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 [...]

Fraud Prevention and Detection

Please join us to increase your awareness of integrity issues and prevention of potential fraudulent and abusive practices against the Medicare Program. We will also review real life fraud cases. There will be time following the presentation to [...]

Medicare Overpayment Process

Ensure that you are compliant and avoid financial penalties by understanding the Medicare overpayment regulations. This session will focus on identifying overpayments, using the proper forms and procedures, the timelines for repayment and the [...]

Medicare Secondary Payer: The Fundamentals Part 1

This is part 1 of a 2-part webinar. In part 1, we introduce our Part A providers to the fundamentals (basics) of Medicare Secondary Payer (MSP) by providing a high-level overview of the Group Health Plan (GHP) and non-GHP MSP provisions. We [...]

Medicare Part B - Submitting Medical Documentation Electronically

During this webinar, we'll cover the enrollment, registration and methods available for submitting medical documentation to National Government Services. There will be time for your questions following the presentation.

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 [...]

[RESOLVED] NGSConnex and Interactive Voice Response System Experiencing Intermittent Issues

[RESOLVED] NGSConnex and Interactive Voice Response System Experiencing Intermittent Issues We were experiencing intermittent outages with NGSConnex and the IVR. In some cases, the IVR was not playing back information when claim status was [...]

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 [...]

Depression 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 [...]

Maintaining Your Provider Files

During this webinar, we'll share information to aid you in maintaining accurate provider enrollment files for the internet-based CMS systems: Identity & Access Management System (I&A), National Plan & Provider Enumeration System [...]

May 31 is World No Tobacco Day

May 31 is World No Tobacco Day World No Tobacco Day (WNTD) on May 31 is a yearly celebration that informs the public of the dangers of using tobacco, the business practices of tobacco companies, what is being done to fight the tobacco [...]

Medicare Secondary Payer: The Fundamentals Part 2

This is part 2 of a 2-part webinar. In part 2, we continue to introduce our Part A providers to Medicare Secondary Payer (MSP) by providing a high-level overview of your MSP responsibilities per your Medicare provider agreement. You will learn [...]

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments Each year, National Government Services experiences numerous EFT rejections due to inactive or closed bank accounts. To ensure continuous Medicare [...]

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments

Provider Enrollment: Confirm Banking Information to Avoid Disruptions in Medicare Payments Each year, National Government Services experiences numerous EFT rejections due to inactive or closed bank accounts. To ensure continuous Medicare [...]

Local Coverage Determination Open Meeting

Local Coverage Determination Open Meeting National Government Services is hosting a Local Coverage Determination Open Meeting on 6/25/2025.  Details are available by accessing the Local Coverage Determination Open Meeting Announcement. [...]

How to Become a Medicare-Enrolled OTP Supplier

How to Become a Medicare-Enrolled OTP Supplier OTPs with current, valid and full certification by the Substance Abuse and Mental Health Services Administration (SAMHSA) and accredited by a SAMHSA-approved accrediting body; including the DEA [...]

Learn Over Lunch – NGSConnex Inquiries

Effective 5/27/2025, National Government Services 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. Are you prepared? Join this session to learn how to efficiently [...]

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 will also review proper modifiers to use to avoid denials. There will be time following the [...]

Overpayments Due to Contractor Audit Reviews

Overpayments Due to Contractor Audit Reviews If you do not agree with any CMS contractor audits determination and you are a provider practicing in JK (CT, MA, ME, NH, NY, RI, VT) or J6 (IL, MN, WI), you may use the Medicare appeals process [...]

CMS Links

Accreditation of Advanced Diagnostic Imaging Suppliers All Fee-For-Service Providers Ambulatory Surgical Centers (ASC) Center Beneficiary Notices Initiative (BNI)  Care Management including: Advanced Care Planning Behavioral [...]

MLN Connects® Newsletter: May 22, 2025

MLN Connects® Newsletter: May 22, 2025 News Discarded Drugs: Get Updated Lists Medicare Provider Payment & Utilization Public Use Files: Annual Update Medicare Fee-for-Service Geographic Variation Public Use Files & Interactive [...]

The 2025 Spring Part B Virtual Conference Begins in One Week!

The 2025 Spring Part B Virtual Conference Begins in One Week! The 2025 Spring Part B Virtual Conference begins in one week! This is your last chance to register and join us on June 3–5, 2025! Don’t miss out on this must-attend event!   [...]

MLN Connects® Newsletter: May 22, 2025

MLN Connects® Newsletter: May 22, 2025 Departments of Labor, Health and Human Services, Treasury Announce Move to Strengthen Healthcare Price Transparency Trump administration issues request for information, guidance to expand access to real [...]

Medically Unlikely Edits

Claim ADRs

Claim Additional Development Requests Types include: Origins Facts Identification NOC and unlisted codes. Modifiers: AS, 22, 52, 53, 62, 66, 80, 81, 82. PWK initiated and records are not [...]

CMS Medically Unlikely Edits

Medically Unlikely Edits and Related Billing Clarifications

Medically Unlikely Edits and Related Billing Clarifications An MUE is the maximum number of UOS allowable under most circumstances for a single HCPCS/CPT code billed by a provider for a particular date of service for a single beneficiary. [...]

Medical Review Targeted Probe and Educate ADRs

Medical Review Targeted Probe and Educate Additional Development Requests Origins Facts Identification CMS’ TPE program is provider specific education that will focus on improving issues without allowing other [...]

General Information

General Information National Government Services or other CMS contractors may need to request additional information for Medicare claims to assess compliance with Medicare rules. These requests are ADRs. An ADR is a notification/letter [...]

