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.
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Jurisdiction C Contact Information

Department	How to Contact	Forms/Instructions
Customer Support	Interactive Voice Response (IVR): 866.238.9650 Phone: 866.270.4909 Hearing Impaired/TTY: Dial 711 Written Inquiries Fax: 615.782.4490 Mailing Address: CGS – Jurisdiction C Written Inquiries PO Box 20010 Nashville, TN 37202 Online Help Center	Hours: Monday through Friday from 7 am - 5 pm CT/8 am - 6 pm ET CMS requires suppliers and providers use self-service technology to access claim status, payment, and beneficiary information. The myCGS DME Web Portal and IVR system are two self-service technologies that allow suppliers to easily access beneficiary and claim information. Phone Calls: Claim and eligibility-specific calls to the Provider Contact Center (PCC) must be authenticated through the Computer Telephone Integration (CTI) system. CSRs will no longer authenticate information verbally over the phone. We will transfer callers back to the CTI line for authentication. Please be prepared to enter all pertinent information related to your inquiry using the CTI system, including: NPI PTAN Last five digits of your tax ID number (TIN) The beneficiary's Medicare Beneficiary Identifier (MBI), DOB, and DOS. Your name and phone number Tip: Use the MBI Letters to Numbers Tool to convert letters to numbers for use on your telephone keypad. Written Inquiries: Please state your question or concern as clearly as possible, including all pertinent information: NPI number PTAN If appropriate, the beneficiary's name, Medicare Beneficiary Identifier (MBI), and date of service. Your name and phone number Last five digits of Tax ID Note: We are unable to respond to email inquiries containing sensitive information such as MBI or Tax ID. Customer Support Webpage
Additional Documentation Request (ADR)	Fax: 615.782.4624 Mailing Address: CGS – Jurisdiction C Medical Review PO Box 20010 Nashville, TN 37202	Refer to the ADR Process for more information.
Advanced Determination of Medicare Coverage (ADMC)	myCGS Web Portal: Click here to get started Fax: 615.782.4647 Mailing Address: CGS – Jurisdiction C ADMC PO Box 20010 Nashville, TN 37202	ADMC Request Form ADMC Webpage
Claim Submission (Paper CMS-1500 Claim Forms only)	Mailing Address: CGS – Jurisdiction C Claims PO Box 20010 Nashville, TN 37202	Refer to Claim Submission and Paper Claims for more information about how to use and obtain paper claim forms from the U.S. Government Bookstore—Purchase Paper Claim Forms. See also: Electronic Claims
Overpayments & Refunds	Fax: 615.782.4477 Mailing Address: CGS Administrators, LLC – DME JC PO Box 955152 St. Louis, MO 63195-3479 Overnight Delivery: Through October 13, 2023: CGS Administrators, LLC - DME JC Lockbox 955152 1005 Convention Plaza SL-MO-C1WS St Louis, MO 63101 Beginning October 14, 2023: CGS Administrators, LLC - DME JC Lockbox 955152 3180 Rider Trail South SL-MO-R1LB Earth City, MO 63045	Offset Request Form Overpayment Recovery Request Form Voluntary Overpayment Refund Form Refer to Overpayment Recovery for more information.
Prior Authorization	myCGS Web Portal: Click here to get started Fax: 615.664.5960 Mailing Address: CGS – Jurisdiction C Medical Review Prior Authorization PO Box 24890 Nashville, TN 37202-4890 esMD: (indicate document type "8")	Prior Authorization (PA) Submission Form Refer to Prior Authorization for more information.
Redeterminations (Appeals)	myCGS Web Portal: Click here to get started on redetermination request submission. Fax: 615.782.4630 Redeterminations Mailing Address: CGS – Jurisdiction C Redeterminations PO Box 20009 Nashville, TN 37202 *Contact information above is for Overpayment Appeals as well.	Refer to Appeals for detailed instructions on appealing claims and overpayments. Redetermination Completion Guide Redetermination Request (Level 1)
Reopenings (Claims Corrections & Adjustments)	myCGS Web Portal: Click here to get started on claim correction or reopening form submission. Reopenings Phone: 866.813.7878 Underpayment Fax: 615.782.4649 Overpayment Fax: 615.782.4477 Mailing Address: CGS – Jurisdiction C Written Reopenings PO Box 20010 Nashville, TN 37202	Refer to Reopenings for detailed instructions on requesting reopenings for minor errors and omissions. Reopening Request Form Completion Guide Reopening Request Form
Other Contacts
People with Medicare (Beneficiary Customer Service)	Phone: 1.800.MEDICARE (800.633.4227) Hearing Impaired/TTY: 1.877.486.2048	www.medicare.gov
Benefits Coordination & Recovery Center (BCRC), formerly known as COBC	Customer Service: 1.855.798.2627 Written Inquiries: Medicare – MSP General Correspondence P. O. Box 138897 Oklahoma City, OK 73113-8897	When to contact the BCRC: To ask a general MSP question. To ask a question regarding the MSP letters and questionnaires (i.e. IEQ and Secondary Claim Development (SCD) questionnaires.) You may contact the BCRC by calling a Customer Service Representative or through Written Correspondence. CMS-Benefits Coordination & Recovery Center (BCRC)
