-
Posting Date: 12/19/2016
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 [...]
Read More -
Posting Date: 07/01/2024
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 [...]
Read More -
Posting Date: 07/17/2024
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. [...]
Read More -
Posting Date:
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 [...]
Read More -
Posting Date: 12/20/2016
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 [...]
Read More -
Posting Date: 05/18/2021
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 [...]
Read More -
Posting Date: 11/25/2024
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 [...]
Read More -
Posting Date: 07/10/2017
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 [...]
Read More -
Posting Date: 03/22/2017
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 [...]
Read More -
Posting Date: 11/09/2015
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 [...]
Read More -
Posting Date: 07/19/2019
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. [...]
Read More -
Posting Date: 06/09/2022
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. [...]
Read More -
Posting Date: 09/29/2017
Hospice Billing Instructions for Influenza, Pneumococcal and Hepatitis B Vaccines
Hospice Billing Instructions for Influenza, Pneumococcal and Hepatitis B Vaccines Medicare covers influenza virus, pneumococcal and hepatitis B vaccines in accordance with coverage requirements, when furnished by a hospice to those [...]
Read More -
Posting Date: 05/14/2018
Canceling a Hospice Notice of Election
Canceling a Hospice Notice of Election When a patient elects hospice, the hospice submits a NOE to the MAC to notify the MAC and all other providers that the patient is now utilizing the Medicare hospice benefit for all services related to the [...]
Read More -
Posting Date: 03/18/2022
Hospice Quality Reporting Program
Hospice Quality Reporting Program Along with the other MACs, National Government Services has received several requests from new hospice providers, as well as national and state hospice associations, regarding training and assistance for [...]
Read More -
Posting Date: 05/11/2018
Hospice Visit Reporting
Hospice Visit Reporting Table of Contents Background Discipline Visits Reporting Visits in the Routine Home Care, Continuous Home Care and Inpatient Respite Care Levels of Care Discipline Revenue and HCPCS Coding Required Detail for [...]
Read More -
Posting Date: 03/30/2020
How to Bill When the Hospice Face-to-Face is Late from a Previous Benefit Period
How to Bill When the Hospice Face-to-Face is Late from a Previous Benefit Period Background CMS requires that a hospice physician or hospice nurse practitioner must have a FTF encounter with each hospice patient prior to the beginning of the [...]
Read More -
Posting Date: 06/20/2025
Annual Logon ID Recertification
All users who access the FISS DDE system are required by the CMS to recertify their access annually. National Government Services will designate one state at a time to complete the annual logon recertification. To complete the recertification [...]
Read More -
Posting Date: 06/20/2025
EDI Enrollment Process User Guide
This guide provides information on the different options available within the National Government Services EDI Enrollment Process User Guide. Please share your thoughts about your experience with our EDI Enrollment process. Reviewed [...]
Read More -
Posting Date: 06/20/2025
EDI Enrollment
Welcome This page is for providers who wish to submit Part A/B claims to Medicare. Once you have completed the initial provider enrollment and received your Welcome letter with Medicare, you can begin the EDI Enrollment process. Table of [...]
Read More -
Posting Date: 06/20/2025
HETS EDI Enrollment Form
HIPAA Eligibility Transaction System (HETS) allows users to exchange HIPAA compliant ANSI ASC X12 270/271 transactions for the purpose of checking Medicare eligibility. The HETS EDI Enrollment Form allows providers to attest their [...]
Read More -
Posting Date: 06/20/2025
Reset My FISS / DDE Password
CMS has directed it’s datacenters to enforce password requirements set forth in the United States Defense Information Systems Agency’s (DISA) Security Technical Implementation Guide (STIG) with regard to RACF password quality rules. The HPE VDC [...]
Read More -
Posting Date: 06/20/2025
Benefits of EDI
There are a number of advantages to enrolling and submitting claims online. Claims and other transactions submitted electronically process considerably faster than paper submission. For example, HIPAA-compliant electronic claims are held in the [...]
