Reminder: New Medicare Part B Redetermination Notice Initiative

Reminder: New Medicare Part B Redetermination Notice Initiative Beginning 3/3/2025, NGS will only issue electronic versions of the MRN when a Medicare Part B Redetermination request is electronically submitted through our portal, NGSConnex. [...]

MLN Connects® Newsletter: February 24, 2025

MLN Connects® Newsletter: February 24, 2025 Compliance Mechanical Ventilation: Bill Correctly for Inpatient Claims Claims, Pricers, & Codes Discarded Drugs & Biologicals: Orphan Drugs with Increased Applicable Percentage for [...]

Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application

Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application  Available now is the revised CMS-855A (09/24) paper application that includes a section for SNF to comply with the 2023 Final rule in reporting [...]

Pre-Exposure Prophylaxis Using Antiretroviral Therapy to Prevent HIV Infection

Preventive Services Guide Pre-Exposure Prophylaxis Using Antiretroviral Therapy to Prevent HIV Infection PrEP involves the use of antiretroviral drugs to decrease the risk of acquiring HIV. Under Section 1861(ddd)(1) of the Social Security [...]

Common Working File Host Dark Days for April 2025 Release

Common Working File Host Dark Days for April 2025 Release For Production, CWF will be observing the Gray Day on Thursday, April 3rd, and Dark Days starting Friday, April 4th through Sunday, April 6th to accommodate the anticipated duration of [...]

Important Update for Part B Providers – New NCCI Lookup Tool

Important Update for Part B Providers – New NCCI Lookup Tool The Medicare NCCI promotes accurate coding and prevents improper payments. We have added the NCCI Lookup Tool to our Part B Tools and Calculators page. This tool helps providers [...]

Standard Companion Guides

Standard Companion Guides Standard Companion Guide Trading Partner Information (275) Standard Companion Guide Trading Partner Information (277) Standard Companion Guide Trading Partner Information (278/275) Standard Companion Guide Health [...]

Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment

Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment Reminder, if a hospital, clinic/group or Independent Diagnostic Treatment Facility has ADI screening equipment, certification from a designated ADI accrediting [...]

MLN Connects® Newsletter: February 28, 2025

MLN Connects® Newsletter: February 28, 2025 CMS Provider Education Message: Hospitals: Actions to Make Healthcare Prices Transparent Update: On February 25, the White House issued an Executive Order to empower patients with clear, accurate, [...]

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

New Medicare Part B Redetermination Notice Initiative – Implementation Delayed

New Medicare Part B Redetermination Notice Initiative - Implementation Delayed As we’ve communicated recently, National Government Services will be starting a new initiative for providers who submit Medicare Part B Redetermination requests [...]

Modifier/Code List

Modifier/Code List CMS established a new modifier, AB, for audiologists to use that describes: audiology service furnished personally by an audiologist without a physician/NPP order for non-acute hearing assessment unrelated to disequilibrium, [...]

MLN Connects® Newsletter: March 6, 2025

MLN Connects® Newsletter: March 6, 2025 News Therapy Services: Get Updates for CY 2025 Hospitals: Apply for Additional Residency Positions by March 31 Compliance Oral Anticancer & Antiemetic Drugs: Prevent Claim Denials Claims, [...]

Understanding the Strength of Medical Evidence In the pursuit of evidence-based medical practice, it is essential to evaluate the quality and strength of scientific research thoroughly. The table below provides a comprehensive ranking of [...]

Privacy Notice Policy

Privacy Notice Policy National Government Services, Inc. (NGS) is a contractor with the Centers for Medicare & Medicaid Services (CMS) under the authority granted in Sections 1842, 1862(b) and 1874 of Title XVIII of the Social Security Act [...]

Contractor Advisory Committee Meeting Records

Contractor Advisory Committee (CAC) Meeting Records Jurisdiction 6 and Jurisdiction K CAC Meeting Records Meeting Date Audio Transcript Key Questions Bibliography 2/3/2025 - Topic: Peripheral Nerve Blocks [...]

