FAQs

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

Please Select a Topic:

Latest Articles

of 2see 25 | see 50 | see 100        Next Page

How can I call Customer Service? 09/04/2020
Am I required to bill with HCPCS modifer JW when reporting waste from a single use drug vial? 09/01/2020
Are chiropractors required to submit therapy codes with both the GP and the GY HCPCS modifiers? 09/01/2020
Are observation codes submitted by the hour or by the calendar date? 09/01/2020
As a rendering physician, how should I report my NPI on a claim? Do I submit differently if I am a member of a group? 09/01/2020
By the time you received my refund, you had already offset my claim. Why wasn't my refund returned to me? 09/01/2020
Can a nurse practitioner perform the initial hospital visit? 09/01/2020
Can a physician or physician's group bill the modifier to indicate a laboratory test was performed by a reference laboratory? 09/01/2020
Can a provider request immediate offset for voluntary refunds or for solicited overpayments prior to the 40-day interval? 09/01/2020
Can a provider submit a hospital inpatient, office or outpatient evaluation on the same calendar date as a critical service? 09/01/2020
Can a service with the GY HCPCS modifier be appealed? 09/01/2020
Can a single visit be counted as both the IPPE and an AWV? 09/01/2020
Can an ABN (Advance Beneficiary Notice of Noncoverage) be issued for HCPCS code A0427-ALS 1/Emergency Transports? 09/01/2020
Can an evaluation and management (E/M) service be performed as a split or shared service? 09/01/2020
Can an independent laboratory bill both non-referred (i.e., self-reported) and referred services on the same CMS-1500 (02/12) claim form? 09/01/2020
Can an independent laboratory bill both non-referred (i.e., self-reported) and referred services on the same electronic claim? 09/01/2020
Can HCPCS modifier JW be billed for the discarded amount of a drug from a multi-use vial? 09/01/2020
Can I bill for drug wastage from a multi-dose/multiuse vial or package of drug or biological? 09/01/2020
Can I bill Railroad Medicare for administering a Part D vaccine? 09/01/2020
Can I bill you for sending requested documentation for a prepayment or postpayment review? 09/01/2020
Can I call the Reopening line to change the total number of post-operative days I billed? 09/01/2020
Can I call the Telephone Reopening Line to correct a rejected claim? 09/01/2020
Can I print or view remittances online? 09/01/2020
Can I request an immediate offset through eServices for both demanded overpayments and voluntary refunds? 09/01/2020
Can I submit a subsequent hospital visit if my documentation does not support one of the three levels of an initial hospital visit? 09/01/2020
Can I use an ABN (Advance Beneficiary Notice of Noncoverage) for chiropractic services? 09/01/2020
Can my billing agency or clearinghouse request my PTAN from Railroad Medicare? 09/01/2020
Can my billing agency or clearinghouse update my provider enrollment record with Railroad Medicare? 09/01/2020
Can other medical services be performed at the same time as an AWV? If so, how are they coded? 09/01/2020
Can Railroad Medicare beneficiaries have coverage through a Medicare Advantage plan? 09/01/2020
Can time be used as a basis for E/M code selection in regards to add-on psychotherapy services? 09/01/2020
Can we bill a patient for a service that denied due to MUE? Should we issue an Advance Beneficiary Notice (ABN) to the patient in this case? 09/01/2020
Can we utilize the "status of three or more chronic/inactive conditions" as an extended History of Present Illness (HPI) for the 1995 guidelines? 09/01/2020
Do I have to be enrolled with Railroad Medicare to be able to order or refer services for a Railroad Medicare beneficiary? 09/01/2020
Do I need to notify Railroad Medicare if we add an additional practice location? 09/01/2020
Do I need to notify Railroad Medicare of a provider or practice name change? 09/01/2020
Do I need to notify Railroad Medicare that a provider's address has changed? I have already notified our local Medicare Administrative Contractor (MAC). 09/01/2020
Do subsequent chiropractic visits need new treatment plans? 09/01/2020
Does it matter what position modifiers are submitted on an anesthesia claim? 09/01/2020
Does it matter what position pricing modifiers are submitted on a claim? 09/01/2020
