Frequently Asked Questions

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

Please Select a Topic:

Latest Articles

of 3see 25 | see 50 | see 100        Next Page

Quarterly Frequently Asked Questions (FAQs): March 2019 03/28/2019
What specific information can ancillary staff (e.g., RN, LPN, CNA) document during an evaluation and management (E/M) encounter? 03/20/2019
Why are my claims rejecting Medicare Secondary Payer (MSP) with Reason Code CO-16 and remarks codes MA04 and MA130 and what do I need to do? 03/19/2019
After I receive a 277CA will I receive anything else? 03/13/2019
How can I tell if I am set up for Electronic Billing? 03/13/2019
How do I restore a remit file? 03/13/2019
If we see a patient for an Annual Wellness Visit on February 14, 2018, would their next AWV eligible date be February 14, 2019? 03/13/2019
Is it acceptable to use "noncontributory, unremarkable or negative" when reporting past, family or social history? 03/13/2019
Is the 277CA returned for each test submission? 03/13/2019
PC-ACE Pro32 software FAQs 03/13/2019
What information do I need to have available when calling for Electronic Data Interchange (EDI) assistance? 03/13/2019
What is a Network Service Vendor? 03/13/2019
What is an approved software vendor? 03/13/2019
What provider address should I include on the EDI enrollment forms? 03/13/2019
What provider name should I include on the EDI enrollment forms? 03/13/2019
What PTAN should I enter on the EDI enrollment forms if the provider is a member of a group? 03/13/2019
What Submitter Name should I enter on the Provider Authorization form? 03/13/2019
When is a provider authorization form required? 03/13/2019
Where in the 277 CA file can we find the rejection message that provides the detailed rejection reason description? 03/13/2019
Will you reject claims with a P.O. Box in the billing provider address? Will you reject claims where the group number and policy number are the same values? 03/13/2019
A provider left our group. We have billed Locum Tenens for 60 days. If we use a different substitute physician every 60 days, can we continue to bill Locum Tenens under the exiting physician's National Provider Identifier (NPI)? 03/12/2019
Am I a type/specialty that can order or refer items or services for Medicare beneficiaries? 03/12/2019
Are chiropractors required to submit therapy codes with both the GP and the GY HCPCS modifiers? 03/12/2019
Are consultation codes deleted for Medicare Advantage plans as well as Medicare fee-for-service? 03/12/2019
Are observation codes submitted by the hour or by the calendar date? 03/12/2019
Are we required to submit our Medicare Secondary Payer (MSP) claims electronically? 03/12/2019
Are Your Medicare Secondary Payer (MSP) Claims Rejecting? 03/12/2019
Can a clinical pharmacist (Pharm D) perform an Annual Wellness Visit (AWV)? 03/12/2019
Can a nurse practitioner perform the initial hospital visit? 03/12/2019
Can a provider bill Medicare for missed appointments and receive reimbursement? 03/12/2019
Can a provider submit charges for evaluation and management "Level 4" office visit and prolonged care if the reason for the prolonged care was based on the patient requiring an interpreter? 03/12/2019
Can a provider submit critical care services and a procedure on the same calendar date? Can you add the time spent performing these separately billable services towards the critical care time? 03/12/2019
Can a psychologist order basic lab tests? 03/12/2019
Can a service be billed as "incident to" if the auxiliary staff performing the service, where there is no face-to-face encounter with the billing provider, changes a patient's treatment plan based on protocol or the results of laboratory tests? 03/12/2019
Can clarification be provided regarding the statement found in the MLN Matters Number: SE1010 Revised, page 8, "The split/shared rules applying to E/M services remain in effect, including those cases where services would previously have been reported by CPT consultation codes?" 03/12/2019
Can I call the Telephone Reopening Line to correct claims that were rejected as unprocessable? 03/12/2019
Can I submit an established patient code if the minimal documentation requirements are not met for a new patient code? 03/12/2019
Can incident to occur in place of service (POS) 19 or 22 (outpatient hospital)? 03/12/2019
Can providers of the same specialty/same group bill for critical care add on codes on the same date of service? 03/12/2019
Can time alone be used to select an E/M code? 03/12/2019
Can we combine the body areas and organ system to determine the complexity of the examination? The CMS 1995 E/M documentation guidelines use the words "and" and "or" on page 10 when referencing how to differentiate the level of complexity of the examination portion of an E/M service. 03/12/2019
Can we fax a primary payer's Explanation of Benefits (EOB) for Medicare Secondary Payer (MSP) claims using the fax attachments for electronic claims process described in the Medicare Advisory? 03/12/2019
CMS Questions and Answers Open in New Window03/12/2019
Deductible and Coinsurance Write-off Amounts for Qualified Medicare Beneficiaries (QMB) 03/12/2019
Do I need to complete a new provider enrollment form if I am making a change to my credentialing information? 03/12/2019
Do you have a coding question? 03/12/2019
Does a beneficiary need to sign an Advance Beneficiary of Noncoverage (ABN) for every visit? 03/12/2019
Does time need to be documented in order to submit for a hospital or nursing facility discharge service? 03/12/2019
How can I check the status of my first level appeal? 03/12/2019
How can I determine what codes/procedures are bundled with a certain code in the CCI edits? 03/12/2019
   Next Page

Contact Palmetto GBA JM Part B Medicare

Email Part B

Contact a specific JM Part B department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

Anonymous

 


spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer