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Posting Date: 01/05/2021
Description of Application Fee
Description of Application Fee The application fee is imposed on institutional providers and suppliers to cover enrollment costs. The application fee for calendar year 2025 is $730. Related Content Federal Register Notice ‒ information [...]
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Posting Date: 04/14/2022
How to Submit a Hardship Request
How to Submit a Hardship Request To request a hardship consideration, submit with a letter and any supporting documentation describing the hardship and why it justifies the exception for your application. Your hardship request will not be [...]
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Posting Date: 04/14/2022
How to Submit a Hardship Request
How to Submit a Hardship Request To request a hardship consideration, submit with a letter and any supporting documentation describing the hardship and why it justifies the exception for your application. Your hardship request will not be [...]
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Posting Date: 04/14/2022
How to Submit a Hardship Request
How to Submit a Hardship Request To request a hardship consideration, submit with a letter and any supporting documentation describing the hardship and why it justifies the exception for your application. Your hardship request will not be [...]
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Posting Date: 06/23/2025
How to Submit a Hardship Request
To request a hardship consideration, submit with a letter and any supporting documentation describing the hardship and why it justifies the exception for your application. Your hardship request will not be considered if it is received [...]
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Posting Date: 06/23/2025
How to Obtain a Refund
A refund will only be granted in the following instances: The application fee was not required for the application submitted A hardship request was subsequently approved and a fee was paid An application was rejected prior to the screening [...]
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Posting Date: 08/21/2018
How to Obtain a Refund
How to Obtain a Refund A refund will only be granted in the following instances: The application fee was not required for the application submitted A hardship request was subsequently approved and a fee was paid An application was [...]
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Posting Date: 04/27/2021
How to Obtain a Refund
How to Obtain a Refund A refund will only be granted in the following instances: The application fee was not required for the application submitted A hardship request was subsequently approved and a fee was paid An application was [...]
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Posting Date: 04/27/2021
How to Obtain a Refund
How to Obtain a Refund A refund will only be granted in the following instances: The application fee was not required for the application submitted A hardship request was subsequently approved and a fee was paid An application was [...]
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Posting Date: 10/28/2021
Other Audit Contractor ADRs
Other Audit Contractor Additional Development Requests Origins Facts Identification Comprehensive Error Rate Testing (CERT) Office of Inspector General (OIG) Recovery Auditor Contractors (RAC) [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction 6 HH+H Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Home Health Services - Medical Necessity ICD-10 Z47-Z47.89 N/A 55H3V – The documentation did [...]
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Posting Date: 06/17/2025
Holding MSP Claims Receiving CWF Edit 6802
Certain MSP claims are incorrectly rejected against CWF edit 6802. On 4/24/2025, CMS directed MACs to hold all MSP claims editing with 6802 while CWF works to correct the issue.
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Posting Date: 10/15/2021
Home Health Referrals
Home Health Referrals Table of Contents Home Health Referrals Order for Home Health Services Documentation to Support Homebound Status Documentation to Support the Need for Skilled Services Documentation Regarding the Face-to-Face [...]
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Posting Date: 01/27/2015
Home Health Forms – Which is Required?
Home Health Forms – Which is Required? The Advance Beneficiary Notice/Home Health Change of Care Notice/Notice of Medicare Noncoverage Scenario ABN HHHCN NOMNC Patient met goals under the POC and is being [...]
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Posting Date: 06/07/2021
Eligibility Criteria for Face-to-Face Encounters
Eligibility Criteria for Face-to-Face Encounters National Government Services is reminding home health providers that a face-to-face encounter form is not adequate documentation to support that a face-to-face encounter occurred. [...]
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Posting Date: 02/08/2021
Wound Care Under the Medicare Home Health Benefit
Wound Care Under the Medicare Home Health Benefit Wound care treatment typically involves three skilled nursing interventions, which may be performed at the same time or separately from each other. The three services are: Performing the [...]
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Posting Date: 05/11/2020
Home Health Plans of Care: NPs, CNSs and PAs Allowed to Certify
Home Health Plans of Care: Nurse Practitioners, Clinical Nurse Specialists and Physician Assistants Allowed to Certify Section 3708 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act (Pub. L. No. 116-136) amended sections [...]
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Posting Date: 11/30/2020
Homebound Status
Homebound Status A Medicare beneficiary must be confined to the home in order to use their Medicare home health benefit. CMS defines homebound status in the CMS IOM Publication 100-02, Medicare Benefit Policy [...]
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Posting Date: 04/12/2022
Home Health: The Definition of an Allowed Practitioner
Home Health: The Definition of an Allowed Practitioner As per MM12615 the “Definition of an Allowed Practitioner” has been revised to read as follows (CR 12615): Medicare Benefit Policy Manual Chapter 7 Section 30.2.1 – Definition of an [...]
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Posting Date: 06/18/2025
MLN Connects® Newsletter: June 18, 2025
MLN Connects® Newsletter: June 18, 2025 News 2023 Doctors & Clinicians Preview Period Open Until June 25 Hospital Price Transparency: Respond to Accuracy & Completeness RFI by July 21 Medicare Part B Discarded Drug Program: Get [...]
