Hierarchy of Medicare Regulations

Hierarchy of Medicare Regulations Have you wondered how Medicare determines what is covered? Below you will find the hierarchy of how Medicare regulations are created. Social Security Act Title XVIII of the Social Security Act is [...]

MLN Connects® Newsletter: October 19, 2023

MLN Connects® Newsletter: October 19, 2023     News 2024 Medicare Parts A & B Premiums and Deductibles Help CMS Improve Provider Resources — Respond by November 9 CMS Health Information Handler Helps You Submit [...]

Browser Compatibility

Browser Compatibility Access NGSConnex using one of the supported browsers below. Microsoft Edge version 88.0 and above Google Chrome version 45.0 and above  Mozilla Firefox version 31.0 and above Apple Safari version 9 and [...]

Mental Health Services

Mental Health Services Medicare Part B provides benefits for psychiatric services, which are medically necessary for the diagnosis or treatment of diagnostic and/or behavioral health treatment. Medicare recognizes the following Part B [...]

Register Today! National Government Services Fall 2023 Medicare Virtual Conference: Understanding Medicare Compliance for Part B Providers

Register Today! National Government Services Fall 2023 Medicare Virtual Conference: Understanding Medicare Compliance for Part B Providers This three full-day virtual conference will offer a variety of Part B sessions geared toward Medicare [...]

Credit Balance Report Reminder

Credit Balance Report Reminder CBRs for the quarter ending 9/30/2023 are now due. CBRs must be submitted within 30 days of the end of the quarter to be considered timely. FISS DDE users who submit the 838 detail page directly over the [...]

Medicare Overpayments Are Not Redeterminations

Medicare Overpayments Are Not Redeterminations Our records indicate some providers are incorrectly submitting redetermination request forms for MSP overpayment issues. Please use this notification as educational instruction from National [...]

MLN Connects® Newsletter: October 26, 2023

MLN Connects® Newsletter: October 26, 2023 News Help CMS Improve Provider Resources — Respond by November 9 CMS Roundup (Oct 20, 2023) Nursing Facility Evaluation and Management Visits: Comparative Billing Report in October Claims, [...]

Part B Top Claim Errors Are Updated

Part B Top Claim Errors Are Updated Our top claim errors are updated on a quarterly basis to reflect current information. Visit Top Claim Errors to learn what you can do to avoid claim processing delays. We’ve listed the error reason code, a [...]

Prior Authorization Outpatient Department Exemption Additional Documentation Requests

Prior Authorization Outpatient Department Exemption Additional Documentation Requests National Government Services Prior Authorization initiated the process of issuing ADRs to exempt providers. Please monitor your facility’s ADR location [...]

Coming Soon ‒ The CY 2024 Medicare Physician Fee Schedule

Coming Soon - The CY 2024 Medicare Physician Fee Schedule The CY 2024 MPFS will soon be available on the Fee Schedule Lookup tool located on NGSMedicare.com, after the CY 2024 physician fee schedule regulation is put on display. Once the Fee [...]

Electronic Cost Report Exhibit Templates

Who May File an Appeal

Who May File an Appeal? Table of Contents Who May File an Appeal? Appointment of Representative When Is an Appointment Not Necessary? Who May Be a Representative How to Make and Revoke an Appointment When Is an Appointment Not [...]

Reopenings for Minor Errors and Omissions

Reopenings for Minor Errors and Omissions Table of Contents Reopenings for Minor Errors and Omissions What is a Clerical Error? Clerical Error and Omission Reopening Request Request a Reopening- NGSConnex Request a Reopening- In Writing [...]

Review Bad Debt Listing

Table of Contents Review Bad Debt Listing Identifying Fee Schedule Services Fee Schedules Included in Bad Debt Policy Related Content [Return to Top] Review Bad Debt Listing Bad debts are unrecovered costs due to uncollectible [...]

Hospice Cap

Hospice Cap Table of Contents The Inpatient Day Limitation Aggregate Cap Calculation Beneficiary Count Proportional Method (applies to most hospices) Streamlined Method  [Return to Top] The Inpatient Day Limitation [...]

Proper Use of Modifiers JW and JZ

Proper Use of Modifiers JW and JZ National Government Services Provider Contact Center has received several inquiries regarding claim denials related to the use of the JW and JZ modifier for drugs/biologicals. As a reminder, effective [...]

November 2023

In This Issue National Government Services Articles for Part A and Part B Providers Collaborative A/B/DME Therapeutic Shoes for Persons with Diabetes Webinar Decrease Burden and Combine Multiple PDFs in one Document Before Responding to [...]

MLN Connects® Newsletter: Take Our Provider Survey Today - November 1, 2023

MLN Connects® Newsletter: Take Our Provider Survey Today - November 1, 2023 News Take Our Provider Survey Today Posted 11/1/2023

MLN Connects® Newsletter: November 2, 2023

MLN Connects® Newsletter: November 2, 2023 News CY 2024 Home Health Prospective Payment System Final Rule CY 2024 End-Stage Renal Disease Prospective Payment System Final Rule Behavioral Health: Medicare Pays for 3 Services [...]