-
Posting Date: 04/15/2022
Ambulance Transports Excluded from SNF Consolidated Billing
Ambulance Transports Excluded from SNF Consolidated Billing When a Medicare beneficiary is a resident in a SNF under a Part A stay, not all ambulance transports are included in the PPS (prospective payment system) payment for a SNF. SNF [...]
Read More -
Posting Date: 07/29/2025
National Government Services Contractor Advisory Committee Meeting
National Government Services Contractor Advisory Committee Meeting There will be a multi-jurisdictional CAC meeting held on Wednesday 8/20/2025 at 3:30-5:30 p.m. ET, 2:30-4:30 p.m. CT. Meeting details can be found on the National Government [...]
Read More -
Posting Date: 12/31/2018
Ambulance Medical Necessity Reminder for ESRD Patients
Ambulance Medical Necessity Reminder for ESRD Patients National Government Services receives a significant amount of dialysis facility ambulance transports that do not meet medical necessity criteria. Documentation must explicitly describe the [...]
Read More -
Posting Date: 04/22/2020
Related Content
Related Content Ambulance Services Center MLN® Booklet: Medicare Ambulance Transports Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-02, Medicare Benefit Policy Manual, Chapter 10, [...]
Read More -
Posting Date: 06/27/2017
Ambulance Medical Necessity
Ambulance Medical Necessity According to the Centers for Medicare & Medicaid Services’ (CMS) Internet Only Manual (IOM) 100-02, Medicare Benefit Policy Manual, Chapter 10, Ambulance Services; (400 KB) 10.2 - Necessity and Reasonableness [...]
Read More -
Posting Date: 06/27/2022
Billing for A0426 or A0428
Billing for A0426 or A0428 National Government Services has been receiving electronic claims with the 2300 REF segment (G1 qualifier) for prior authorization, however, the value entered in REF02 is a ZIP code. This segment is intended for the [...]
Read More -
Posting Date: 08/06/2015
Medical Necessity of Ambulance Services
Medical Necessity of Ambulance Services Table of Contents Medical Necessity of Ambulance Services What You Can Do Nearest Appropriate Facility: GY Modifier What You Can Do Related Content [Return to Top] Medical [...]
Read More -
Posting Date: 04/29/2022
Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports
Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports The CMS implemented the prior authorization of RSNAT. NGS J6 states Illinois, Minnesota, and Wisconsin were added to the RSNAT Model effective with dates [...]
Read More -
Posting Date: 11/12/2020
Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity
Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity Recent National Government Services educational efforts have highlighted an issue between facilities and the ambulance [...]
Read More -
Posting Date: 06/03/2022
Network Service Vendors
Network Service Vendors National Government Services requires connectivity to the EDI Gateway for exchange of EDI data through select NSVs. In addition to connectivity to the EDI Gateway for the exchange of HIPPAA transactions, these vendors [...]
Read More -
Posting Date: 07/29/2025
Automated CMS System for Tracking Audit and Reimbursement Calculated Tentative
Automated CMS System for Tracking Audit and Reimbursement Calculated Tentative Beginning with cost reports received on or after 7/14/2025, all hospital cost reports will process through the automated CMS STAR Calculated Tentative. With this [...]
Read More -
Posting Date: 07/29/2025
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. [...]
Read More -
Posting Date: 06/01/2020
New York State Ambulance Services in Rural Areas (for JK providers only)
New York State Ambulance Services in Rural Areas NYS has unique requirements for the payment of paramedic intercept services when an ambulance company can provide only BLS services. Paramedic intercept services can be approved in counties and [...]
Read More -
Posting Date: 07/30/2025
Care Management: Health Related Services
As part of a continued series, we're raising awareness on the benefits of care management. During this webinar, we’ll discuss the care management services that Medicare covers in relation to health related services including caregiver [...]
Read More -
Posting Date: 07/30/2025
Submitting Part B Medicare Secondary Payer Claims with Correct Insurance Type Codes
This webinar offers an opportunity to deepen your understanding of Medicare Secondary Payer (MSP) insurance type codes. Using the correct insurance type code is essential for ensuring claims are processed smoothly when Medicare is not the [...]
Read More -
Posting Date: 07/30/2025
Submitting Part B Medicare Secondary Payer Claims with Correct Insurance Type Codes
This webinar offers an opportunity to deepen your understanding of Medicare Secondary Payer (MSP) insurance type codes. Using the correct insurance type code is essential for ensuring claims are processed smoothly when Medicare is not the [...]
Read More -
Posting Date: 03/26/2021
Main Menu Options
Main Menu Options The main menu and subsequent menus can be navigated by using your voice or using touch‐tone on your telephone keypad. You can also use touch‐tone entry for provider numbers, Medicare numbers, PTAN, NPI, TIN, dates of service, [...]
Read More -
Posting Date: 09/16/2020
Patient Status <6>
table, td, th table { border-collapse: collapse; width: 50%; } Patient Status Patient status information is now accessible via our secure online portal, NGSConnex. To access our portal, go to NGSMedicare.com. Revised 7/24/2025
Read More -
Posting Date: 09/16/2020
General Information <8>
table, td, th table { border-collapse: collapse; width: 50%; } General Information <8> When the general information option is selected, the IVR will prompt you to choose from the following options: Phone numbers Addresses [...]
Read More -
Posting Date: 07/30/2025
Interactive Voice Response System Changes
Interactive Voice Response System Changes As we’ve communicated, we’re making changes to our IVR system. If you call the IVR tonight, 7/30/2025, you may experience intermittent outages while we make updates. These changes to the IVR will be [...]
Read More -
Posting Date: 09/16/2020
Tips for Success
Tips for Success Speak naturally and clearly in a quiet environment. Use mute when you're not speaking. Avoid the use of cellular phones or speaker phones. Have information available and organized before you call. Switch to touch‐tone if [...]
Read More -
Posting Date: 09/16/2020
Tips for Success
Tips for Success Speak naturally and clearly in a quiet environment. Use mute when you're not speaking. Avoid the use of cellular phones or speaker phones. Have information available and organized before you call. Switch to [...]
Read More -
Posting Date: 09/16/2020
Claim Status <2>
table, td, th table { border-collapse: collapse; width: 50%; } Claim Status <2> If you are part of a group, remember to use the group NPI, PTAN and TIN for authentication purposes. When Claim Status is selected, the IVR will [...]
Read More