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Posting Date: 05/05/2021
Description of NPI and a Link to NPPES Registry
Description of NPI and a Link to NPPES Registry As mandated by HIPAA, you should maintain (verify and update) your NPI data via NPPES on a regular basis. The NPI: is a ten-digit number and must be submitted on the enrollment form, [...]
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Posting Date: 05/05/2021
Description of NPI and a Link to NPPES Registry
Description of NPI and a Link to NPPES Registry As mandated by HIPAA, you should maintain (verify and update) your NPI data via NPPES on a regular basis. The NPI: is a ten-digit number and must be submitted on the enrollment form, will [...]
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Posting Date: 05/05/2021
Description of NPI and a Link to NPPES Registry
Description of NPI and a Link to NPPES Registry As mandated by HIPAA, you should maintain (verify and update) your NPI data via NPPES on a regular basis. The NPI: is a ten-digit number and must be submitted on the enrollment form, [...]
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Posting Date: 06/12/2025
Medicare Secondary Payer: A Review of the Disabled with a Large Group Health Plan Provision
In this webinar, we will review the criteria of the Disabled with a Large group health plan (LGHP), Medicare Secondary Payer (MSP) provision. Understanding this criteria will help your facility identify and bill the appropriate primary payer [...]
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Posting Date: 11/16/2021
Jurisdiction 6 State Licensing and Certification Websites
Jurisdiction 6 State Licensing and Certification Websites The following list contains helpful links to websites of some organizations within J6 that can be used to verify your status. Table of Contents Illinois Minnesota [...]
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Posting Date: 04/15/2022
Jurisdiction K State Licensing and Certification Websites
Jurisdiction K State Licensing and Certification Websites The following list contains helpful links to websites of some organizations within JK that can be used to verify your status. Table of Contents Connecticut Maine [...]
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Posting Date: 08/21/2018
Certified Provider and State Survey Agency
Certified Provider and State Survey Agency Table of Contents Certified Provider and State Survey Agency Certified Providers/Suppliers Certified Providers and Certified Suppliers That Enroll Via the Form CMS-855A Certified Suppliers That [...]
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Posting Date: 08/21/2018
State License and Registrations for Individuals and Organizations
State License and Registrations for Individuals and Organizations Prior to submitting a provider enrollment application to Medicare, ensure that all applicable state licensing and/or specialty certification requirements are current. Each state [...]
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Posting Date: 01/17/2017
State License and Registrations for Individuals and Organizations
State License and Registrations for Individuals and Organizations Prior to submitting a provider enrollment application to Medicare, ensure that all applicable state licensing and/or specialty certification requirements are current. Each state [...]
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Posting Date: 12/05/2016
Eligible Physicians
Eligible Physicians Physicians who can enroll in Medicare: Doctor of: Medicine (MD) Osteopathy (DO) Chiropractic (DC) Dentistry (DMD) (DDS) Optometry (OD) Psychiatry (MD) Podiatry (DPM) Reviewed 6/12/2025
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Posting Date: 12/05/2016
Eligible Nonphysicians
Eligible Nonphysicians Nonphysician Practitioners who can enroll in Medicare. Below you can find the definition, qualifications and supporting documentation for each specialty. Visit Obtain/Verify State License for assistance with license [...]
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Posting Date: 04/08/2021
Eligible Part B Suppliers
Eligible Part B Suppliers Suppliers who can enroll in Medicare: Ambulance Service Supplier Ambulatory Surgical Centers (ASC) Clinic/Group Practices Hospital Department(s) Home Infusion Therapy (HIT) Independent Clinical Laboratory [...]
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Posting Date: 08/21/2018
Eligible Part B Physicians and Nonphysicians to Enroll as Ordering and Referring Only
Eligible Part B Physicians and Nonphysicians to Enroll as Ordering and Referring Only Physician and nonphysician practitioners who can enroll in Medicare solely to order or refer: Doctors of medicine or osteopathy Doctors of dental surgery [...]
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Posting Date: 06/06/2025
Part A Summit Let’s Chat: Prior Authorization for Certain Hospital Outpatient Department Services
This Let’s Chat session focuses on Prior Authorization for certain hospital outpatient department (OPD) services and is an informal opportunity for you to chat with our staff about the selected topic. During the session, you may ask us [...]
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Posting Date: 06/12/2025
Provider Enrollment: Completing the CMS-855A Paper Application
During this webinar, we’ll provide an understanding of how to complete the CMS-855A provider enrollment paper application.
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Posting Date: 06/12/2025
Provider Enrollment: Completing the CMS-855I Paper Application
During this webinar, we’ll provide an understanding of how to complete the CMS-855I provider enrollment paper application for a group member, sole proprietor or sole owner and we’ll also focus on reassigning Medicare benefits.
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Posting Date: 06/12/2025
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 [...]
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Posting Date: 06/12/2025
PECOS: Manage Signatures and Additional Information Requests
During this webinar, we’ll give direction for the Provider Enrollment, Chain and Ownership System (PECOS) application on understanding how to manage signatures and respond to additional information request from submitted applications.