Related Resources

Related Resources MLN® Educational Tool: How to Use the Medicare National Correct Coding Initiative (NCCI) Tools Medicare National Correct Coding Initiative (NCCI) Edits Medicare NCCI Medically Unlikely Edits (MUEs) National Correct [...]

The National Correct Coding Initiative Lookup Tool

The National Correct Coding Initiative Lookup Tool The National Correct Coding Initiative Lookup Tool is designed to help providers identify when certain codes are subject to the automated code pair edits. Search for coding pairs by entering a [...]

Ways to Respond to ADRs

Ways to Respond to ADRs When you are ready to submit, refer to the ADR for the specific submission methods available. NGS offers multiple ways for providers to submit their documentation in response to an ADR. CMS audit contractors notate in [...]

Relocation of the Medically Unlikely Edit Webpage Information

Relocation of the Medically Unlikely Edit Webpage Information National Government Services would like to inform you of an important change regarding the placement of the MUE section on our website. The MUE information has been relocated and is [...]

National Correct Coding Initiative and Medically Unlikely Edits

Quarterly Version Update Changes

Quarterly Version Update Changes CMS posts changes to each of its NCCI PTP published edit files on a quarterly basis. This includes additions, deletions and modifier indicator quarterly changes to PTP column one/column two correct coding edits [...]

Procedure to Procedure Edits

Procedure to Procedure Edits The NCCI contains one table of edits for physicians/practitioners and one table of edits for outpatient hospital services. Hospital PTP edits apply to types of bills subject to the outpatient code editor for the [...]

Add-on Codes

Add-on Codes Add-on codes are specific types of HCPCS/CPT codes intended to describe services that can only be reported in conjunction with a primary procedure. They represent additional work performed during the primary procedure and [...]

Smoking Cessation Tools and Resources - You Can Help Your Patients Quit Tobacco Use

Smoking Cessation Tools and Resources - You Can Help Your Patients Quit Tobacco Use Smokefree.gov Centers for Disease Control and Prevention: Tips from Former Smokers campaign Centers for Disease Control and Prevention: Office on Smoking [...]

Medicare Physician Fee Schedule Database

Medicare offers several tools to help providers bill their services. Many questions you have can be answered by learning how to access and use the Medicare Physician Fee Schedule Database. We hope you'll join us for an overview of this database.

Steps to Claim Corrections

This webinar includes the top continuous errors we find at National Government Services with claim submissions. Join us to learn how to correct your claims. We will also include an interactive segment on the different claim scenarios that cause [...]

Proper Part B Claim Submissions

This webinar is intended to educate providers and office staff members on how to complete a clean claim to avoid claim rejections, developments or denials. We will guide you through the CMS-1500 claim form and the electronic equivalent loops [...]

Being Compliant by Avoiding Claim Denials, Reopenings and Redeterminations

National Government Services is committed to reducing provider burden associated with Medicare claim denials, reopenings and appeals. Don’t wait until you receive the claim denials that will increase your time, effort, and cost to have the [...]

Laboratory Part B Billing

During this webinar, we'll review the Centers for Medicare & Medicaid Services billing requirements for laboratory and pathology services and includes appropriate modifier usage when submitting claims for laboratory/pathology services. [...]

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 [...]

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.

Medically Unlikely Edits

Medically Unlikely Edits An MUE is the maximum number of UOS allowable under most circumstances for a single HCPCS/CPT code billed by a provider for a particular date of service for a single beneficiary. All claims submitted by physicians [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Freedom of Information Act (FOIA) [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Freedom of Information Act (FOIA) [...]

Provider Contact Center

Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Freedom of Information Act (FOIA) [...]

Using NGSConnex to Prevent Eligibility Denials and Rejections

During this webinar, we'll examine common eligibility denials and rejections for National Government Services Part B claims and provide strategies from NGSConnex to prevent them in future submissions. There will be time following the [...]

Medical Necessity and the Advance Beneficiary Notice

Register for this webinar and learn how to properly administer the Advance Beneficiary Notice of Noncoverage (ABN) within the office setting. If you are a physician, nonphysician practitioner or office staff member and interested in learning [...]

Unprocessable Claim Rejections and Corrections

Unprocessable Claim Rejections and Corrections Unprocessable claims are medical claims that cannot be processed by Medicare Part B National Government Services, because they contain incomplete, missing or invalid information. Incomplete [...]

MLN Connects® Newsletter: May 29, 2025

MLN Connects® Newsletter: May 29, 2025 News Inpatient Hospital Admissions: Transferring Medical Review Responsibilities for Short Stay Claims Medicare Shared Savings Program: Apply Now MLN Matters® Articles National Coverage [...]

National Correct Coding Initiative

National Correct Coding Initiative CMS developed the NCCI to promote national correct coding methodologies and eliminate improper coding of Medicare Part B claims. Coding policies are based on coding conventions defined in the AMA’s CPT [...]

FY 2027 Hospital Wage Index Development Timetable Final

FY 2027 PUF Release

FY 2027 PUF Release Availability and Revisions to Wage Index PUF On Friday, 5/23/2025, CMS released the preliminary FY 2027 Worksheet S-3, Parts II and III wage index PUF. The FY 2027 IPPS wage index will be calculated based on Federal [...]

Skilled Nursing Facility Town Hall Question and Answers

Skilled Nursing Facility Town Hall Questions and Answers Are daily notes required for skilled rehabilitation? Answer: Daily notes for rehabilitation are not required, however, they do support that therapy performed was skilled and [...]

Required Documentation

Required Documentation Table of Contents Required Documentation The medical record should contain patient specific information detailing Certification and Recertification Requirements Signature Requirement for Certifications and [...]

NGS Medical Review Process

NGS Medical Review Process Medicare contractors, like National Government Services, operate the medical review program to prevent improper payments and protect the Medicare Trust Fund. Medical reviews involve the collection and clinical review [...]