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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.

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

End User License Agreement

These materials contain Current Dental Terminology, Fourth Edition (CDT), copyright © 2002, 2004 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

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  1. 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.
  2. 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 websiteExternal Website.
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myCGS User Manual Chapter 1

Chapter 1 – myCGS Overview

What is myCGS?

The myCGS portal is a web-based application developed by CGS that is available to suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) who serve beneficiaries in Jurisdictions B and C. Using myCGS is a fast and easy way to get Medicare claim and billing information.

myCGS offers suppliers a wide range of functionality and support, such as:

  • Beneficiary Eligibility
    Find beneficiary eligibility, Medicare Secondary Payer, Medicare Advantage Plan, home health episode, hospice, and inpatient stay information.
  • Claim Status
    Check on the status of claims you've submitted to Jurisdiction B or C
  • Same or Similar Information
    Search beneficiary claim history for same or similar items
  • Redetermination and Reopening Status and Submission
    Check the status of your Redetermination and Reopening requests and submit new requests directly through myCGS
  • ADMC and Prior Authorization Status and Submission
    Submit ADMC and Prior Authorization requests and check their status directly through myCGS
  • Claim Corrections
    Make corrections to claims that have been processed by CGS
  • And More!

This manual contains the information you need to navigate myCGS and take advantage of its many helpful features. The instructions in this manual assume that you are familiar with basic Medicare rules and regulations as they pertain to DMEPOS suppliers. For a detailed overview of Medicare DMEPOS rules and regulations, refer to our Supplier Manual. The Supplier Manual is the first resource that you should use for Medicare billing questions. You can access the Supplier Manual at the links below (depending on your jurisdiction).

DME MAC Jurisdiction B Supplier Manual

DME MAC Jurisdiction C Supplier Manual

For instructions on myCGS registration and user maintenance, refer to the myCGS Registration & Account Management Guide. For news and updates regarding myCGS, as well as other important DME MAC articles and information, be sure to subscribe to our ListServ, the CGS electronic mailing list.

If you have any questions that cannot be answered in this manual or the Supplier Manual, contact our Customer Service Department at one of the following phone numbers (be sure to call the correct jurisdiction ):

Jurisdiction B: 1.866.590.6727

Jurisdiction C: 1.866.270.4909

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Who Can Use myCGS?

Any DMEPOS supplier or affiliate who serves beneficiaries in Jurisdictions B and/or C may register for myCGS. All myCGS users must be approved through the myCGS registration process before receiving the ability to use myCGS. For assistance with registering for myCGS, refer to the myCGS Registration GuidePDF.

There are three different types of myCGS user roles—End User, Designated Approver, and CHBA. The majority of the functionality within myCGS is available to all user roles. The additional feature of being able to maintain user privileges is available only to Designated Approvers.

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Logging in to myCGS

Before you can use myCGS, you must complete the registration process and receive a myCGS User ID and password. Refer to the myCGS Registration GuidePDF for instructions on how to register.

Once you have successfully registered, follow these steps to log in to myCGS:

  1. Open myCGS.
  2. Select the Log in to DME myCGS link.
  3. Log in using your myCGS User ID and Password.

    NOTE: Your account will be locked if you enter your password incorrectly three consecutive times within a 120-minute period. Once your account is locked, you must call our Provider Contact Center to have your account unlocked.

  4. Generate a Multi-Factor Authentication (MFA) code. To generate an MFA code, press the appropriate button (or letter on your keyboard—T, E, or B) for how you would like to receive the code—Text, Email, or Both, or if you have Google Authenticator set up, simply enter your Google Authenticator code. Once you have received the MFA code, enter the code and press Next.

    NOTE: Text and email MFA codes are valid for up to 12 hours after they are initially generated and can be reused throughout the entire 12-hour window. Note that if you request another MFA code, only the most recently generated code is valid.

  5. Read the myCGS Terms and Conditions, and then select your DME Jurisdiction (B or C).

    NOTE: You can easily switch back and forth between Jurisdictions B and C without having to log out of myCGS. Refer to the Switching between Jurisdictions section below.

