Connecticut ASC Fee Schedule Listing

Connecticut ASC Fee Schedule Listing  CMS is using CBSA planning areas/numbers instead of counties for fee schedule listings for ASCs in the state of Connecticut.  CBSAs refer collectively to metropolitan statistical areas and [...]

Jurisdiction K Part B Top Claim Errors Are Updated

Jurisdiction K Part B Top Claim Errors Are Updated Did you know we publish the top claim errors on our website? This resources provides detailed information including: the error reason code; a description of the error; the error type; [...]

Frequently Asked Questions Have Been Reviewed and Updated

Frequently Asked Questions Have Been Reviewed and Updated We’ve reviewed and updated our educational FAQs. Visit our Help and FAQs page located within the Education section of our website. Please take time to review these FAQs for answers to [...]

Medicare Telehealth Changes for 2024/2025

Medicare Telehealth Changes for 2024/2025 Table of Contents Major Medicare Telehealth Flexibilities Not Affected by the End of the PHE Reporting Home Address Direct Supervision Requirements Teaching Physicians Remote Evaluations, [...]

Top Claim Errors Reviewed and Updated

Top Claim Errors Reviewed and Updated Using data analysis, we review and update the Top Claim Errors on a quarterly basis. View Top Claim Errors to quickly identify the information you need to avoid processing delays and get [...]

Top Claim Errors Reviewed and Updated

Top Claim Errors Reviewed and Updated Using data analysis, we review and update the Top Claim Errors on a quarterly basis and provide: the error reason code; a description of the error; the error type; details that include steps you [...]

Hospitals Must Correctly Code Claims Involving Chimeric Antigen Receptor T-cell and Other Immunotherapy to Receive Proper Payment

Hospitals Must Correctly Code Claims Involving Chimeric Antigen Receptor T-cell and Other Immunotherapy to Receive Proper Payment We have noticed that inpatient hospital claims for CAR T-cell and other immunotherapy are not always coded [...]

Frequently Asked Questions Have Been Reviewed and Updated

Frequently Asked Questions Have Been Reviewed and Updated We’ve reviewed and updated our educational FAQs. Visit our Help and FAQs page located within the Education section of our website. Topics available are: ASCA Appeals CAR T-cell [...]

Part A Fundamentals of Medicare Online Guide

Part A Fundamentals of Medicare Online Guide Attention Part A Providers and Support Staff:  National Government Services produces the Fundamentals of Medicare online guide to help build understanding of the Original Medicare [...]

Medicare Participating Physicians Directory

Medicare Participating Physicians Directory The 2025 MEDPARD is now available. It includes all Part B providers in Jurisdiction 6 and Jurisdiction K who have agreed to accept assignment on all Medicare-covered services. The updated list [...]

New Medicare Part B Redetermination Notice Initiative

New Medicare Part B Redetermination Notice Initiative  National Government Services is excited to announce a new initiative for providers who submit Medicare Part B appeals using our portal, NGSConnex.  Starting 3/3/2025, NGS [...]

Take Advantage of Tobacco Counseling When Performing Medicare Wellness Visits 

Take Advantage of Tobacco Counseling When Performing Medicare Wellness Visits Medicare providers have a valuable opportunity to optimize revenue and improve patient outcomes through Medicare's Annual Wellness Visits. These visits help identify [...]

EDI Gateway Outage

The National Government Services EDI gateway was unavailable for all submitters. 

J6 Part B Applying for an Extended Repayment Schedule

Diabetes Screening

Preventive Services Guide Diabetes Screening Table of Contents Diabetes Screening Coverage Criteria and Frequency Limits HCPCS/CPT Coding Diagnosis Coding Cost Sharing Reimbursement Nonparticipating Providers Common Claim [...]

KX Modifier Threshold

KX Modifier Threshold The Bipartisan Budget Act of 2018 repealed application of the Medicare outpatient therapy caps but retains the former cap amounts as a threshold above which claims must include the KX modifier as a confirmation that [...]

Discarded Drugs/Wastage and JW, JZ Modifier

Discarded Drugs/Wastage and JW, JZ Modifier Medicare may pay for discarded drugs or wasted drugs and biologicals when: The provider/supplier must discard the remainder of a single-dose container after administering a dose or quantity to a [...]

Medicare Part B Independent Physical, Occupational and Speech Therapy Providers

Medicare Part B Independent Physical, Occupational and Speech Therapy Providers National Government Services is addressing providers who frequently submit clerical error reopenings to add the KX modifier to Medicare Part B claims for physical, [...]

New Medicare Part B Redetermination Notice Initiative

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

Methods for Responding to an ADR

Methods for Responding to an ADR Table of Contents Submitting Documentation NGSConnex Mailing an ADR CD/DVD esMD Fax [Return to Top] Submitting Documentation NGSConnex is the preferred method of submission. National [...]

Fee Schedules Description

Fee Schedule Lookup To initiate a search, select a fee schedule type from the drop-down menu, complete all required fields, then select Search. Note: If your search does not display the fee schedule or effective date (range) you enter, [...]

