Medical Review: Targeted Probe and Educate Review Topics

Jurisdiction K HHH Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Home Health Medical Necessity N/A 55H3V– The documentation did not support the medical [...]

Understanding the Approval Recommendation Process for Certified Providers

Understanding the Approval Recommendation Process for Certified Providers The certified provider completes and submits a CMS-855 enrollment application and all supporting documentation to its MAC, including any state require documentation [...]

Ambulance Services and the Advance Beneficiary Notice of Noncoverage

Ambulance Services and the Advance Beneficiary Notice of Noncoverage To follow are Medicare’s guidelines regarding the use of an ABN for ambulance services. Per the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) [...]

MLN Connects® Newsletter: March 27, 2025

MLN Connects® Newsletter: March 27, 2025 News Extension of Medicare Provisions Final National Coverage Determination: Transcatheter Tricuspid Valve Replacement Nutrition-Related Health Conditions: Recommend Medicare Preventive Services [...]

Fundamentals of Medicare

LCD Open Meeting Records

Open Meeting Records Jurisdiction 6 and Jurisdiction K Open Meeting Records Meeting Date Audio Transcript 3/13/2025 – J6/JK Open Meeting Recording Transcript  10/24/2024 – J6/JK Open Meeting [...]

Hospital Acquired Conditions and Present on Admission Resource for Acute Care Hospital Facilities

Hospital Acquired Conditions and Present on Admission Resource for Acute Care Hospital Facilities The hospital is the entity required to bill POA indicators on all inpatient claims billed to Medicare. However, accurate coding of all diagnosis [...]

NCCI Lookup Tool Top

National Correct Coding Initiative Lookup Tool The NCCI PTP lookup tool is designed to help providers identify when certain codes are subject to the automated code pair edits. When two codes of an edit pair are identified, the major code [...]

Provider Outreach and Education Reminders

Additional Events Links

Resources Education Partnership Request Form Five Steps to Webinar Success Provider Outreach and Education Reminders

Additional Events Links

Resources Education Partnership Request Form Five Steps to Webinar Success Provider Outreach and Education Reminders

Telehealth Services

Telehealth Services Table of Contents General Information Originating Site Distant Site List of Covered Medicare Telehealth Services Billing Facility Fee for Originating Site Payment for Professional Fee Place of [...]

Telehealth Extension 2025

Telehealth Extension 2025 A Congressional continuing resolution bill has extended telehealth coverage for services in all U.S. geographic locations through 9/30/2025. Based on this guidance, National Government Services will continue to pay [...]

Credentialing, Enrollment and Revalidation

Credentialing, Enrollment and Revalidation Table of Contents Requirements Facilities that are not qualified Qualifications Application Forms You Will Need Required Application Fee Documentation State Survey, Tie-in Notice [...]

Learn About PECOS Web

Learn About PECOS Web Table of Contents CMS Provider Enrollment Systems Advantages of Online Enrollment Get Started Other Resources Get Access Password Requirements Multi-Factor Authentication Get Help [Return to [...]

FQHC MAO Supplemental Payment Calculation Form

Register Now for the Spring 2025 Virtual Conference

Register Now for the Spring 2025 Virtual Conference Don’t miss the opportunity to register for the 2025 Spring Part B Virtual Conference: Understanding Medicare Compliance for Part B Providers! Enhance your understanding and apply what you [...]

Acute Care Hospitals: Advance Beneficiary Notice of Noncoverage (CMS-R-131 Form) for Outpatient Services

Acute care hospitals: Do you understand when and how to issue an Advance Beneficiary Notice of Noncoverage (ABN) for outpatient services? Join this session to learn more about the voluntary and mandatory ABN, three payment liability conditions, [...]

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 [...]

Helping Your Patients Stop Smoking

Helping Your Patients Stop Smoking Quitting Tobacco – Slips and Relapses Quitting smoking has health benefits at any age, no matter how long or how much you have smoked. If you slip or relapse, don’t be afraid to try and quit again. Each quit [...]