  6. Once you have successfully logged in, you will be taken to the myCGS Home screen.

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Once logged in (as an End User or CHBA), you will see eight menu selections across the top of the myCGS portal—Home, Beneficiary Information, Claims, Claim Preparation, Finance, Reprocessing, MBI Lookup, and News & Information. To get started, select the menu that contains the information you need. In this manual, you will find a section devoted to each of these menu screens.

NOTE: If you are registered for myCGS as a Designated Approver, then you will be taken directly to the User Management section of myCGS when you first log in. Press the Home menu to go to the End User section. Refer to the Admin section in this manual for additional information.

If one or more of your menu options has a locked icon, then you do not have permission to view/use that menu. Request access to any locked menus from your Designated Approver. You will not be able to access a locked menu until your Designated Approver updates your user permissions. Refer to the Locked Menus section below.

NOTE: Be sure to log in regularly and to keep your password up to date. If you do not log in for 30 consecutive days, your account will be suspended—in order to reactivate your account, you must call our Provider Contact Center. If you do not log in for 90 consecutive days, your account will be deactivated, and you will need to re-register for myCGS. In order to qualify as an active login, you must successfully complete the entire myCGS login process, including use of your MFA code.

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myCGS Interface Overview

myCGS contains eight primary menu options, as well as account, help, and feedback sections. Use the sections throughout this manual to find detailed information about all of the myCGS functions and capabilities.

The image below shows the main areas of myCGS:

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Switching between Jurisdictions

If you are a supplier who services beneficiaries in both Jurisdictions B and C, myCGS allows you to easily switch back and forth between the two jurisdictions. To do so, simply press the appropriate jurisdiction button in the top-center of your screen.

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You can always know which jurisdiction you are currently viewing based on the color scheme of myCGS, as well as the JB or JC label in the top-right corner of the main body of myCGS. As you can see in the screen images below, yellow is Jurisdiction B, and green is Jurisdiction C.

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Change NPI/PTAN

Most of the functional capabilities in myCGS depend on your supplier information—your NPI and PTAN. If you represent a company that uses only one NPI/PTAN, then you do not need to worry about changing NPI/PTANs—your correct NPI/PTAN information will always populate automatically in any screen that requires supplier information in myCGS. But if you represent a company that has multiple NPI/PTAN combinations, then you need to make sure you are using the appropriate NPI/PTAN for the information you are requesting.

NOTE: myCGS will automatically give you access to all of the NPI/PTAN combinations that are associated with your Tax ID.

Switching between NPI/PTANs in myCGS is easy. In the upper-right corner of myCGS, you will always see the NPI/PTAN associated with your account that is currently selected. This NPI/PTAN will auto-populate in any functional screen within myCGS that requires supplier information.

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To change to a different NPI/PTAN, use the dropdown arrow found in the "Select Jurisdiction" box---a dropdown menu will appear that allows you to switch to a different NPI/PTAN.

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If you have a large number of NPI/PTAN combinations, you can enter the first few digits of your desired NPI to narrow down your search and easily find the NPI/PTAN you need.

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Medicare ID

Beginning January 1, 2020, all transactions in myCGS should be completed using the Medicare Beneficiary Identifier (MBI) as the beneficiary's Medicare ID, with limited exceptions. All search screens in myCGS either default to the MBI or are MBI-only.

There are rare occasions in which you may still need to use a Health Insurance Claim Number (HICN) in myCGS. For any screen that allows either MBI or HICN, the default value of the Medicare ID field is MBI. If you need to search by HICN, enter the HICN in the Medicare ID field and then select the HICN radio button.

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Locked Menus

Your organization's Designated Approver has the ability to grant or take away user permissions specific to your user profile. These permissions control which features you can and cannot use in myCGS. If one of your function menus shows a closed lock icon, then you do not have permission to use this function and will not be able to access the menu.

NOTE: If you are a CHBA user, your permissions have been set by the DMEPOS supplier in their CEDI authorization agreement.

If you need access to a menu which is currently locked, contact your Designated Approver and request access.

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