Read More -
Posting Date: 06/20/2025
I Am Not Yet Enrolled in Medicare
You can only begin set up with EDI if you are a participating provider in the Medicare program. If you have not submitted an application to enroll in Medicare, please visit our Enrollment section of the site for guidelines. If you have a [...]
Read More -
Posting Date: 06/20/2025
Trading Partner ID Recertification
All active trading partners are required to recertify their access annually. CMS requires any changes in demographic, contact information or access for a trading partner ID (TP ID) are communicated to the A/B MAC within 30 days of the change. [...]
Read More -
Posting Date: 07/19/2023
National Government Services Contractor Codes
National Government Services Contractor Codes The Contractor Code is a five-digit numeric code that indicates your MAC, also known as the Carrier Code, or Payer ID. Part B Professional: Connecticut 13102 Illinois 06102 Maine 14112 [...]
Read More -
Posting Date: 05/01/2018
Medical Policy Contact Information
Medical Policy Contact Information Please Note: General inquiries related to Medicare coverage policies, including clinical issues, drugs, radiopharmaceuticals, local and national coverage determinations, billing and reimbursement must be [...]
Read More -
Posting Date: 09/21/2020
Interactive Voice Response System
Interactive Voice Response System State IVR Number Hours Available* Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont 877-567-7205 Monday–Friday: 6:00 a.m.–7:00 p.m. ET [...]
Read More -
Posting Date: 04/22/2021
Provider Contact Center
Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Freedom of Information Act (FOIA) [...]
Read More -
Posting Date: 04/01/2020
EDI Help Desk Information
EDI Help Desk Information Toll-Free Number Jurisdiction 6: 877-273-4334 Jurisdiction K: 888-379-9132 Hours of Operation Monday–Friday: 8:00 a.m.–5:00 p.m. ET * Closed for training on the 2nd and 4th Friday of the month from 12:00–4:00 [...]
Read More -
Posting Date: 06/23/2025
How to Obtain a Refund
A refund will only be granted in the following instances: The application fee was not required for the application submitted A hardship request was subsequently approved and a fee was paid An application was rejected prior to the screening [...]
Read More -
Posting Date: 08/21/2018
How to Obtain a Refund
How to Obtain a Refund A refund will only be granted in the following instances: The application fee was not required for the application submitted A hardship request was subsequently approved and a fee was paid An application was [...]
Read More -
Posting Date: 04/27/2021
How to Obtain a Refund
How to Obtain a Refund A refund will only be granted in the following instances: The application fee was not required for the application submitted A hardship request was subsequently approved and a fee was paid An application was [...]
Read More -
Posting Date: 04/27/2021
How to Obtain a Refund
How to Obtain a Refund A refund will only be granted in the following instances: The application fee was not required for the application submitted A hardship request was subsequently approved and a fee was paid An application was [...]
Read More -
Posting Date: 05/03/2024
About Prior Authorization
About Prior Authorization CMS has implemented Prior Authorization (PA) programs nationwide to ensure that Medicare beneficiaries continue to receive reasonable and necessary care while protecting the Medicare Trust Fund from improper payments. [...]
Read More -
Posting Date: 06/23/2025
Part A Ambulance Transport: Understanding the Basics
The purpose of this presentation is to give Medicare Part A Ambulance providers a better understanding of who is responsible to report services to Medicare.
Read More -
Posting Date: 01/31/2022
Exemption Process
Exemption Table of Contents Exemption Exemption Database Standard Review Cycle Process Exemption Cycle Process Ten Claim Sample Additional Documentation Requests (ADRs) Related Content [Return to Top] Exemption Exemption is a [...]
Read More -
Posting Date: 10/26/2022
Prior Authorization OPD Alerts
Prior Authorization OPD Alerts Month/Year Topic August 2024 Removal of Facet HCPCS Codes July 2023 Prior Authorization Outpatient Department Rejections Alert July 2023 Prior [...]
Read More -
Posting Date: 06/09/2021
Expedited Requests
Expedited Requests The requester may submit an expedited review of the PAR if it is determined that a delay could seriously jeopardize the beneficiary’s life, health, or ability to regain maximum function. If the medical documentation does not [...]
Read More