Details are available by accessing the Local Coverage Determination Open Meeting Announcement. [...]

How to Become a Medicare-Enrolled OTP Supplier

How to Become a Medicare-Enrolled OTP Supplier OTPs with current, valid and full certification by the Substance Abuse and Mental Health Services Administration (SAMHSA) and accredited by a SAMHSA-approved accrediting body; including the DEA [...]

Learn Over Lunch – NGSConnex Inquiries

Effective 5/27/2025, National Government Services will no longer accept inquiries submitted through the postal service to any of our P.O. Boxes or faxed to any of our fax lines. Are you prepared? Join this session to learn how to efficiently [...]

The National Correct Coding Initiative and Medically Unlikely Edits for Part B Providers

This webinar will assist Part B providers with navigating tables for the National Correct Coding Initiative and the medically unlikely edits. We will also review proper modifiers to use to avoid denials. There will be time following the [...]

Overpayments Due to Contractor Audit Reviews

Overpayments Due to Contractor Audit Reviews If you do not agree with any CMS contractor audits determination and you are a provider practicing in JK (CT, MA, ME, NH, NY, RI, VT) or J6 (IL, MN, WI), you may use the Medicare appeals process [...]

CMS Links

Accreditation of Advanced Diagnostic Imaging Suppliers All Fee-For-Service Providers Ambulatory Surgical Centers (ASC) Center Beneficiary Notices Initiative (BNI)  Care Management including: Advanced Care Planning Behavioral [...]

MLN Connects® Newsletter: May 22, 2025

MLN Connects® Newsletter: May 22, 2025 News Discarded Drugs: Get Updated Lists Medicare Provider Payment & Utilization Public Use Files: Annual Update Medicare Fee-for-Service Geographic Variation Public Use Files & Interactive [...]

The 2025 Spring Part B Virtual Conference Begins in One Week!

The 2025 Spring Part B Virtual Conference Begins in One Week! The 2025 Spring Part B Virtual Conference begins in one week! This is your last chance to register and join us on June 3–5, 2025! Don’t miss out on this must-attend event!   [...]

MLN Connects® Newsletter: May 22, 2025

MLN Connects® Newsletter: May 22, 2025 Departments of Labor, Health and Human Services, Treasury Announce Move to Strengthen Healthcare Price Transparency Trump administration issues request for information, guidance to expand access to real [...]

Medically Unlikely Edits

Claim ADRs

Claim Additional Development Requests Types include: Origins Facts Identification NOC and unlisted codes. Modifiers: AS, 22, 52, 53, 62, 66, 80, 81, 82. PWK initiated and records are not [...]

CMS Medically Unlikely Edits

Medically Unlikely Edits and Related Billing Clarifications

Medically Unlikely Edits and Related Billing Clarifications An MUE is the maximum number of UOS allowable under most circumstances for a single HCPCS/CPT code billed by a provider for a particular date of service for a single beneficiary. [...]

Medical Review Targeted Probe and Educate ADRs

Medical Review Targeted Probe and Educate Additional Development Requests Origins Facts Identification CMS’ TPE program is provider specific education that will focus on improving issues without allowing other [...]

General Information

General Information National Government Services or other CMS contractors may need to request additional information for Medicare claims to assess compliance with Medicare rules. These requests are ADRs. An ADR is a notification/letter [...]

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 Medicare NCCI Medically Unlikely Edits (MUEs) National Correct [...]

The National Correct Coding Initiative Lookup Tool

The National Correct Coding Initiative Lookup Tool The National Correct Coding Initiative Lookup Tool is designed to help providers identify when certain codes are subject to the automated code pair edits. Search for coding pairs by entering a [...]