License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2009 American Medical Association (AMA). All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials including but not limited to CGS fee schedules, general communications, Medicare Bulletin, and related materials internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA website.

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

AMA Disclaimer of Warranties and Liabilities.

CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

CMS Disclaimer

The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

This license will terminate upon notice to you if you violate the terms of this license. The AMA is a third party beneficiary to this license.

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

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Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT-4 only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT-4 is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT-4. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT-4 for resale and/or license, transferring copies of CDT-4 to any party not bound by this agreement, creating any modified or derivative work of CDT-4, or making any commercial use of CDT-4. License to use CDT-4 for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association website.
Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government use. Please click here to see all U.S. Government Rights Provisions.
ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT-4 is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CDT-4. The ADA does not directly or indirectly practice medicine or dispense dental services. The sole responsibility for the software, including any CDT-4 and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third-party beneficiary to this Agreement.
CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT-4 should be addressed to the ADA. End users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT-4. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled "I ACCEPT". If you do not agree to the terms and conditions, you may not access or use the software. Instead, you must click below on the button labeled "I DO NOT ACCEPT" and exit from this computer screen.

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April 2, 2019

Medicare Credit Balance Quarterly Reminder

As a reminder, the Medicare Credit Balance Report for the quarter ending March 31, 2019 is due in our office postmarked by April 30, 2019.

A Medicare credit balance is an amount determined to be refundable to the Medicare program for an improper or excess payment made to a provider due to a claim submission or processing error. Each provider must submit the Medicare Credit Balance Report (CMS-838)and certification for each individual PTAN within 30 days of the quarter end date.

Submission Methods

The Medicare Credit Balance Report may be submitted by using one of the following options. Please choose ONE option and do not submit duplicate reports.

myCGS Portal Benefits and Tips:

Use the Forms tab to complete the CMS-838 electronically.
Attach up to 5 documents in a PDF format (each up to 5MB in size). NOTE: The first attachment must be the signed CMS-838 Credit Balance.
When the submission is complete, you will receive a confirmation message in the Messages tab.
Within 24 hours, you will receive a message that includes a Submission ID and instructions on how to check the status.
For additional information, please reference the following resources:
- myCGS User Guide, "Chapter 7: Forms Tab"
- Making It Easy to Submit Your Credit Balance (CMS-838) Report! job aid

	Part A	Home Health and Hospice
Fax:	1.803.462.2584 MCBR Receipts Attn: Credit Balance Reporting	1.615.664.5987 MCBR Receipts Attn: Credit Balance Reporting
Regular and Certified Mail:	CGS Attn: Credit Balance Reporting P.O. Box 20023 Nashville, TN 37202	CGS Attn: HHH Credit Balance Reporting P.O. Box 20014 Nashville, TN 37202
Fed Ex/UPS/Overnight Courier:	CGS J15 Credit Balance Reporting 26 Century Blvd STE ST610 Nashville, TN 37214-3685	CGS J15 Credit Balance Reporting 26 Century Blvd STE ST610 Nashville, TN 37214-3685

Avoid Rejections and/or Payment Suspensions

Listed below are the most common errors and resolutions to help avoid rejections and/or suspension of payments.

Type of Error	Resolution
Proper documentation not submitted when there is no credit balance.	Each provider must submit a quarterly Credit Balance Report (Form CMS-838). If you have low Medicare utilization, as specified in the Provider Reimbursement Manual, CMS Pub. 15-1, Ch. 24, §2414.4 B, or file less than 25% Medicare claims per year, you do not have to submit Form CMS-838. However, you do need to submit the Certification Page and a letter indicating that you are a low Medicare utilization provider.
Incorrect calendar quarter ended date	The quarter ending dates are: March 31 June 30 September 30 December 31 On the CMS-838 Certification Page, include the month, day and year for the appropriate quarter (e.g., 3/31/19 or March 31, 2019).
Credit balance submitted to the incorrect Medicare Administrative Contractor (MAC)	If you submit claims to more than one MAC, review the claim information (on the remittance advice, Direct Data Entry (DDE) or myCGS Claim Status) and ensure the credit balance is reported and submitted to the MAC that processed the claim.
Missing or incorrect certification date	On the CMS-838 Certification Page, a date must be present and it must be on/after the quarter end date.

If you have general questions related to the Credit Balance report, contact the appropriate Provider Contact Center below.

Home Health and Hospice – 1.877.299.4500 (Option 1)
KY/OH Part A – 1.866.590.6703 (Option 4)

License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

AMA Disclaimer of Warranties and Liabilities.

CMS Disclaimer

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

Medicare Credit Balance Quarterly Reminder

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