Frequently Asked Questions

Find answers to frequently asked Medicare questions below. For help with eServices, view our eServices FAQs.

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What subsequent hospital visits guidelines/criteria must be met in order for an interval history to be considered problem focused, expanded problem focused or detailed? 03/03/2020
What type of documentation is needed to support an assistant surgeon's claim? 03/03/2020
When a patient is admitted to observation status must the place of service and codes billed by the Part B provider always match what the hospital bills on the UB claim form? 03/03/2020
When an LCD is retired, does this mean that the information in the LCD is obsolete? 03/03/2020
When I call the Interactive Voice Response (IVR) system and select option #2 "Payment Information" then option #1 for "Payment Floor Information," the IVR states that I have 256 claims on the payment floor for $10,652.10. Where do those numbers come from and what is the payment floor? 03/03/2020
When is a beneficiary eligible for the Annual Wellness Visit? 03/03/2020
When using bilateral procedure modifier, do I always submit "1" in the units field? 03/03/2020
When using the Clock Draw test (CDT) to assess the patient's cognitive function as part of the Annual Wellness Visit, do we need to scan the actual paper CDT into the patient's medical record? 03/03/2020
Where can I locate a listing of the Medicare provider specialty codes? 03/03/2020
Who are the medical directors for Palmetto GBA? 03/03/2020
Why are some of our claims denying with message B9 (patient enrolled in hospice)? The services are unrelated to the patient's hospice diagnosis. 03/03/2020
Why can't we get claim status, entitlement or deductible information from a customer service representative? 03/03/2020
Why did Medicare deny my claim indicating that a Skilled Nursing Facility (SNF) is responsible for payment of my service? 03/03/2020
Why isn't a procedure code listed on the Medicare Physician Fee Schedule (MPFS)? 03/03/2020
Why must providers use available self-serve tools for certain actions instead of speaking with a Palmetto GBA customer service representative? 03/03/2020
"Incident To" and Split/Shared Services Frequently Asked Questions 03/03/2020
Quarterly Frequently Asked Questions (FAQs): January 2020 02/03/2020
Quarterly Frequently Asked Questions (FAQs): November 2019 12/02/2019
Quarterly Frequently Asked Questions (FAQs): June 2019 05/27/2019
Quarterly Frequently Asked Questions (FAQs): March 2019 03/28/2019
Quarterly Frequently Asked Questions (FAQs): November 2018 11/20/2018
Quarterly Frequently Asked Questions (FAQs): August 2018 08/13/2018
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