New York

New York Member Name Professional Title Association Business Name/Address Email Auster, Morris Vice President Division of Socio-Medical Economics Medical Society of the State of New York P. O. Box 5404 [...]

Save the Date! National A/B MAC Ambulance Provider/Supplier Coalition

Save the Date! National A/B MAC Ambulance Provider/Supplier Coalition Attention Ambulance Providers As the MACs celebrate and honor the dedication and contributions to healthcare made by those who provide frontline lifesaving services to our [...]

Transitional Care Management

Transitional Care Management Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99495: Moderate complexity F2F 7 to 14 days 99496: High complexity F2F 7 days [...]

Medicare Part B Redetermination Notice Initiative Coming Soon

Medicare Part B Redetermination Notice Initiative Coming Soon National Government Services will discontinue issuing paper MRNs for Medicare Part B redetermination requests that are submitted electronically through our portal, NGSConnex. [...]

Home Health Billing When a New MBI is Assigned

Home Health Billing When a New MBI is Assigned A patient’s MBI number is required on all home health billing submitted to Medicare. CMS will issue a new MBI when an original MBI may have been, or has been compromised. There are times a home [...]

MLN Connects® Newsletter: March 13, 2025

MLN Connects® Newsletter: March 13, 2025 News Medicare Shared Savings Program: Application Deadlines for January 1, 2026, Start Date Claims, Pricers & Codes ICD-10 Coordination & Maintenance Committee: Submit Procedure Code [...]

What Should Be Provided if Medical Records Are Requested for Review?

What Should Be Provided if Medical Records Are Requested for Review? The following should be considered if applicable to the service being reviewed. This is not intended to be an all-inclusive list. Progress/visit notes Physician orders [...]

Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate

Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate Table of Contents Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate Background: Standard Payment vs. [...]

Claims for Drugs Without a Product-Specific Code Assigned

Claims for Drugs Without a Product-Specific Code Assigned National Government Services has noticed that when a claim RTPs for additional information to be added to the Remarks field concerning certain drugs, some providers attempt to provide [...]

Denials for HCPCS G2211

NCCI editing for HCPCS G2211 code was updated on 12/05/2024 to require HCPCS G0463 as the primary code for G2211 add-on code. This has resulted in denials of claims for the add-code G2211 when billed with CPTs 99202-99205 and 99211-99215. [...]

Home Health and Hospice New Provider Orientation

This webinar is designed for new home health and hospice agencies in an effort to provide essential information on: Doing business with National Government Services as your Medicare Administrative Contractor, Self-service tools to help make [...]

Provider Enrollment: Eliminate Development Request for Additional Information

Provider Enrollment: Eliminate Development Request for Additional Information To eliminate requests for additional information and documentation on provider enrollment applications, ensure all necessary actions are complete before submission. [...]

PECOS: View and Manage Reassignments through Group Enrollment

During this webinar, we’ll provide an understanding of how to view and manage reassignments through the group enrollment in Provider Enrollment, Chain and Ownership System (PECOS), including to add or terminate reassignments. Individual [...]

Provider Enrollment Revalidation Overview

During this webinar, learn about important changes in the revalidation process, how to determine Medicare enrollment revalidation due date and information to avoid disruption in Medicare billing.

Getting Access to PECOS

During this webinar, we’ll discuss how to obtain access to the Internet-based Provider Enrollment Chain & Ownership System (PECOS) and gain connection to provider enrollment record as well as understand other Centers for Medicare & [...]

Complying with Medicare Signature Requirements

Complying with Medicare Signature Requirements Medicare Compliance: Verify signature requirements have been met before you submit your medical records to prevent CERT errors. Review the CERT Alert article Signature [...]

NGSConnex: Part B Redetermination Electronic Notification of Decision Letters

National Government Services will discontinue issuing paper Medicare Part B redetermination requests that are submitted electronically through our portal, NGSConnex. Instead, they will only be accessible to view and print electronically through [...]

Provider Enrollment: Eliminate Development Request for Additional Information

Provider Enrollment: Eliminate Development Request for Additional Information To eliminate requests for additional information and documentation on provider enrollment applications, ensure all necessary actions are complete before submission. [...]