MLN Connects® for Thursday, August 15, 2019

MLN Connects® for Thursday, August 15, 2019 New Medicare Card: Transition Period Ends in Less Than 5 Months MLN Connects® for Thursday, August 15, 2019 View this edition as a PDF News New Medicare Card: Transition Period Ends in [...]

MLN Connects® for Thursday, August 8, 2019

MLN Connects® for Thursday, August 8, 2019 New Medicare Card: Will Your Claims Reject? MLN Connects® for Thursday, August 8, 2019 View this edition as a PDF News New Medicare Card: Will Your Claims Reject? Securing Access to [...]

MLN Connects® Special Edition - Wednesday, August 7, 2019

MLN Connects® Special Edition - Wednesday, August 7, 2019 Don't Miss Out: Register for Payment Rule Listening Sessions Today Physician Fee Schedule Proposed Rule: Understanding 3 Key Topics Listening Session — August 12 OPPS and ASC [...]

Reminder: Medicare Part B Providers Receiving Hardcopy Standard Paper Remittances – Moving to Biweekly Mailing Schedule

Reminder: Medicare Part B Providers Receiving Hardcopy Standard Paper Remittances – Moving to Biweekly Mailing Schedule Beginning 8/9/2019, we will change from a weekly to biweekly mailing schedule for Part B hard copy SPR. The only exception [...]

MLN Connects® Special Edition - Friday, August 2, 2019

MLN Connects® Special Edition - Friday, August 2, 2019 IPPS/LTCH: FY 2020 PPS Final Rule IRF: FY 2020 Payment and Policy Changes Hospice: FY 2020 Hospice Payment Rate Final Rule IPPS/LTCH: FY 2020 PPS Final Rule On August 2, CMS [...]

August is National Immunization Awareness Month

August is National Immunization Awareness Month This annual health observance is a great opportunity to educate seniors and other Medicare beneficiaries about the importance of disease control and prevention through immunization. [...]

MLN Connects® for Thursday, August 1, 2019

MLN Connects® for Thursday, August 1, 2019 Protect Your Patients’ Identities: Use the MBI Now MLN Connects® for Thursday, August 1, 2019 View this edition as a PDF News SNF: FY 2020 Payment and Policy Changes IPF: FY 2020 [...]

MLN Connects® Special Edition - Monday, July 29, 2019

MLN Connects® Special Edition - Monday, July 29, 2019 Medicare and ASC Payment System CY 2020 Proposed Rule ESRD and DMEPOS CY 2020 Proposed Rule PFS: Proposed Policy, Payment, and Quality Provisions Changes for CY 2020 On July 29, [...]

MLN Connects® for Thursday, July 25, 2019

MLN Connects® for Thursday, July 25, 2019 Questions about Using the MBI? MLN Connects® for Thursday, July 25, 2019 View this edition as a PDF News New Medicare Card: Questions about Using the MBI? 2020 QRDA III Implementation Guide, [...]

Targeted Probe and Educate Letters – An Informational Overview

Targeted Probe and Educate Letters – An Informational Overview As part of our contractual obligation with the CMS, NGS, your Jurisdiction 6 or K MAC performs TPE to analyze provider compliance with CMS regulatory requirements. The TPE review [...]

Health and Human Services Office of Inspector General Telehealth and Potential Fraud

Health and Human Services Office of Inspector General Telehealth and Potential Fraud The DHHS, of whom the CMS reports to, published a brief last week from the OIG regarding telehealth and the PHE expansion of services. The article addresses [...]

Understanding your Remittance Advice for Merit-Based Incentive Payment System Adjustments

Understanding your Remittance Advice for Merit-Based Incentive Payment System Adjustments National Government Services has seen an increase in invalid overpayment requests related to the MIPS program. MIPS is part of the QPP that determines [...]

MLN Connects® Special Edition for Thursday, February 3, 2022

MLN Connects® Special Edition for Thursday, February 3, 2022 Biden-Harris Administration Will Cover Free Over-the-Counter COVID-19 Tests Through Medicare CMS Developing Initiative to Enable Access to Eight Free Over-the-Counter COVID-19 Tests [...]

Provider Enrollment Authorization and Accreditation

​​​​​​​Provider Enrollment Authorization and Accreditation Provider Enrollment added articles State License and Registrations for Certified Providers and Suppliers and Certified Provider and State Survey Agency for reminders, clarification and [...]

Top Claim Errors

Top Claim Errors Did you know we publish the top claim errors on our website? This information provides you with: the error reason code; a description of the error; the error type; details that include steps you can take to [...]

