Search Results - NGSMEDICARE

Posting Date: 09/04/2024

Psychotherapy Services

Psychotherapy Services Medicare Regulations Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-02, Medicare Benefit Policy Manual, Chapter 6, Section 70.1 Local Coverage Determination (LCD): [...]

Posting Date: 06/05/2025

Part A Summit - NGSConnex: User Pain Points Examples/Solutions

Are you experiencing issues while utilizing NGSConnex? Join this informative session to learn what user pain points are and how to resolve these issues from an NGSConnex Agile Product Owner. This session will encompass issues with [...]

Posting Date: 06/05/2025

Part A Summit- Navigating Billing and Documentation for Behavioral Health Services in Federally Qualified Health Centers

Unlock the secrets to effective billing and documentation for behavioral health services within Federally Qualified Health Centers. This collaborative webinar will include insights from Medical Review and is designed to help healthcare [...]

Posting Date: 06/05/2025

Part A Summit- Skilled Nursing Facility: Coverage and Documentation

During this collaborative education session between Case Management and Medical Review, attendees will learn documentation requirements for skilled nursing facility (SNF) coverage, how to properly respond to Additional Documentation Requests [...]

Posting Date: 06/05/2025

Part A Summit – How to Submit an Appeal Request

Join us for a comprehensive session focused on understanding the appeal submission process within National Government Service. This presentation is designed to guide participants through each step of submitting an appeal, ensuring clarity and [...]

Posting Date: 06/10/2025

Part A Summit - Maintaining Your Provider Files

This virtual webinar will aid in maintaining accurate provider enrollment files for the internet-based Centers for Medicare & Medicaid Services systems: Identity & Access Management System, National Plan & Provider Enumeration [...]

Posting Date: 06/10/2025

Part A Summit- Navigating NGS and CMS Websites

Join us for this informative session where we will review how to find helpful Medicare references and resources on the National Government Services website (www.NGSMedicare.com) and the Centers for Medicare & Medicaid Services website [...]

Posting Date: 01/04/2022

Meeting Schedules

Meeting Schedules Jurisdiction 6: Illinois, Minnesota, Wisconsin Jurisdiction K: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Meeting Date/Time Provider Type Chairpersons [...]

Posting Date: 06/09/2025

Medicare Secondary Payer: A Review of the Working Aged with an Employer Group Health Plan Provision

In this webinar, we will review the criteria of the Working Aged with an Employer group health plan (EGHP), Medicare Secondary Payer (MSP) provision. Understanding this criteria will help your facility identify and bill the appropriate primary [...]

Posting Date: 01/14/2022

Meeting Schedule for Home Health and Hospice

Meeting Schedule for Home Health and Hospice Jurisdiction 6 (Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Jersey, New York, Northern Mariana Island, Oregon, Puerto Rico, U.S. Virgin [...]

Posting Date: 06/09/2025

[RESOLVED] Fiscal Intermediary Standard System and Multi Carrier System Experiencing Outages

[RESOLVED] Fiscal Intermediary Standard System and Multi Carrier System Experiencing Outages The FISS and MCS are now available and Part A and Part B providers can check claim status in NGSConnex and the IVR system. We apologize for any [...]

Posting Date: 02/04/2022

Medical Review: Targeted Probe and Educate Review Topics

Medical Review: Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to [...]

Posting Date: 06/11/2025

Alcohol Misuse, Counseling to Prevent Tobacco Use and Lung Cancer Screening

During this webinar, we’ll review the coverage, coding and billing guidelines for the Medicare Part B preventive services benefits of alcohol misuse, counseling to prevent tobacco use and lung cancer screening.

Posting Date: 06/11/2025

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 & [...]

Posting Date: 06/11/2025

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.

Posting Date: 06/11/2025

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 [...]

Posting Date: 06/11/2025

Provider Enrollment: Completing the CMS-855B Paper Application

During this webinar, we'll provide an understanding of how to complete the CMS-855B provider enrollment paper application for a clinic, group or supplier.

Posting Date: 07/18/2023

Medical Review: Targeted Probe and Educate Review Topics

Jurisdiction K Part B Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Paring or Cutting of Benign Hyperkeratotic Lesion 11055, 11056, 11057 A07 – The [...]

Posting Date: 06/23/2025

Billing Telehealth Services for Part B Providers

During this webinar, we’ll provide you with insight into covered Medicare telehealth services and coverage requirements. We’ll discuss originating sites, distant sites and billing and payment guidelines.

Posting Date: 07/12/2024

Hospice Transfers

Hospice Transfers The purpose of a hospice transfer is to allow the beneficiary the opportunity to transfer to another agency without affecting the current benefit period and providing continuity of care. Instead of the beneficiary revoking [...]

Posting Date: 07/14/2024

Expanded Home Health Value-Based Purchasing Model

Expanded Home Health Value-Based Purchasing Model Overview The HHVBP Model is an initiative by CMS aimed at improving the quality of care provided by home health agencies while also fostering greater efficiency. It builds on the original [...]

Posting Date: 10/04/2021

Implementation of the Election Statement Addendum

Implementation of the Election Statement Addendum Hospice Election Statement Addendum Hospice care is a benefit under the hospital insurance program. To be eligible to elect hospice care under Medicare, the beneficiary must be entitled to [...]

