P.O. Box Mailing Addresses

P.O. Box Mailing Addresses Business Function State Mailing Address Additional Documentation Requests CT, MA, ME, NH, NY, RI, VT National Government Services, Inc. P.O. Box 7108 Indianapolis, IN [...]

P.O. Box Mailing Addresses

P.O. Box Mailing Addresses Business Function Mailing Address Additional Development Requests National Government Services, Inc. Attn: Medical Review P.O. Box 6474 Indianapolis, IN 46206-6474 [...]

P.O. Box Mailing Addresses

P.O. Box Mailing Addresses Business Function State Mailing Address Additional Documentation Requests CT, MA, ME, NH, NY, RI, VT National Government Services, Inc. P.O. Box 7108 Indianapolis, IN [...]

New Recovery Audit Contractor

New Recovery Audit Contractor On 4/28/2025, CMS awarded Cotiviti GOV Services LLC the RAC contracts for Region 5 . Region 5 encompasses JA, JB, JC, JD, and the HHH MACs: J6, J15, JK, and JM. Performant previously managed Region 5 and will [...]

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 [...]

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 [...]

Colorectal Cancer Screening: Promoting Good Health Through Disease Prevention and Detection

Medicare covers many preventive services to keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain diseases. Register today for an [...]

Repetitive Scheduled Non-Emergent Ambulance Transports Prior Authorization

Attention All Independent Ambulance Suppliers! If you are providing repetitive, scheduled, non-emergent ambulance transports (RSNAT), you'll want to attend this webinar. Join us to learn everything you need to know about the RSNAT program.

Preventive Vaccines for FQHCs and RHCs Guidance

Preventive Vaccines for FQHCs and RHCs Guidance Effective 7/1/2025, FQHCs and RHCs will bill and receive payment for all four types of Part B preventive vaccines (pneumococcal, influenza, COVID-19 and hepatitis B) and their administration at [...]

Medicare Part B Top 10 Claim Denials

Each quarter, we host this webinar to address the top claim denials we receive. We research and identify common errors and offer solutions to prevent them, which has effectively reduced errors. There will be time following the presentation to [...]

Learning Medicare Secondary Payer Interactively

Join us for an interactive learning webinar where you can engage and have fun at the same time! It’s all about learning the Part B Medicare Secondary Payer (MSP) provisions with live case scenarios. Providers will understand their [...]

LCD and Billing and Coding Article Updates – July 2025

LCD and Billing and Coding Article Updates – July 2025 Billing and Coding: Respiratory Pathogen Panel Testing (A58741) Based on the HCPCS quarterly updates the following updates have been made to the article: PLA Codes 0240U and 0241U have [...]

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a “Stay of Enrollment” or claim rejections which may [...]

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line

Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a “Stay of Enrollment” or claim rejections which may [...]

Three-Day Qualifying Hospital Stay Required for Medicare-Covered SNF Stay

Three-Day Qualifying Hospital Stay Required for Medicare-Covered SNF Stay Medicare coverage of inpatient SNF services requires a qualifying, medically necessary inpatient hospital stay of at least three consecutive calendar days within 30 [...]

MLN Connects® Newsletter: July 3, 2025

MLN Connects® Newsletter: July 3, 2025 Proposed Payment Rules ESRD: CY 2026 Proposed Rule — Submit Comments by August 29 Home Health: CY 2026 Proposed Rule — Submit Comments by August 29 News CMS Launches New Model to Target Wasteful, [...]

Medicare Secondary Payer: A Review of the Non-Group Health Plan MSP Provisions

In this webinar, we review the workers’ compensation, No-Fault (including medical-payment coverage) and the Liability Medicare Secondary Payer (MSP) provisions. Understanding these provisions will help your facility identify and bill the [...]

Medicare Secondary Payer: Payment and Beneficiary Responsibility

In this webinar, we review how Medicare determines if an Medicare Secondary Payer (MSP) payment is due on a claim, how the MSP payment module determines the amount of an MSP payment, how coding reported on MSP claims can impact payment, and how [...]

