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 [...]

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 [...]

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 [...]

NGSConnex: Beneficiary Eligibility, Look Up and MBI Look Up

Knowing if your patient is Medicare eligible is important for correct claims processing. Please join us for this NGSConnex webinar where we will review beneficiary eligibility and look up, help you understand the eligibility panels, learn how [...]

PCACE Full Install Text - ALOB

Version 6.7 (Institutional and Professional) PC-ACE users

PCACE Download Text - ALOB

The installation code to run the full install or the upgrade for PC-ACE is: NGSMAC1 Important Warning: For PC-ACE version 6.7 updated version: please be patient and allow the full install or update complete. It is important that you do not [...]

PCACE Upgrade Text - ALOB

Version 6.7 (Institutional and Professional) PC-ACE users

About PC-ACE

About PC-ACE The National Government Services PC-ACE free billing software is available for NGS J6 and JK providers only. If you are not a J6 or JK provider, the free billing software must be obtained from your MAC. PC-ACE is a [...]

About PC-ACE

About PC-ACE The National Government Services PC-ACE free billing software is available for NGS J6 and JK providers only. If you are not a J6 or JK provider, the free billing software must be obtained from your MAC. PC-ACE is a stand-alone [...]

Provider Enrollment: Reduce Development Requests for Additional Action

Provider Enrollment: Reduce Development Requests for Additional Action In an effort to reduce the request of additional information and/or documentation on provider enrollment applications, verify all required actions are complete prior to [...]

NGSConnex: Local Security Officer Overview, Access and Navigation

This webinar is geared toward all lines of business for those who will be a Local Security Officer (LSO) in the NGSConnex portal. Come join us and see how NGSConnex can make your life a little easier. We will review the responsibilities of an [...]

NGSConnex: Standard User Overview, Access and Navigation

This webinar is geared toward all lines of business for those who will be standard users in the NGSConnex portal. Come join us and see how NGSConnex can make your life a little easier. We will review what NGSConnex has to offer including [...]

NGSConnex: Additional Development Requests and Inquiries

This webinar is for current and future NGSConnex users who want to learn more about viewing and responding to additional development requests sent to you by National Government Services, and how to submit an electronic inquiry to our Provider [...]

Podiatry Services - Routine Foot Care and Debridement of Nails

While the Medicare Program generally excludes routine foot care services from coverage, there are specific indications or exceptions under which there are program benefits. Medicare payment may be made for routine foot care when the patient has [...]

Prior Authorization Outpatient Department Exemption and ABN ADRs

Prior Authorization Outpatient Department Exemption and ABN ADRs National Government Services Prior Authorization initiated the process of issuing ADRs to 2025 exempt providers. Historically, claims await a provider’s response in FISS DDE [...]

Chronic Care Management

Chronic Care Management Table of Contents Billing Codes Chronic Pain Management and Treatment Codes Billing and Documentation Care management for chronic conditions Related Content [Return to Top] Billing Codes 99490: Provide at [...]

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 Centers for Medicare & Medicaid Services (CMS)-1500 [...]

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 Centers for Medicare & Medicaid Services (CMS)-1500 [...]

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 [...]

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 [...]

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 [...]

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 [...]

Utilizing Third Party Billing Companies

Medicare providers frequently outsource their billing, financial, and enrollment services. During this webinar, we’ll highlight the need to contract with Centers for Medicare & Medicaid Services (CMS)-approved entities and ensure these [...]

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 [...]

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 [...]

ADR Documentation List by Reason Code

How to Find and Respond to a Prior Authorization ADR Table of Contents How to Find and Respond to a PA Pre and Post Payment ADR Steps to View and Print ADRs from FISS/DDE Provider Online System Related Content [Return to Top] How to [...]

Exemption Process

Exemption Table of Contents Exemption Exemption Database Standard Review Cycle Process Exemption Cycle Process Ten Claim Sample Additional Documentation Requests (ADRs) How to Find and Respond to a Prior Authorization ADR Related [...]

MLN Connects® Newsletter: July 10, 2025

MLN Connects® Newsletter: July 10, 2025 News Hospital Price Transparency: Respond to Accuracy & Completeness RFI by July 21 Alert: Medicare Fraud Scheme Involving Phishing Requests Via Fax and Other Means Transcatheter Edge-to-Edge [...]

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 [...]

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 [...]

Phonetic Alphabet

table, td, th table { border-collapse: collapse; width: 50%; } Phonetic Alphabet To assist you when speaking terms that are alpha-numeric, we've implemented the phonetic alphabet. When speaking an alpha character, please use the either [...]

Phonetic Alphabet

table, td, th table { border-collapse: collapse; width: 50%; } Phonetic Alphabet To assist you when speaking terms that are alpha-numeric, we've implemented the phonetic alphabet. When speaking an alpha character, please use the [...]

Principal Care Management

Principal Care Management PCM is a model of care focused on patients with a single, high-risk chronic condition expected to last 6 months to 1 year or until the patient’s death and designed to improve health outcomes and reduce complications. [...]

IMPORTANT: Action Required for SNF Due Date of 8/1/2025

IMPORTANT: Action Required for SNF Due Date of 8/1/2025 For those SNFs that have not yet submitted their Form CMS-855A revalidation application or, as applicable, SNF Attachment, this is an important reminder that you must do so by [...]

Interactive Voice Response System Changes Coming Soon

Interactive Voice Response System Changes Coming Soon We’re making changes to our IVR system soon. You’ll still dial the same number, but you’ll hear a new voice. If the IVR doesn't recognize your voice, we recommend you switch to touch tone. [...]

LCD and Billing and Coding Articles Updates

LCD and Billing and Coding Articles Updates Local Coverage Determinations Drugs and Biologicals, Coverage of, for Label and Off-Label Uses (L33394) This LCD was released to Final on 5/29/2025 and will be effective 7/13/2025. The Indications [...]

Chiropractic Billing and Documentation

During this webinar, we will discuss chiropractic coverage, coding guidelines and the importance of documentation in order to support billing for these services.

How do we report unilateral vs. bilateral injections?

Have the payable diagnoses for IVIG and Rituximab changed? I don’t see all of the previously payable diagnoses in the applicable drug local coverage determinations (LCDs) and articles.

When did this go into effect?