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.

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 [...]

Holding MSP Claims Receiving CWF Edit 6802

Certain MSP claims are incorrectly rejected against CWF edit 6802. On 4/24/2025, CMS directed MACs to hold all MSP claims editing with 6802 while CWF works to correct the issue.

Understanding Medicare Fraud and Abuse

Learn about fraud and abuse affecting providers and your Medicare patients to increase your awareness of integrity issues and prevent potential fraudulent and abusive practices against the Medicare Program.

Reducing Unprocessable Claims

When claims are submitted with invalid, incomplete or incorrect information, our claims processing system will detect these errors and will reject claims as unprocessable. Our goal is to assist our providers in submitting claims correctly the [...]

Practitioners - Are You Ordering Surgical Dressings for Your Patients?

Practitioners - Are You Ordering Surgical Dressings for Your Patients? In order for a DME supplier to provide surgical dressings to your patients, there are actions you can take to make sure that all the required supporting medical record [...]

Clinicians: Are You Ordering Urological Supplies for Your Patients?

Clinicians: Are You Ordering Urological Supplies for Your Patients? Urological supplies are covered as part of the prosthetic device benefit as outlined in the Social Security Act, Section 1861(s)(8). Prosthetic devices (other than dental) [...]

Meeting Minutes

Meeting Minutes Jurisdiction 6 Illinois, Minnesota, Wisconsin Jurisdiction K Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Jurisdiction 6 and Jurisdiction K Combined Meeting 4/3/2025 12/5/2024 [...]

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 [...]

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 [...]

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

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 [...]

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.

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 [...]

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 [...]

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, [...]

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 [...]

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 [...]

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 [...]

Colorectal Cancer Screening

Preventive Services Guide Colorectal Cancer Screening Screenings are performed to diagnose colorectal cancer or to determine a beneficiary’s risk for developing colorectal cancer. Colorectal cancer screening may consist of several different [...]

Telehealth & Remote Patient Monitoring Updates

Telehealth & Remote Patient Monitoring Updates The CMS MLN Booklet® Telehealth & Remote Patient Monitoring has been updated with important information effective 10/1/2025. Posted 5/8/2025

Register Now and Join Us!

Register Now and Join Us! June 3-5, 2025 There's still time to register for the 2025 Spring Part B Virtual Conference. Immerse yourself in expert-led sessions designed to transform compliance understanding into action.   Posted 5/13/2025

Hospice Billing Coffee Break

Provider Outreach and Education is hosting a 30-minute coffee break to help answer your troublesome hospice billing questions. This is a great opportunity to discuss areas of billing more in depth and review helpful guides and resources. Keep [...]

Medicare Part B Preventive Services: Intensive Behavioral Therapy for Obesity and Depression Screening

During this webinar, we'll review the Medicare coverage, coding and billing guidelines for intensive behavioral therapy for obesity and screening for depression in adults.

Ambulance Medical Necessity

Ambulance Medical Necessity According to the Centers for Medicare & Medicaid Services’ (CMS) Internet Only Manual (IOM) 100-02, Medicare Benefit Policy Manual, Chapter 10, Ambulance Services; (400 KB) 10.2 - Necessity and Reasonableness [...]

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 & [...]

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 [...]

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.

Complying with Medicare Signature Requirements

Complying with Medicare Signature Requirements Medicare Compliance: Verify signature requirements have been met before you submit your medical records to prevent CERT errors. Review the CERT Alert article Signature [...]

NGSConnex: Part B Redetermination Electronic Notification of Decision Letters

National Government Services will discontinue issuing paper Medicare Part B redetermination requests that are submitted electronically through our portal, NGSConnex. Instead, they will only be accessible to view and print electronically through [...]

Home Health and Hospice New Provider Orientation

This webinar is designed for new home health and hospice agencies in an effort to provide essential information on: Doing business with National Government Services as your Medicare Administrative Contractor, Self-service tools to help make [...]

Provider Enrollment: Eliminate Development Request for Additional Information

Provider Enrollment: Eliminate Development Request for Additional Information To eliminate requests for additional information and documentation on provider enrollment applications, ensure all necessary actions are complete before submission. [...]