Jurisdiction 6 State Licensing and Certification Websites

Jurisdiction K State Licensing and Certification Websites

Jurisdiction 6 State Licensing and Certification Websites

Jurisdiction K State Licensing and Certification Websites

Provider Enrollment: Obtaining and Verifying State License

Provider Enrollment: Obtaining and Verifying State License Providers must contact their State agency when initially enrolling or making a change to a current Medicare enrollment for certification materials for their provider/supplier type. For [...]

Certified Provider and State Survey Agency

Certified Provider and State Survey Agency

MLN Connects® Newsletter for Thursday, August 4, 2022

MLN Connects® Newsletter for Thursday, August 4, 2022 ICD-10-CM Code Files: Fiscal Year 2023 News Hospices: Volunteer to Test Hospice Outcomes & Patient Evaluation Instrument Immunization: Protect Your Patients Claims, Pricers, [...]

Modifier 52 Claim Submission Billing Reminder

Modifier 52 Claim Submission Billing Reminder National Government Services found that on many occasions, providers are billing for reduced services with modifier 52 appended to the CPT code; however, they are billing the regular charged amount [...]

Comprehensive Error Rate Testing Redetermination Deadline 9/27/2022

Comprehensive Error Rate Testing Redetermination Deadline 9/27/2022 The CERT RY 2022 is quickly coming to an end. The deadline for redetermination completion is 9/27/2022 to be considered for the CERT RY. National Government Services requests [...]

Comprehensive Error Rate Testing Documentation Deadline 8/22/2022

Comprehensive Error Rate Testing Documentation Deadline 8/22/2022 The CERT RY 2022 is quickly coming to an end. In order to give sufficient time for the CERT RC to complete the review of your claims, all documentation and additional [...]

October 2022 Release "Dark Days" for the Common Working File Hosts

October 2022 Release "Dark Days" for the Common Working File Hosts For the upcoming October 2022 Release: For Production, CWF will be observing the Gray Day on Thursday, September 29th and Dark Days starting Friday, September 30th through [...]

MLN Connects® Newsletter for Thursday, August 11, 2022

MLN Connects® Newsletter for Thursday, August 11, 2022 Monkeypox & Smallpox Vaccines: New Product Codes News Monkeypox & Smallpox Vaccines: New Product Codes Payment Allowance Update for COVID-19 Monoclonal Antibody Therapy [...]

CMS Identifies National System Issue

CMS Identifies National System Issue CMS identified a national system issue, which may have inadvertently adjusted previously processed Part B claims with dates of service (DOS) on or after January 1, 2021. These adjustments processed on July [...]

National Government Services Medicare Spring 2022 Virtual Conference

National Government Services Medicare Spring 2022 Virtual Conference Medicare For You Wednesday, 5/11/2022 – Thursday, 5/12/2022 The NGS Provider Outreach and Education Team is holding our latest bi-annual virtual conference on Wednesday, [...]

Log Out

Log Out You will be logged out of NGSConnex automatically after 30-minutes of inactivity. This is a CMS - security requirement to protect provider and beneficiary information. When you are ready to exit the system, click Log Out icon located [...]

Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow!

Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow! Medicare for You offers valuable information that is fundamental for you, as a provider, to submit claims with the needed information so you realize the [...]

Submit an Adjustment to Correct Claims Partially Denied by Automated LCD-NCD Denials

Submit an Adjustment to Correct Claims Partially Denied by Automated LCD-NCD Denials NGS would like to remind providers that using adjustment reason code “LN” to submit adjusted claims (xx7, xxQ), where changes were made to an LCD/NCD denied [...]

Screen Movements

  Chapter III: Navigating the Online System Screen Movements Purpose To move within the FISS/DDE Provider Online System, providers will perform several different screen movements. The following chart outlines the various screen [...]

MLN Connects® Newsletter for Thursday, August 18, 2022

MLN Connects® Newsletter for Thursday, August 18, 2022 Discontinuing Use of Certificates of Medical Necessity & Durable Medical Equipment Information Forms    News CMS Discontinuing the Use of Certificates of Medical [...]

Accessibility Statement

Accessibility Features of the National Government Services Website The NGSMedicare.com website employs many features to make information more accessible. If you have comments or suggestions, please use our Site Feedback mechanism to let us [...]

MLN Connects® Special Edition for Thursday, August 18, 2022

MLN Connects® Special Edition for Thursday, August 18, 2022 Creating a Roadmap for the End of the COVID-19 Public Health Emergency News Creating a Roadmap for the End of the COVID-19 Public Health Emergency Health Care System Resiliency [...]

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 [...]