Create an Account - Local Security Officer

Create an Account — Local Security Officer Table of Contents Create an Account — Local Security Officer (LSO) Step 1 – Account Step 2 – Individual Step 3 – Business [Return to Top] Create an Account — Local Security [...]

Create an Account - Standard

Create an Account – Standard Table of Contents Create an Account – Standard Step 1 – Account Step 2 – Individual Step 3 – Business [Return to Top] Create an Account – Standard An NGSConnex Standard Account holder will [...]

Change Your Password

Change Your Password Select the Manage Account button on the NGSConnex home page. Select User Profile. You must change your NGSConnex password at least once every 60 days. This is a CMS security requirement to have online access to [...]

MSP Payment and Savings Calculator Bottom

How to Determine the Medicare Secondary Payment Amounts First, the MSP payment is determined by the following: Actual charge by physician/supplier or OTAF minus amount paid by primary Usual Medicare payment determination  Fee [...]

NGSMedicare.com Scheduled Maintenance on Sunday, 2/9/2025

NGSMedicare.com Scheduled Maintenance on Sunday, 2/9/2025 We will experience intermittent outages with NGSMedicare.com on Sunday, 2/9/2025 due to maintenance. NGSMedicare.com will be fully operational on Monday, 2/10/2025. We apologize for [...]

Remittance Advice

RuralServ

Telehealth

How to File an Appeal with Original Medicare

State Health Insurance Assistance Program

Verify and Manage Signatures

Incident To Services

PECOS Correct and Resubmit Application Instructions

J6 Medicare Secondary Payer Overpayment Request Form

Fee-for-Service Home Health Beneficiary Notice of Noncoverage

Form CMS-339, Transmittal 8

Medicare FQHC PWK Fax/Mail Cover Sheet

Overpayment Recovery Unit FQHC Voluntary Refund Form

Medical Nutrition Therapy

Diabetes Self-Management Training

Diabetes Screening

JK Medicare Secondary Payer Part B Carrier Voluntary Refund Form

Beneficiary Notices Initiatives

Announcing Service Specific Post-Payment Audits of Individual Psychotherapy Services for J6 A Regions: IL, WI and MN

Edit Reason Code: 5FSEP Bill Type = 13X, 85X CPT/HCPCS/Modifiers:90832- 90834 Overview The Medical Review Department of National Government Services will be performing service specific post-payment reviews for claims submitted to Medicare [...]

Tips for Documenting Homebound Status

Tips for Documenting Homebound Status Comprehensive and accurate documentation is crucial to providing safe and effective care to Medicare beneficiaries. National Government Services' medical review team reviews this documentation while making [...]

Physicians and Nonphysician Practitioners: Revised CMS-855I Medicare Enrollment Application Required November 1 (Combined CMS-855I and CMS-855R)

Physicians and Nonphysician Practitioners: Revised CMS-855I Medicare Enrollment Application Required November 1 (Combined CMS-855I and CMS-855R) If you don’t use PECOS, use the revised CMS-855I (Medicare Enrollment Application - Physicians and [...]

Update: End Stage Renal Disease Claim Adjustments Needed Due to CWF Error in Date of First Dialysis

Update: End Stage Renal Disease Claim Adjustments Needed Due to CWF Error in Date of First Dialysis As of 7/18/2023, CMS has identified that the CWF continues to have some inaccurate dates for the first date of dialysis. We will advise when [...]

I Am a Provider and “I Want to Complete an EDI Registration Form”

I Am a Provider and “I Want to Complete an EDI Registration Form” This selection will prompt you to complete the EDI Registration Form. This option is for providers who wish to submit claim files using a third party such as a billing service [...]

I Am a Provider and “I Want to Complete a Connex Registration Form”

I Am a Provider and “I Want to Complete a Connex Registration Form” This selection will prompt you to complete the Connex Registration Form. This option is for providers who wish to send claims or receive remits through the NGSConnex portal. [...]

Clearinghouse

Clearinghouse When Clearinghouse is selected as your submitter type the following objective will be displayed. Select the objective and then click Next. I am a Clearinghouse and “I want to complete an EDI Registration Form” This objective [...]

Common Questions

Common Questions What is the Entity Name? This is the EXACT provider’s name that was submitted in section 2 of the CMS-855/PECOS enrollment application when applying to participate with Medicare.   What information should be put in [...]

I Am a Provider and “I Want to Connect Directly to the Part A FISS/DDE System”

I Am a Provider and “I Want to Connect Directly to the Part A FISS/DDE System” This selection will prompt you to complete the Logon Request Form. This option is for providers who need to request, modify, reinstate, or add additional access to [...]

I Am a Provider and “I Want to Allow a 3rd Party Billing Service to Bill for Me Using the Part A FISS DDE System”

I Am a Provider and “I Want to Allow a 3rd Party Billing Service to Bill for Me Using the Part A FISS DDE System” This selection will prompt you to complete the Letter of Authorization Form. This option is for providers who wish to allow [...]

I Am a Billing Service and “I Want to Complete an EDI Registration Form”

I Am a Billing Service and “I Want to Complete an EDI Registration Form” This selection will prompt you to complete the EDI Registration Form. This objective is for billing services who need to obtain a new TPID or make a change to an [...]