Helpful Resources Change of Address Find & Compare Doctors, Plans, Hospitals, Suppliers, & Other Providers Beneficiary Fact Sheets for Medicare Coverage and Cost Medicare & You Handbook Medicare.gov Sign into Medicare.gov

Helpful Resources Change of Address Find & Compare Doctors, Plans, Hospitals, Suppliers, & Other Providers Beneficiary Fact Sheets for Medicare Coverage and Cost Medicare & You Handbook Medicare.gov Sign into Medicare.gov

Helpful Resources Change of Address Find & Compare Doctors, Plans, Hospitals, Suppliers, & Other Providers Beneficiary Fact Sheets for Medicare Coverage and Cost Medicare & You Handbook Medicare.gov Sign into Medicare.gov

Helpful Resources Change of Address Find & Compare Doctors, Plans, Hospitals, Suppliers, & Other Providers Beneficiary Fact Sheets for Medicare Coverage and Cost Medicare & You Handbook Medicare.gov Sign into Medicare.gov

Medicare’s Annual Wellness Visit in Illinois: Understanding the Benefit and Preventing Denials

Medicare’s Annual Wellness Visit in Illinois: Understanding the Benefit and Preventing Denials National Government Services Jurisdiction 6 MAC by Michael J. Dorris; Carolyn S. Henson, CPC , CAC, CACO, CPC-I, AAPC I-10 Instructor; and Nathan [...]

Medicare’s Annual Wellness Visit in Wisconsin: Understanding the Benefit and Preventing Denials

Medicare’s Annual Wellness Visit in Wisconsin: Understanding the Benefit and Preventing Denials National Government Services Jurisdiction 6 MAC by Michael J. Dorris; Carolyn S. Henson, CPC , CAC, CACO, CPC-I, AAPC I-10 Instructor; and Nathan [...]

Billing Fascia Iliaca Blocks with 64999

Billing Fascia Iliaca Blocks with 64999 National Government Services is receiving information that does not provide the documentation necessary to process claims for Fascia Iliaca Blocks when billed with CPT 64999. Since this is an unlisted [...]

Registration Is Open for the Medicare Part B 2024 Spring/Summer Virtual Conference! Mastering Medicare: Tuesday Tutorials for Part B Providers

Registration is Open for the Medicare Part B 2024 Spring/Summer Virtual Conference! Mastering Medicare: Tuesday Tutorials for Part B Providers We’ve devoted Tuesdays in June to host a series of educational webinars focused on evaluation and [...]

MLN Connects® Newsletter: May 16, 2024

MLN Connects® Newsletter: May 16, 2024 News Administration Acts to Improve Access to Kidney Transplants DMEPOS: Updated List of Items Potentially Subject to Conditions of Payment Lymphedema Compression Treatment Items: New [...]

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS Enrollment Forms

Provider Enrollment: NGSMedicare.com Website Resources to Help Reduce Development on CMS Enrollment Forms To reduce requests for additional information, National Government Services offers several provider enrollment topics, helpful tips and [...]

Cost Report Submission Checklist

Upcoming Annual Logon ID Recertification

Upcoming Annual Logon ID Recertification Upcoming Annual Logon ID Recertification for Maine, Massachusetts, New Hampshire, Vermont, Rhode Island Regions Beginning the week of 5/6/2024, the Maine, Massachusetts, New Hampshire, Vermont, Rhode [...]

Upcoming Annual Logon ID Recertification

Upcoming Annual Logon ID Recertification Upcoming Annual Logon ID Recertification for Maine, Massachusetts, New Hampshire, Vermont, Rhode Island Regions Beginning the week of 05/06/2024, the Maine, Massachusetts, New Hampshire, Vermont, Rhode [...]

CHOPD Accelerated Payments to Providers

CHOPD Advance Payments to Providers

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today!

Medicare Part B 2024 Spring/Summer Virtual Conference: Mastering Medicare-Tuesday Tutorials for Part B Providers-Register Today! We’ve dedicated Tuesdays for the month of June to deliver valuable educational topics that will help our provider [...]

CR13566 - Outlier Reconciliation and Cost-to-Charge Ratio (CCR) Updates for the Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS

CR13566 - Outlier Reconciliation and Cost-to-Charge Ratio (CCR) Updates for the Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Posted 5/16/2024

Accelerated Payments to Providers

Advance Payments to Providers

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 [...]

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 [...]

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 [...]

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 [...]

Billing Overlap/Dispute Resolution Process

Billing Overlap/Dispute Resolution Process Table of Contents Billing Overlap/Dispute Resolution Process Mailing Addresses and Fax Number JK: J6: General Inquiries JK: J6: [Return to Top] Billing Overlap/Dispute [...]

National Government Services: Raising Awareness About Care Management

National Government Services: Raising Awareness about Care Management According to the Center for Disease Control, six in ten adults in the U.S. have a chronic disease and four in ten adults have two or more. As your MAC for Jurisdiction 6 [...]

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 [...]

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 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 [...]

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. [...]

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 [...]

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] [...]

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 [...]

Notice of Admission Questions and Answers

Notice of Admission Questions and Answers Medicare requires HHAs to submit a one-time NOA instead of RAPs for new admissions starting on or after 1/1/2022. HHAs shall no longer submit RAPs, TOB 0322 for any HH periods of care with a “From” [...]

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 Notes [...]

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 [...]

Telehealth Home Health Services: New G-Codes

Telehealth Home Health Services: New G-Codes 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. Effective 1/1/2023, HHAs may begin voluntarily [...]

Home Health Therapy Billing

Home Health Therapy Billing Table of Contents Home Health Therapy Billing 32X TOB: Billing Therapy Under a Home Health Plan of Care Discipline Revenue Codes (UB-04 FLs 42-43) Discipline HCPCS Codes (UB-04 FL 44) Service Units [...]

Overlapping Claim Tips for Resolution

Overlapping Claim Tips for Resolution Table of Contents Overlapping Claim Tips for Resolution Type of Bills Impacted Inpatient Hospital Overlap Tips Hospital Discharge Coding Hospital Overlapping with Home Health Care Hospital [...]