Provider Enrollment: Eliminate Development Request for Additional Information

Provider Enrollment: Eliminate Development Request for Additional Information To eliminate requests for additional information and documentation on provider enrollment applications, ensure all necessary actions are complete before submission. [...]

Medicare Part B Targeted Probe and Educate Process

Are you familiar with targeted probe and educate? Perhaps you've heard of it but are not sure what it entails. Either way, consider attending this webinar as we cover this important topic. We'll discuss everything you need to know so if [...]

EDI Enrollment processing update

EDI Enrollment processing update National Government Services, EDI Enrollment Department will require all information submitted for EDI access to be valid and accurate. Exceptions will no longer be made when validating and processing requests [...]

Eligible Method II Providers

Eligible Method II Providers If a CAH wants to become a Method II biller, email the request to A&R at ngsreimbursement@anthem.com.  Suppliers who can enroll as a Method II Biller Reassignment. Doctor of Medicine (MD) Doctor of [...]

The Medicare Appeals Process: What You Need to Know

This informative session will help you navigate Medicare’s appeals process by providing information on what an appeal is, how to determine if a claim can be appealed, who may file an appeal, the appeal levels, timeframes and documentation [...]

Paperwork Segment – PWK

Paperwork Segment – PWK PWK is a segment in the 837 electronic claim transaction. It links an electronic claim with the supporting documentation submitted by the provider. PWK indicators on the electronic claim notify NGS that documentation [...]

Paperwork Segment – PWK

Paperwork Segment – PWK The paperwork segment of an electronic claim submission is commonly known as PWK. PWK can be used when an electronically submitted claim requires additional documentation for purposes of claim processing. View our [...]

Local Coverage Determination Open Meeting Announcement

Local Coverage Determination Open Meeting Announcement Table of Contents Jurisdiction 6/Jurisdiction K Part A/Part B MAC Requests to Present Registered Presenters (Slide Presentations Only) Observers Comments on Proposed LCDs [...]

MLN Connects® Newsletter: May 13, 2025

MLN Connects® Newsletter: May 13, 2025 News CMS Seeks Public Input on Improving Technology to Empower Medicare Beneficiaries Posted 5/13/2025

MLN Connects® Newsletter: May 15, 2025

MLN Connects® Newsletter: May 15, 2025 News CMS Releases Draft Guidance for the Third Cycle of Medicare Drug Price Negotiation Program to Lower Drug Prices for American Patients Opioid Treatment Programs: CY 2025 Updates Laboratories: [...]

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.

Private Practice Physical/Occupational Therapy Billing

We invite you to join our informative webinar focused on billing guidelines for physical and occupational therapy in private practice. During this webinar, we'll review important topics such as the appropriate use of the KX modifier and the [...]

How to Avoid Duplicate Claims

Duplicate denials continue to be one of the top billing errors. Unnecessary duplicate filing of Medicare claims cost the provider's office valuable time and resources, as well as Medicare's time and money to process them. Please join us [...]

Provider Enrollment: Completing the CMS-855A Paper Application

During this webinar, we’ll provide an understanding of how to complete the CMS-855A provider enrollment paper application.

Medicare Compliance With the Incident To Provision

Do you have nonphysician practitioners that are, or could be, providing services incident to the physicians in the practice? Are you following the Centers for Medicare & Medicaid Services (CMS) regulations for this program? Staying [...]

Provider Enrollment: Completing the CMS-855I Paper Application

During this webinar, we’ll provide an understanding of how to complete the CMS-855I provider enrollment paper application for a group member, sole proprietor or sole owner and we’ll also focus on reassigning Medicare benefits.

Counseling to Prevent Tobacco Use

In an effort to raise awareness and increase utilization of tobacco use counseling, we’ll focus on the effects of nicotine dependence including affected health consequences during this webinar. Medicare coverage, coding, billing and [...]

Counseling to Prevent Tobacco Use

In an effort to raise awareness and increase utilization of tobacco use counseling, we’ll focus on the effects of nicotine dependence including affected health consequences during this webinar. Medicare coverage, coding, billing and [...]

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.