Medicare Secondary Payer: Adjustment Claims

In this webinar, we will review how to prepare and submit adjustments (Type of Bill XX7) to change processed or rejected claims for Medicare Secondary Payer (MSP)-related reasons. We discuss adjusting Medicare primary, MSP, and cost-avoided [...]

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.

Home Health Billing Coffee Break

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

Appeal Status <7>

Appeal Status <7> When Appeal Status is selected, the IVR will request and collect the following information: NPI PTAN TIN HICN or MBI Refer to the Phonetic Alphabet for assistance with speaking alpha characters [...]

Request an Immediate Recoupment

National Government Services has implemented a standardized “immediate recoupment” process that gives you the option to avoid interest from accruing on claims overpayments when the debt is recouped in full prior to or by the 30th day from the [...]

Complete a Voluntary Refund

A voluntary refund is when you have self-identified you have been overpaid and you need to refund the excess funds to Medicare. All checks are made payable to National Government Services. Whenever possible, the refund to Medicare should be [...]

Set Up an Extended Repayment Schedule

If repaying an overpayment would constitute a “hardship” on the provider, a request for an ERS should be submitted immediately. While you may request an ERS at any time during the debt-collection process, timely submission of a valid request [...]

Payment Withholding Information

Payment Withholding Information What Is a Payment Withholding? Why Are Payments Withheld? Who Can I Contact for Further Assistance? What About Cost Report Interim and Final Settlement Withholdings? What Is a Payment Withholding? An [...]

MSP Post-Pay Adjustments

If you have received an overpayment because Medicare paid as the primary insurer and another insurance carrier should be the primary payer, follow the instructions on the Part A voluntary refund form. A separate refund form is needed for [...]

Refunds Due to Beneficiaries by Providers

Refunds Due to Beneficiaries by Providers In some situations, providers are responsible for refunding monies to beneficiaries that have paid for services providers have determined to be noncovered and nonpayable by Medicare. When an ABN has [...]

Credit Balance Reporting

Table of Contents What is a Credit Balance? What Should I Do When I Have a Credit Balance? Additional Tips for a Successful Credit Balance Report Submission [Return to Top] What is a Credit Balance? Generally, when a provider [...]

CMS-855I Completion Tips for Physicians and NPPs in Private Practice Revalidation Application

CMS-855I Completion Tips for Physicians and NPPs in Private Practice Revalidation Application Follow the instructions printed on the CMS-855I application and refer to this list of sections required for revalidation. Section Required [...]

Cognitive Assessment

Cognitive Assessment Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99483: 60 minute face-to-face [Return to Top] Billing Information Cognitive assessment [...]

Transitional Care Management

Transitional Care Management Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99495: Moderate complexity F2F 7 to 14 days 99496: High complexity F2F 7 days [...]

Psychiatric Collaborative Care Model

Psychiatric Collaborative Care Model The psychiatric CoCM was introduced in 2018 and Medicare began making separate payments using CPT codes 99492, 99493 and 99494. Effective 1/1/2021, G2214 was added to Psychiatric CoCM to cover shorter [...]

Radiopharmaceutical Reimbursement National Government Services has reviewed the radiopharmaceutical pricing methodology set forth in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Section 303(h) which states that [...]

Need Answers? The Options to Consider Before Calling or Writing Into Medicare

National Government Services self-service options and other channels can answer most of provider’s questions. During this session, we will show you how to effectively utilize these tools.

July Code Set Update for PC Print: July 2025

July Code Set Update for PC Print: July 2025 The PC Print July code set update will be available on our website 7/9/2025. The update contains the following enhancements:    CR13999 Remittance Advice Remark Code (RARC), Claims [...]

July Code Set Update for PC Print: July 2025

July Code Set Update for PC Print: July 2025 The PC Print July code set update will be available on our website 7/9/2025. The update contains the following enhancements:    CR13999 Remittance Advice Remark Code (RARC), Claims [...]