Posting Date: 10/05/2022

Tips for Responding to a Hospice ADR

Tips for Responding to a Hospice ADR National Government Services performs medical review audits of services billed to Medicare to validate that the documentation supports coverage and level of services billed. If one of your claims is [...]

Posting Date: 10/22/2015

Hospice Documentation Tips

Hospice Documentation Tips Medicare coverage of hospice depends on a physician’s certification that an individual’s prognosis is a life expectancy of six months or less if the terminal illness runs its normal course. It is important that the [...]

Posting Date: 10/04/2021

Documentation Requirements for the Medicare Hospice Election Statement

Documentation Requirements for the Medicare Hospice Election Statement Election of Hospice Hospice care is a benefit under the hospital insurance program. To be eligible to elect hospice care under Medicare, the beneficiary must be entitled [...]

Posting Date: 06/01/2018

Avoiding Reason Code 38200

Avoiding Reason Code 38200 Claims are rejected with reason code 38200 when the FISS finds a previously submitted billing transaction that is a duplicate of the recently submitted billing transaction where all of the following fields on the [...]

Posting Date: 07/14/2024

Correcting Reason Code 37253

Correcting Reason Code 37253 To ensure home health claim information aligns with OASIS data, the iQIES OASIS claim data match is essential. If no matching assessment is found in iQIES when a claim is submitted, it will be returned with reason [...]

Posting Date: 05/08/2023

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 [...]

Posting Date: 01/13/2022

Billing the Home Health Notice of Admission Electronically

Billing the Home Health Notice of Admission Electronically Table of Contents Billing the Home Health Notice of Admission Electronically NOA Claim Page 1 NOA Claim Page 2 NOA Claim Page 3 NOA Claim Page 4 NOA Claim Page 5 [...]

Posting Date: 11/21/2024

Incarcerated or Unlawfully Present in the U.S. Claim Rejections (U538H, U538Q)

Incarcerated or Unlawfully Present in the U.S. Claim Rejections (U538H, U538Q) This stringent claim editing process helps ensure that Medicare does not make payments for services rendered to beneficiaries who are not eligible due to being [...]

Posting Date: 12/30/2022

Telehealth Home Health Services

Telehealth Home Health Services Prior to 1/1/2023, data on telecommunications technology used during a 30-day period of care at the patient level was not collected on HH claims. On 7/1/2023 reporting telecommunications G codes became [...]

Posting Date: 05/19/2022

Home Health Third Party Liability Demand Billing

Home Health Third Party Liability Demand Billing Table of Contents Background What is a Demand Bill? Requirements for Submission How to Submit a TPL Demand Bill Claim Page 1: Claim Page 2 – Covered and Noncovered Charges Claim [...]

Posting Date: 05/19/2022

Billing the Home Health Period of Care Claim - PDGM

Billing the Home Health Period of Care Claim – PDGM Table of Contents Billing the Home Health Period of Care Claim – PDGM Claim Page 1: Claim Page 2: Claim Page 3 Claim Page 4 Claim Page 5 Related Resources [Return to Top] [...]

Posting Date: 12/05/2017

Disposable Negative Pressure Wound Therapy Services Under Home Health

Disposable Negative Pressure Wound Therapy Services Under Home Health Effective for services furnished on or after 1/1/2017, Medicare will make separate payment to HHAs for dNPWT services for patients under the home health benefit. NPWT [...]

Posting Date: 05/19/2022

Home Health Demand Billing

Home Health Demand Billing Table of Contents Background What is a Demand Bill? Requirements for Submission How to Submit a Demand Bil Claim Page 1: Claim Page 2: Covered and Noncovered Charges Claim Page 2: All Noncovered Charges [...]

Posting Date: 01/13/2022

Billing the Home Health Notice of Admission via DDE

Billing the Home Health Notice of Admission via DDE Table of Contents Billing the Home Health Notice of Admission via DDE NOA Claim Page 1 NOA Claim Page 4 Notes Related Content [Return to Top] Billing the Home Health [...]

Posting Date: 05/09/2022

Home Health Agency Transfer and Dispute Protocol

Home Health Agency Transfer and Dispute Protocol Specific protocol and steps must be followed prior to opening an admission period for a new patient. Step One: Verify the patient’s eligibility You must ensure the patient is not [...]

Posting Date: 07/21/2022

Late Notice of Admission - The Exception Process

Late Notice of Admission - The Exception Process Table of Contents Timeliness of the NOA and the Penalty Requirements for Submission of the NOA Exception Process Canceling a Timely NOA to Correct an Error Reasons Not to Cancel an NOA [...]

Posting Date: 05/09/2022

Home Health Transfers

Home Health Transfers Table of Contents Background What To Do As a Receiving HHA What To Do As the Initial HHA What To Do In Case of a Dispute Related Content [Return to Top] Background A home health transfer occurs when a [...]

Posting Date: 02/26/2016

Reporting Home Health Periods with No Skilled Visits

Reporting Home Health Periods with No Skilled Visits Eligibility for the Medicare HH benefit requires that the beneficiary have a need for intermittent skilled nursing care, PT, SLP, or a continuing need for OT. The need for skilled care makes [...]