CEDI (Electronic Data Interchange)	CEDI Helpdesk Phone: 866.311.9184 Email: ngs.cedihelpdesk@anthem.com	www.ngscedi.com Contact CEDI regarding: Electronic Claim Submission, Electronic Remittance Notices, and 276/277 transactions
CGS Headquarters	Address: CGS Headquarters 26 Century Blvd., Ste ST610 Nashville, TN 37214-3685
Competitive Bidding Implementation Contractor (CBIC)	Beneficiaries should call 1.800.MEDICARE (1.800.633.4227) for assistance with questions about the competitive bidding program or claims. Suppliers or referral agents who have questions about the competitive bidding program should contact the CBIC: 877-577-5331	Competitive Bidding Implementation Contractor (CBIC) website
Comprehensive Error Rate Testing (CERT)	Mailing Address: CERT Documentation Center 8701 Park Central Drive, Suite 400-A Richmond, VA 23227 Fax: 804.261.8100 Toll Free Phone: 888.779.7477 Email: CertProvider@empower.ai	CERT C3HUB web site
Electronic Funds Transfer (EFT)	Mailing Address: See National Provider Enrollment (NPE) East or NPE West	Electronic Funds Transfer (EFT) Authorization Form NOTE: This form must be mailed in with original signatures and banking information.
Freedom of Information Act (FOIA)	Mailing Address: Attn: DME MAC Freedom of Information Coordinator Suite ST610 26 Century Blvd Nashville, TN 37214	Refer to Supplier Manual: Chapter 1 - Introduction (DME MAC Jurisdiction C) for additional information and examples. All FOIA requests are subject to fees for search, review, and copy/duplication. Before submitting your request, you may want to see if the information can be obtained from our website.
National Provider Enrollment (NPE) East Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, District of Columbia, Puerto Rico, US Virgin Islands)	Phone:866-520-5193 Provider Enrollment Status Inquiry Tool Mailing Address: Novitas Solutions, Inc. PO Box 3704 Mechanicsburg, PA 17055-1863	National Provider Enrollment (NPE) East (Novitas Solutions)
National Provider Enrollment (NPE) West Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, Northern Mariana Islands	Phone: 866.238.9652 Email National Provider Enrollment (NPE West) Mailing Address: National Provider Enrollment (NPE) West Palmetto GBA AG-495 PO Box 100142 Columbia, SC 29202-3142	National Provider Enrollment (NPE) West (Palmetto GBA)
Office of Inspector General (OIG) to report fraud and abuse	File a Complaint Online Phone: 1.800.HHS.TIPS (1.800.447.8477) TTY Phone: 1.800.377.4950 Mailing Address: U.S. Department of Health and Human Services Office of Inspector General ATTN: OIG HOTLINE OPERATIONS PO Box 23489 Washington, DC 20026	OIG Hotline
Pricing, Data Analysis, and Coding (PDAC)	Contact Center Phone: 877.735.1326	Medicare Pricing, Data Analysis and Coding (PDAC)
Reconsiderations (Appeals) Durable Medical Equipment (DME) Qualified Independent Contractor (QIC) for second level independent external reviews of Medicare Fee-for-Service healthcare denials.	Mailing Address: Maximus Federal Services, Inc. Medicare DME 3750 Monroe Avenue Suite 777 Pittsford, NY 14534 Phone: 585.348.3200 Email: DMEInfo@MAXIMUS.com	MAXIMUS Federal Services
Recovery Auditor (RAC)	Phone: 866.201.0580	Performant Recovery, Inc.
Supplemental Medical Review Contractor (SMRC)	Phone: 1.833.860.4133 Email: SMRCMail@Noridian.com	Supplemental Medical Review Contractor (SMRC)-Noridian Healthcare Solutions, LLC (NHS)
Supplier Enrollment National Supplier Clearing House (NSC)	Starting November 7, 2022, 2 contractors will process Medicare enrollment applications for DMEPOS suppliers to make sure they meet all supplier standards and enrollment requirements. Refer to National Provider Enrollment (NPE) East or National Provider Enrollment (NPW) West above.
The Centers for Medicare & Medicaid Services (CMS)	Toll-Free Phone: 877.267.2323 Local Phone: 410-786.3000 TTY Toll-Free Phone: 866.226.1819 TTY Local Phone: 410-786-0727	CMS Website
Other Helpful Links
CMS CMS Website The Medicare Learning Network® (MLNs) CMS Social Media: YouTube Twitter RSS Feeds and Podcasts Manuals Transmittals HIPAA and Administrative Simplification Central provider webpage ICD-10 Medicare Remit Easy Print (MREP) Software
DME MACs Jurisdiction A – Noridian Healthcare Solutions – Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont Jurisdiction B – CGS – Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin Jurisdiction C – CGS – Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, and West Virginia Jurisdiction D – Noridian Healthcare Solutions – Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, and Wyoming
Remittance Advice Reason Codes
Unified Program Integrity Contractors (UPIC) CoventBridge Group – UPIC Midwestern (Unified Program Integrity Contractor) for IA, IL, IN, KS, KY, MI, MN, MO, NE, OH, & WI Qlarant – UPIC Southwest (Unified Program Integrity Contractor) for AR, CO, LA, MS, NM, OK, & TX Safeguard Services, LLC – UPIC Southeast Unified Program Integrity Contractor) for AL, FL, GA, NC, PR, SC, TN, VA, VI, & WV

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")

Jurisdiction C Contact Information

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