Medicare Advantage Information For Part A and Part B Not Offered on the IVR Beginning 3/14/2025

Medicare Advantage Information For Part A and Part B Not Offered on the IVR Beginning 3/14/2025 Effective the evening of 3/14/2025, the Medicare IVR system will no longer provide information regarding the Medicare Advantage:  plan [...]

Medicare Diabetes Prevention Program

Medicare Diabetes Prevention Program Table of Contents Background What is the Medicare Diabetes Prevention Program? Overview of MDPP What is Covered Through the Model? What Does this Mean for Beneficiaries? What Does this Mean [...]

Membership Rosters

Membership Rosters Jurisdiction 6 and Jurisdiction K Home Health POE Advisory Group Roster Member Provider/Institution State Abreau-Costa, Maria Mozaic Senior Life Connecticut Adam, Sherie [...]

Diabetes Self-Management Training

Preventive Services Guide Diabetes Self-Management Training According to the Centers for Disease Control and Prevention, approximately 38.4 million Americans have diabetes and 27.2 million people aged 65 years or older (48.8%) have been [...]

Common Questions for Diabetes Self-Management Training and Medical Nutrition Therapy

Common Questions for Diabetes Self-Management Training and Medical Nutrition Therapy Table of Contents Diabetes Programs Billing for Services DSMT and MNT Telehealth Services Related Content [Return to Top] Diabetes Programs [...]

Meeting Schedules

Meeting Schedule Part A POE AG Meetings for Jurisdiction 6 and Jurisdiction K J6: Illinois, Minnesota, Wisconsin and Federally-Qualified Health Centers in all states JK: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island [...]

The National Correct Coding Initiative

The National Correct Coding Initiative The purpose of the NCCI PTP edits is to prevent improper payment when incorrect code combinations are reported. The NCCI contains one table of edits for physicians/practitioners and one table of edits for [...]

Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating

Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating Did you know that tobacco cessation counseling is a covered Medicare service? Brief tobacco counseling provides substantial health benefits while producing cost savings. [...]

HCPCS 90658 Claim Hold

Claim hold for CPT 90658 (influenza vaccine)

FQHC Claim Hold Effective DOS 1/1/2025

CMS has issued claim hold instructions to all MACs, due to release and testing of a new FQHC pricer.

[RESOLVED] Medicare Claim Process System Experiencing Outages

[RESOLVED] Medicare Claim Process System Experiencing Outages We were experiencing outages with our IVR and NGSConnex claim status functionality. Technical support was engaged and the issue is now resolved. The IVR and NGSConnex claim status [...]

MLN Connects® Newsletter: February 14, 2025

MLN Connects® Newsletter: February 14, 2025 News Complex Non-Chemotherapeutic Drug Administration: Determining Payment for Services Claims, Pricers, & Codes Ambulance Fee Schedule: CY 2025 Inflation Factor Integrated Outpatient [...]

PA Exemption Tool Top

Prior Authorization Exemption Status Inquiry Tool This is a self-service tool to allow both hospital or physician office staff responsible for submitting PARs, to check the exempt status of the HOPD. This tool will only recognize the [...]

Reminder: New Medicare Part B Redetermination Notice Initiative

Reminder: New Medicare Part B Redetermination Notice Initiative As we’ve communicated, National Government Services is transitioning to electronic notifications for Part B Medicare Redetermination decisions when a Medicare Part B [...]

Collaborative Urological Supplies Webinar Coming 3/27/2025

Collaborative Urological Supplies Webinar Coming 3/27/2025 This is your opportunity to hear directly from the Medicare contractors regarding Medicare’s criteria necessary for the coverage of urological supplies. Representatives from all four [...]

Requirements of Medicare Opt-Out Affidavit Agreement

Requirements of Medicare Opt-Out Affidavit Agreement Amendment 4507 of the Balanced Budget Act of 1997 permits a physician or practitioner to “opt out” of Medicare and enter into private contracts with Medicare beneficiaries if specific [...]

Prepare and Submit an MSP Conditional Claim

Table of Contents Background Step 1: Determine if You Can Submit a Conditional Claim Step 2: Prepare a Conditional Claim Conditional Billing Code Table Step 3: Check for a Matching MSP Record for the Beneficiary in the Common [...]

Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment

Reminder, if a hospital, clinic/group or Independent Diagnostic Treatment Facility has ADI screening equipment, certification from a designated ADI accrediting organization needs to be implemented or updated on the Medicare enrollment. The [...]

Audit and Reimbursement

Audit and Reimbursement Cost Report Filing State/Region Contact Information Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont JK_Cost_Report_Filing@anthem.com FQHC (All), [...]