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Posting Date: 06/12/2025
Understanding the Submission Requirement for a Revalidation Application
Understanding the Submission Requirement for a Revalidation Application According to the 42 Code of Federal Regulations Section 424.515(b), providers and suppliers are required to submit a CMS-855 application with complete information for [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction 6 Part B Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or [...]
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Posting Date: 06/12/2025
MLN Connects® Newsletter: June 12, 2025
MLN Connects® Newsletter: June 12, 2025 News Final National Coverage Determination: Noninvasive Positive Pressure Ventilation in Home for Treatment of Chronic Respiratory Failure Consequent to COPD Skilled Nursing Facility Value-Based [...]
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Posting Date: 08/24/2022
Description of NPI and a Link to NPPES Registry
Description of NPI and a Link to NPPES Registry As mandated by HIPAA, you should maintain (verify and update) your NPI data via NPPES on a regular basis. The NPI: is a ten-digit number and must be submitted on the enrollment form, [...]
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Posting Date: 06/13/2025
Inpatient Rehabilitation Facilities: Preparing and Submitting Compliant Claims to Medicare
In this webinar, we will review Medicare's general inpatient billing requirements for Inpatient Rehabilitation Facility including bill types, billing frequency, interim billing, benefits exhaust billing, billing when claims are paid by [...]
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Posting Date: 06/22/2022
Standard Companion Guide Trading Partner Information
Standard Companion Guide Trading Partner Information Instructions Related to the X12 275 Claims Attachment Version 6020 and HL7 Consolidated Clinical Document Architecture R2.1 Companion Guide Version Number: 9.0 Revised: June 2025 Preface [...]
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Posting Date: 08/15/2022
Eligible Method II Providers
Eligible Method II Providers If a CAH wants to become a Method II biller, email the request to A&R at ngsreimbursement@anthem.com. Suppliers who can enroll as a Method II Biller Reassignment. Doctor of Medicine (MD) Doctor of [...]
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Posting Date: 06/16/2025
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 [...]
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Posting Date: 06/16/2025
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 [...]
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Posting Date: 06/16/2025
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 [...]
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Posting Date: 06/16/2025
Interactive Voice Response System Changes Coming Soon
Interactive Voice Response System Changes Coming Soon We’re making changes to our IVR system. You’ll still dial the same number, but you’ll hear a new voice. Although the IVR provides instructions throughout the call, we want to point out some [...]
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Posting Date: 01/01/1970
Part A - Promo 1
Banner saying "NGS RuralServ - Changing the way we deliver education to you." /web/ngs/ruralserv?selectedArticleId=1987743&lob=96664&state=97178&rgion=93623
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Posting Date: 06/16/2025
Medicare Part B Ambulance Coverage, Basics and Billing
During this webinar, we'll educate new staff or those needing a refresher on basic Medicare Part B ambulance billing guidelines.
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Posting Date: 06/16/2025
Medicare Portable X-Ray Survey Reminder
Medicare Portable X-Ray Survey Reminder MACs, under the direction of the CMS, are conducting a national cost analysis survey to assess the transportation components of portable X-ray services, specifically HCPCS codes R0070 and R0075. This [...]
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Posting Date: 07/14/2022
View a General Inquiry
View a General Inquiry Table of Contents View a General Inquiry Attachments [Return to Top] View a General Inquiry National Government Services, Inc. will respond to your inquiry via NGSConnex within 45-business days of the date your [...]
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Posting Date: 03/22/2024
Hospice Certifying Physician Medicare Enrollment Information
Hospice Certifying Physician Medicare Enrollment Information Under CMS' current regulations, the hospice medical director or the physician member of the hospice interdisciplinary group (the “hospice physician”) and the attending physician (if [...]
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Posting Date: 05/14/2018
Hospice Claim Reporting Requirements for Attending and Certifying Physicians
Hospice Claim Reporting Requirements for Attending and Certifying Physicians Under CMS' current guidelines, the hospice medical director or the hospice physician and the attending physician (if the beneficiary has one), must initially [...]
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Posting Date: 06/24/2025
Observance of Fourth of July 2025
Observance of Fourth of July 2025 In observance of the Fourth of July 2025, National Government Services offices will be closed on Friday, 7/4/2025. Please note: EDI claim files transmitted after 4:00 p.m. central time/5:00 p.m. eastern time [...]
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Posting Date: 06/24/2025
National Government Services Important Update
National Government Services Important Update ALERT: Medicare Fraud Scheme Involving Phishing Fax Requests National Government Services wants to share with our providers an urgent issue that has been identified by CMS. CMS has been flooded [...]
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Posting Date: 06/24/2025
How to Pay the Application Fee
The application fee must be paid electronically. Important: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee using the Provider Enrollment, [...]
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Posting Date: 01/05/2021
How to Pay the Application Fee
How to Pay the Application Fee The application fee must be paid electronically. IMPORTANT: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee [...]
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Posting Date: 01/05/2021
How to Pay the Application Fee
How to Pay the Application Fee The application fee must be paid electronically. Important: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee [...]
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