Does Medicare allow providers to bill a patient for a missed appointment? 09/01/2020
Does Medicare reimburse for ambulance transportation to and from a physician's office? 09/01/2020
Does Railroad Medicare cover shingles vaccines? 09/01/2020
Does Railroad Medicare cover TDAP shots? 09/01/2020
Does Railroad Medicare cover tetanus shots? 09/01/2020
Does Railroad Medicare have Local Coverage Determinations (LCDs)? 09/01/2020
Generally speaking, when we say 'objective measures,' what does that mean? 09/01/2020
How can I determine if an MUE value applies to the date of service or the line of service? 09/01/2020
How can I get a duplicate remittance notice? 09/01/2020
How can I tell if a remittance was paid by paper check or by electronic funds transfer (EFT)? 09/01/2020
How do I address Chiropractic treatment goals if I see the patient once and no further treatment is necessary? 09/01/2020
How Do I Find a Form? 09/01/2020
How do I make text larger to make it easier to read? 09/01/2020
How do I report a provider address change? 09/01/2020
How do I request immediate offset on an established overpayment due to Railroad Medicare? 09/01/2020
How do I submit an Appeal online? 09/01/2020
How do I upload attachments to an appeal request? 09/01/2020
How do I verify the effective date of my electronic fund transfer (EFT)? 09/01/2020
How do you determine if an ambulance transport is considered emergent? 09/01/2020
How does a chiropractor submit a claim for an office visit and X-rays to Medicare for the denial of statutorily excluded services for the patient's secondary insurance company? 09/01/2020
How is compliance with the CERT contractor's request for medical records beneficial to providers? 09/01/2020
How long does the CERT contractor have to review the medical records? 09/01/2020
How long will it take Railroad Medicare to issue a PTAN? 09/01/2020
How many units of services should I submit when I am billing a bilateral surgical procedure with CPT modifier 50? 09/01/2020
How often are CARCs and RARCs updated? 09/01/2020
How should time spent with the patient and/or family member doing psychotherapy be documented? 09/01/2020
How should we calculate the time for time-based psychotherapy services for the purposes of submitting claims? 09/01/2020
How will we be notified of the review decision? 09/01/2020
How would I know a Railroad patient is enrolled in a Medicare Advantage plan when they presented their Railroad Medicare Card? 09/01/2020
I am a hospitalist and all records for my services are part of the patient's hospital record. Why do Medicare contractors send me the request for medical records and not the hospital? 09/01/2020
I am an opt-out physician and would like to order and refer services. What do I need to do? 09/01/2020
I billed for a chemotherapy drug with HCPCS code J9999 and it denied. Why? 09/01/2020
I billed multiple patients on one ambulance trip with HCPCS modifier GM, why are my claims still being denied? 09/01/2020
I did not receive the prepayment ADR letter Medical Review sent for my claim. How can I get a copy of the letter? 09/01/2020
I have primary payment for a consultation service. My software does not allow me to change the procedure code to an E/M code that Medicare will accept. Since Medicare no longer accepts consultation codes, can I bill the patient the co-pay from the primary insurance and not submit a claim to Medicare? 09/01/2020
I just received my Part B MAC PTAN. How soon can I request a Railroad Medicare PTAN through the PTAN Lookup and Request Tool? 09/01/2020
I noticed a "multiple procedure" modifier on my remittance advice but I did not submit it. The service was allowed, but should I have included this modifier on my claim? 09/01/2020
I rarely file paper claims and do not want to buy new forms. What are my options? 09/01/2020
I received a letter saying I have to file claims electronically with Railroad Medicare and references "ASCA". What does "ASCA" mean? 09/01/2020
I sent my claim to Railroad Medicare but the IVR and eServices indicate that it is not on file. Should I call and ask a representative to search for the claim? 09/01/2020
If a paramedic (not an EMT) is requested for a transport (emergent or non-emergent), but no advanced life support (ALS) procedures are performed is it considered an ALS transport? 09/01/2020
