Electronic Funds Transfer Form and Instructions

Table of Contents Electronic Funds Transfer Form and Instructions CMS-588 EFT Completion Tips for Sole Proprietors, Sole Owners, Clinic/Groups, Organizations, Providers and Suppliers [Return to Top] Electronic Funds Transfer Form and [...]

Electronic Funds Transfer Form and Instructions

Electronic Funds Transfer Form and Instructions Table of Contents Electronic Funds Transfer Form and Instructions  CMS-588 EFT Completion Tips for Sole Proprietors, Sole Owners, Clinic/Groups, Organizations, Providers and Suppliers [...]

SNF and Swing Bed Quarterly Top Claim Errors

Do you struggle with your claim denials, rejections and return to provider (RTP) claims? Do you want to be proactive in preventing unnecessary errors? Join us in a review of top claim errors for your provider type based on recent data analysis [...]

Long-Term Care Hospitals: Preparing and Submitting Compliant Inpatient Claims

In this webinar, we will review Medicare's general inpatient billing requirements for Long-Term Care Hospitals including bill types, billing frequency, interim billing, benefits exhaust billing, billing when claims are paid by Medicare [...]

Medicare Secondary Payer: A Review of the End-Stage Renal Disease with an Employer Group Health Plan Provision – Part 1

This is a two-part webinar; we suggest you attend both parts. In Part 1 on 7/29/2025, we will review the End-Stage Renal Disease with an EGHP Medicare Secondary Payer provision as it applies to patients eligible for Medicare based solely on [...]

Medicare Secondary Payer: A Review of the End-Stage Renal Disease with an Employer Group Health Plan Provision – Part 2

This is a two-part webinar; we suggest you attend both parts. In Part 1 on 7/29/2025, we will review the End-Stage Renal Disease with an EGHP Medicare Secondary Payer provision as it applies to patients eligible for Medicare based solely on [...]

Improving Customer Experience

Improving Customer Experience We are committed to improving your experience. Please watch this two-minute video that explains how each day we review comments from providers who submit surveys to let us know what is working well and how we can [...]

Ambulance Services and Establishing Medical Necessity for Part B Providers

This webinar will help the ambulance community understand the importance of medical necessity as it pertains to Medicare’s coverage guidelines.

Bone Mass Measurement: Promoting Good Health Through Disease Prevention and Detection

Medicare covers many preventive services to keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain diseases. Register today for an [...]

EDI Enrollment J6

Helpful Resources Approved Entities Network Service Vendors EDI Application Status Search Tool NPI/PTAN Crosswalk Contact the EDI Help Desk: 877-273-4334 Available by phone or email Monday–Friday* 8:00 a.m.–5:00 p.m. ET 7:00 a.m.–4:00 p.m. [...]

EDI Enrollment JK

Helpful Resources Approved Entities Network Service Vendors EDI Application Status Search Tool NPI/PTAN Crosswalk Contact the EDI Help Desk: 888-379-9132 Available by phone or email Monday–Friday* 8:00 a.m.–5:00 p.m. ET 7:00 a.m.–4:00 p.m. [...]

ASCA Requirements for Paper Claim Submissions

Table of Contents ASCA Requirements for Paper Claim Submissions Submitting Electronic Claims Submitting Paper Claims ASCA Exception Criteria Related Content [Return to Top] ASCA Requirements for Paper Claim Submissions [...]

Using the Medicare Coverage Database: How to Find Important Medicare Coverage Information

Are you responsible for looking up whether a service is covered in the Medicare program at your facility but you're not sure where to look for the most relevant information? As a health care provider, you are responsible for understanding [...]

The National Correct Coding Initiatives Procedure-to-Procedure and Medically Unlikely Edits

Centers for Medicare & Medicaid Services developed the National Correct Coding Initiative (NCCI) program to promote national correct coding. Incorrect coding often leads to improper payment and increases the paid claims error rate. If you [...]

Administrative Simplification Compliance Act Waiver Request Form

July 2025 Release "Dark Days" for the Common Working File Hosts

July 2025 Release "Dark Days" for the Common Working File Hosts For the Upcoming July 2025 Release: For Production, CWF will be observing the Gray Day on Wednesday, 7/2/2025 and Dark Days starting Thursday, 7/3/2025 (including July 4th [...]

July 2025 EDI Front End Quarterly Release

July 2025 EDI Front End Quarterly Release Please be advised that while the CMS mandated release for July 2025 will be installed the weekend of 7/6/2025, the code set updates included with this release will not be effective in the EDI Front-End [...]

July 2025 EDI Front End Quarterly Release

July 2025 EDI Front End Quarterly Release Please be advised that while the CMS mandated release for July 2025 will be installed the weekend of 7/6/2025, the code set updates included with this release will not be effective in the EDI Front-End [...]

Claim Denials for Medically Unnecessary Ambulance Transports: Avoiding Reason Code 55B10

Claim Denials for Medically Unnecessary Ambulance Transports Table of Contents Claim Denials for Medically Unnecessary Ambulance Transports Medical Necessity and Coverage Guidelines for Ambulance Transport Avoiding Reason Code 55B10 [...]

Coverage of Rural Air Ambulance Services

Coverage of Rural Air Ambulance Services Section 415 of the Medicare Modernization Act of 2003 provides coverage for rural air ambulance services that are reasonable and necessary and ordered by qualified personnel. Medicare considers the [...]