Overpayment: How Should I Respond?

Table of Contents Overpayment: How Should I Respond? What Action Should I Take? Complete a Voluntary Refund Where Should I Send my Forms and Payments? [Return to Top] Overpayment: How Should I Respond? An overpayment may be [...]

Pricing <5>

table, td, th table { border-collapse: collapse; width: 50%; } Pricing <5> When Pricing is selected, the IVR will play the following: "To obtain pricing information, visit NGSMedicare.com and use our fee schedule lookup tool, [...]

The National Correct Coding Initiative and Medically Unlikely Edits for Part B Providers

This webinar will assist Part B providers with navigating tables for the National Correct Coding Initiative and the medically unlikely edits. We'll also review the proper modifiers to use to avoid denials. There will be time for your [...]

The National Correct Coding Initiative and Medically Unlikely Edits for Part B Providers

This webinar will assist Part B providers with navigating tables for the National Correct Coding Initiative and the medically unlikely edits. We'll also review the proper modifiers to use to avoid denials. There will be time for your [...]

Download PC Print

Download PC Print Please select from the two available versions of PC Print below. PC Print 7.1.5 PC Print 9.3.2 For the most current CARC/RARC code sets with full narrative and business scenarios, please download PC Print 9.3.2. and [...]

Prior Authorization OPD Alerts

Prior Authorization OPD Alerts Month/Year Topic July 2025 Prior Authorization Outpatient Department Exemption and ABN ADRs August 2024  Removal of Facet HCPCS Codes July 2023 Prior [...]

Documentation Information

Documentation Information It is recommended that PARs are submitted at least seven calendar days prior to the expected date of service to allow National Government Services (NGS) the full standard timeframe to receive and review requests. [...]

Medicare Global Surgery

Global surgery policy was introduced into Medicare over thirty years ago and still today some of the concepts can be confusing. During this webinar, we'll go through the global surgery policy as it stands today, and cover when the global [...]

Requesting an Exception to Timely Filing

Requesting an Exception to Timely Filing Table of Contents Requesting an Exception to Timely Filing No Appeal Rights for Claims Denied Based on Timely Filing Limit Provider Liability Exceptions that May Allow the Time Limit to be [...]

Advanced Care Planning

Advanced Care Planning ACP is a voluntary, face-to-face discussion between you and your patient, their family member, caregiver or surrogate (as appropriate) to discuss the patient’s health care wishes if they become unable to make their own [...]

Behavioral Health Integration

Behavioral Health Integration Table of Contents BHI Overview Eligible Conditions Part B Billing/Coding BHI Services New Coding and Payment for BHI Conditions Billed by Clinical Psychologists and Clinical Social Workers Initiating [...]

CERT Awareness Week One – 2025 CERT Documentation Deadline

CERT Awareness Week One – 2025 CERT Documentation Deadline  The Part A, Part B, DME, home health and hospice, and Railroad Board MACs are working together to promote the importance of complying with CERT documentation requests. This is [...]

Home Health Certifying Provider Change

Home Health Certifying Provider Change Home health certifying physician or NPP changes can occur anytime for a variety of reasons. Some examples may include practitioner retirement or vacation and patient choice. Regardless of the [...]

Meet Cotiviti - The Recovery Audit Contractor for CMS Region 5

This presentation introduces Cotiviti to Region 5 providers, offers an overview of the Medicare Fee-for Service Recovery Audit Program and demonstrates the features and functionality that equip providers to comprehensively respond to audits [...]

Medicare Part B Targeted Probe and Educate Process

During this webinar, we’ll help the Medicare provider community understand the targeted probe and educate program.

Let's Chat About Provider Enrollment

During this session, you’ll have the opportunity to ask questions about all aspects of provider enrollment. Answers will be provided by a panel of subject-matter experts. As this is a question-and-answer session, there is no presentation available.

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 [...]

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 [...]