If a patient is being transported to a wound care center located within a hospital or on hospital grounds, which destination modifier would be used when filing the claim? 09/01/2020
If a patient is transported by ambulance to hospice prior to the initial assessment and development of the plan of care, what destination modifier do I use? 09/01/2020
If a patient presents to the office for an injection or venipuncture, would it be acceptable to submit an office or other outpatient visit CPT code? 09/01/2020
If an ambulance is dispatched as a result of a 911 call, arrives at the scene, does an assessment of the patient and it is found there is no need for the transport, would the Advanced Beneficiary Notice (ABN) be used in this case if we intend to bill the patient? 09/01/2020
If another provider admits a patient into Observation Care and I provide a consult, can I bill the observation care code? 09/01/2020
If Medicare determines that my records are not legible, will you treat this as if no documentation is available? 09/01/2020
If my patient is registered in the emergency department and I am asked to see him/her, may I submit the emergency service? 09/01/2020
If the patient's secondary insurance is requiring a denial from Medicare for services that are statutorily non-covered, how does a chiropractor submit a claim for an office visit and X-rays to Medicare for denial? 09/01/2020
In my notes, I documented pain and muscle spasm in the lumbar region at L2-L3, but my claim denied due to an incomplete P.A.R.T. exam. Can you explain why? 09/01/2020
Is a chiropractor required to submit claims for non-covered services, such as an office visit, and how do I know if the patient's secondary insurance will consider the service if Medicare does not cover it? 09/01/2020
Is a supervising physician's signature required for services performed by a physician assistant in the emergency department? 09/01/2020
Is an address required in block 32 of the CMS 1500 (02/12) claim form when the place of service code billed is 12 (Home)? 09/01/2020
Is it acceptable to document "VSS" (vital signs stable)? How many vital signs must be listed in order to receive "credit" for the 1995 guidelines under "constitutional"? 09/01/2020
Is it acceptable to highlight information in the medical records when responding to a Medical Review Additional Documentation Request (ADR)? 09/01/2020
Is Medicare the Primary or Secondary Payer? 09/01/2020
Is the Beneficiary Signature required for emergency ambulance transports? 09/01/2020
Is the hospital responsible for the payment of the transports while the patient is an inpatient? 09/01/2020
Is there a deductible or coinsurance/copayment for the Annual Wellness Visit (AWV)? 09/01/2020
May we fax documentation in response to Additional Documentation Request (ADR) letters? 09/01/2020
Medicare Secondary Payer (MSP) Frequently Asked Questions 09/01/2020
My claim rejected with a remittance message code MA83, saying: "Did not indicate whether we are the primary or the secondary payer?" What does this mean? 09/01/2020
My claim rejected with remittance message MA116 - Did not complete the statement 'Homebound' on the claim to validate whether laboratory services were performed at home or in an institution. Where do I put "Homebound" on a claim? 09/01/2020
My claim was denied with remittance messages 183 and N574. I submitted the name and NPI of the ordering/referring provider. What is wrong? 09/01/2020
My claims are denying because Medicare records show another insurance should be paying as primary to Medicare. The patient has recently retired and says the insurance has ended. Who can I call to get the patient's Medicare record updated? 09/01/2020
My paper claim was rejected with remittance message N265? What information was missing? 09/01/2020
My paper claims are rejecting with remittance message N257 - Missing/incomplete/invalid billing provider/supplier primary identifier. I am entering the provider's NPI on the claims. What is wrong with my claims? 09/01/2020
Once I submit a request for immediate offset, what can I expect? Will my debt automatically be paid off? Will interest accrue? 09/01/2020
One physician in a group performed a surgical procedure but a different physician in the same group was responsible for follow up after the surgery. Do we submit as split post-op care? 09/01/2020