Submitting Revalidation via PECOS

During this webinar, we’ll provide an understanding of how to utilize the Centers for Medicare & Medicaid Services (CMS) Internet-based Provider Enrollment Chain & Ownership System (PECOS) to be comfortable in navigating the system to [...]

Provider Enrollment: NGSMedicare.com Resources to Streamline CMS Enrollment Form Process

Provider Enrollment: NGSMedicare.com Resources to Streamline CMS Enrollment Form Process To eliminate the need for additional information requests, NGS offers a variety of provider enrollment resources on our website. These include valuable [...]

Benefits of Quitting Tobacco

Benefits of Quitting Tobacco Quitting tobacco use in any form is one of the most important actions people can take to improve their health. This is true regardless of their age or how long they have been using tobacco products. While quitting [...]

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.

Provider Enrollment: Resources from NGSMedicare.com to Streamline the CMS-855A Application Process

Provider Enrollment: Resources from NGSMedicare.com to Streamline the CMS-855A Application Process To eliminate the need for additional information requests, NGS offers a variety of provider enrollment resources on our website. These include [...]

Benefits of EDI

Prior Authorization for Certain Hospital Outpatient Department Services – The Exemption Process

In this webinar, the Exemption Team will compare the standard prior authorization review process to the exemption process with a focus on how to gain exemption status and remain exempt through the post pay claim review process.

Portable X-Ray Cost Analysis Survey

Portable X-Ray Cost Analysis Survey NGS, in collaboration with other MACs, has launched a crucial initiative to assess and update transportation allowances for portable X-ray services, as mandated by the CMS every five years. Given that [...]

MLN Connects® Newsletter: May 1, 2025

MLN Connects® Newsletter: May 1, 2025 News Clinical Laboratory Fee Schedule Preliminary Gapfill Rates: Submit Comments by June 28 Compliance Acute Care Hospital Outpatient Services for Hospice Enrollees: Reduce Improper Payments [...]

Changes to the Written General Inquiries Process at National Government Services, Inc.

Changes to the Written General Inquiries Process at National Government Services, Inc. Effective 5/27/2025, NGS 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. The [...]

Investigational Device Exemption Requests ‒ Renewals and Modifications

Investigational Device Exemption Requests ‒ Renewals and Modifications Effective for Category A and B IDE studies approved by the FDA on or after 1/1/2015, interested parties (i.e. study sponsors) seeking Medicare coverage must submit a [...]

Understanding the 2026 Cost Analysis Survey for Medicare Allowances on Portable X-Ray Transportation Codes R0070 and R0075

Understanding the 2026 Cost Analysis Survey for Medicare Allowances on Portable X-Ray Transportation Codes R0070 and R0075 Introduction Medicare plays a critical role in ensuring beneficiaries receive medically necessary diagnostic services, [...]

2024 Medicare Cost Report Due Dates

2024 Medicare Cost Report Due Dates FYE 12/31/2024 cost reports are due by 6/2/2025. We strongly encourage early filing of the cost report. Early-filed cost reports that are rejected will receive a grace period to resubmit prior to [...]

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.

COVID-19

COVID-19 The 2019 Novel Coronavirus (COVID-19) was declared a PHE on 3/13/2020 and it was officially expired on 5/11/2023. Please visit CMS' Current emergencies web page for complete details on the PHE. Email Updates To keep you informed [...]

Reminder: New Medicare Part B Redetermination Notice Initiative

Reminder: New Medicare Part B Redetermination Notice Initiative As a reminder, beginning 3/3/2025, National Government Services will only issue electronic versions of the MRN when a Medicare Part B Redetermination request is electronically [...]

2025 Gapfill Request

2025 Gapfill Request National Government Services, the MAC for JK and J6 is in receipt of the new laboratory test codes identified by the CMS to be gap-fill priced for 2025. The PAMA regulations instruct the MACs to establish local payment [...]

2025 Gapfill Request Reminder

2025 Gapfill Request Reminder National Government Services, the MAC for JK and J6, is in receipt of the new laboratory test codes identified by CMS to be gap-fill priced for 2025. Please access the complete information on our website: 2025 [...]