Provisional Period of Enhanced Oversight for New Hospices

Provisional Period of Enhanced Oversight for New Hospices In recent years, CMS has reported a significant increase in fraudulent hospice billing practices, which cost the Medicare Program millions of dollars annually. The CMS has initiated a [...]

Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted Retroactive Medicare Entitlement

Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted Retroactive Medicare Entitlement Table of Contents Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted [...]

Hospice Billing Codes Chart

Hospice Billing Codes Chart Table of Contents Hospice Billing Codes Chart Condition Codes (CC) (UB-04 FL 18-28) Occurrence Codes (OC) and Dates (UB-04 FLs 31-34) Occurrence Span Code and Date (UB-04 FLs 35-36) Value Codes (VCs) and CBSA [...]

Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77

Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77 Table of Contents Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77 Example of the Proper Use of OC 27 Example of the Proper Use of OC 27 with OSC 77 [...]

Filing an Electronic Notice of Change of Ownership (TOB 8XE)

Filing an Electronic Notice of Change of Ownership (TOB 8XE) The Notice of Change of Ownership (TOB 8XE) is submitted when the hospice has a change of ownership that results in a change of the PTAN. Please refer to the Hospice Change of [...]

Hospice Change of Ownership

Hospice Change of Ownership Table of Contents Hospice Change of Ownership What is Not a CHOW The Provider Enrollment Process Purchase Agreement Merger/Acquisition [Return to Top] Hospice Change of Ownership CHOW is defined [...]

Filing an Electronic Notice of Cancelation (Type of Bill 8XD)

Filing an Electronic Notice of Cancelation (Type of Bill 8XD) Table of Contents Filing an Electronic Notice of Cancelation (Type of Bill 8XD) Steps to Cancel a NOE Steps to Cancel a Benefit Period Submitting the 8XD Related Content [...]

Filing an Electronic Notice of Transfer (Type of Bill 8XC)

Filing an Electronic Notice of Transfer (Type of Bill 8XC) Table of Contents Filing an Electronic Notice of Transfer (Type of Bill 8XC) Correcting the Transfer Date on a Previous Submitted Notice of Transfer Related Content [Return to [...]

Hospice Site of Service Codes

Hospice Site of Service Codes Table of Contents Hospice Site of Service Codes HCPCS Codes Site of Service Location Notes Edits Related Content [Return to Top] Hospice Site of Service Codes Hospice agencies must report an HCPCS [...]

17729 and 17730 Hospice Claim Edits for Certifying Physicians

17729 and 17730 Hospice Claim Edits for Certifying Physicians Effective for hospice claims with claim ‘From’ dates on or after 6/3/2024, new claim edits have been implemented per CR 13342 to enforce CMS’ rule to deny hospice claims if the name [...]

Billing Hospice Transfers

Billing Hospice Transfers Once a beneficiary elects to receive care under the Medicare hospice benefit, he or she waives rights to Medicare payments for hospice care provided by any other hospice other than the one they have chosen/designated. [...]

Hospice Notice of Election Termination/Revocation (Type of Bill 8xB)

Hospice Notice of Election Termination/Revocation (Type of Bill 8xB) Table of Contents Hospice Notice of Election Termination/Revocation Examples of NOTR Time Frames Reminders/Notes on the NOTR Correcting a Discharge Date on an [...]

Hospice Room and Board Denials

Hospice Room and Board Denials Medicare does not pay the room and board fees for hospice beneficiaries that reside in a SNF or a nursing facility (NF), as these charges are statutorily excluded from Medicare coverage. However, these charges [...]

Professional Services During a Patient Hospice Election

Professional Services During a Patient Hospice Election Table of Contents Article Overview Hospice Election Medicare Payment During Hospice Election Determining the Correct Entity to Bill Separately Payable Part B Services [...]

Termination of the Hospice Benefit Component of the VBID Model on 12/31/2024

Termination of the Hospice Benefit Component of the VBID Model on 12/31/2024 After carefully considering recent feedback about the increasing operational challenges of the Hospice Benefit Component and limited and decreasing participation [...]

The Medicare Hospice Benefit: Effects on Other Provider Types

The Medicare Hospice Benefit: Effects on Other Provider Types Table of Contents The Medicare Hospice Benefit: Effects on Other Provider Types What is Hospice Care Providing Services Related to the Terminal Condition Providing Services [...]

Reporting Hospice Discharges, Revocations and Transfers

Reporting Hospice Discharges, Revocations and Transfers Medicare regulations at 42 CFR 418.26 outline three reasons for discharge from hospice care: The beneficiary moves out of the hospice’s service area or transfers to another [...]

Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims

Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims Once a hospice chooses to admit a Medicare beneficiary, it may not automatically or routinely discharge the beneficiary at its discretion, even if the care promises [...]

Filing an Electronic Notice of Election (Type of Bill 8XA)

Filing an Electronic Notice of Election (Type of Bill 8XA) The NOE, TOB 8XA, is submitted when the hospice receives a signed election statement from the beneficiary acknowledging that he/she wishes to enroll in the Medicare hospice benefit. [...]

Value-Based Insurance Design Model Hospice Benefit Component Overview

Value-Based Insurance Design Model Hospice Benefit Component Overview Beginning on 1/1/2021, CMS is testing the inclusion of the Part A Hospice Benefit within the MA benefits package through the Hospice Benefit Component of the VBID Model. [...]