Our claim was denied for MUE. Can we request a reopening to change the units of service billed? 09/01/2020
Payment was reduced (down coded) for E/M services because the documentation was not legible to the reviewer. What should I include in an appeal request? 09/01/2020
Please clarify the guidelines for advanced life support (ALS) assessment with no services in response to a 911 dispatch. I thought that if an ALS assessment was done, the transport is automatic, as this was a 911 dispatch. 09/01/2020
Postpayment Review Documentation Requests FAQs 09/01/2020
Provider Signature Attestation FAQs 09/01/2020
Provider Signature Log FAQs 09/01/2020
Should Railroad Medicare PTANs Be Submitted On Claims? 09/01/2020
The immediate offset form was sent. Why is the overpayment still outstanding? 09/01/2020
The PWK fax cover sheets ask for ACN number, what is an ACN number? 09/01/2020
What address are prepayment Additional Documentation Request (ADR) letters sent to? 09/01/2020
What are National Correct Coding Initiative (NCCI) Procedure to Procedure edits? 09/01/2020
What are the documentation requirements for billing observation or inpatient hospital care services (including admission and discharge services)? 09/01/2020
What codes should we bill to Railroad Medicare for the administration of a preventive immunization? 09/01/2020
What does MA04 "Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible" mean? 09/01/2020
What if I can't get a handwritten or electronic signature because the provider is deceased or has left the practice? 09/01/2020
What immunizations does Medicare Part D cover? 09/01/2020
What is Comprehensive Error Rate Testing? 09/01/2020
What is medical review? 09/01/2020
What is the CERT provider compliance error rate? 09/01/2020
What is the correct Medicare Secondary Payer (MSP) type to use when filing an electronic claim? 09/01/2020
What is the definition of a "new patient" when selecting an E/M CPT code? 09/01/2020
What is the difference between MUE date of service edit indicators MAI 2 and MAI 3? 09/01/2020
What is the difference between the 1995 and 1997 Evaluation and Management (E/M) Guidelines? 09/01/2020
What is the provider's enrollment effective date with Railroad Medicare? 09/01/2020
What is the purpose of a Comparative Billing Report (CBR)? 09/01/2020
What is the Qualified Medicare Beneficiary (QMB) program? 09/01/2020
What is the TTY/TDD provider service center number for Railroad Medicare Providers? 09/01/2020
What modifiers are required when billing for beneficiaries enrolled in hospice? 09/01/2020
What provider identification information do I need when I call Customer Service? 09/01/2020
What should I do if I disagree with a letter of review findings for a review of medical records? 09/01/2020
What should I do if the beneficiary and/or representative refuses to sign for an ambulance transport? 09/01/2020
What specific information can ancillary staff (e.g., RN, LPN, CNA) document during an evaluation and management (E/M) encounter? 09/01/2020
When billing a drug with HCPCS modifier JW, should the modifier be applied to the amount of the drug that was administered, the amount discarded, or both? 09/01/2020
When billing psychotherapy with an E/M service, can we include the time spent on the E/M service when selecting the appropriate add-on psychotherapy code? 09/01/2020
When billing time-based psychotherapy, what code should I use when the time spent doing psychotherapy does not match the time in the code descriptions? 09/01/2020
When billing to Part B on a CMS-1500 (02/12) claim, how should a laboratory report services performed by a reference laboratory? 09/01/2020
When I check eligibility through the eServices portal will it show Medicare Advantage plan enrollment? 09/01/2020
When is a Physician Certification Statement (PCS) required for Ambulance services? 09/01/2020
When scoring documentation for E/M services, can a review or order of a pulse oximetry reading be counted as a vital sign under constitutional? 09/01/2020
   Next Page

Contact Railroad Medicare

Email Railroad Medicare

Contact a specific Railroad Medicare department

Provider Contact Center: 888-355-9165

IVR: 877-288-7600

TTY: 877-715-6397

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

 

Click to Chat Now