LICENSES AND NOTICES

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 websiteExternal 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

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.

THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED "I ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.

IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "I DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN.

IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.

  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.
  3. 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.
  4. 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.
  5. 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.


myCGS

Intro

What is myCGS?

myCGS is a FREE, web-based, secure provider self-service application developed specifically to serve the needs of health care providers and their staff throughout our Jurisdiction 15. CGS's goal is to give providers secure, fast access to their Medicare information seamlessly via the myCGS portal.

The myCGS application provides the following types of information:

  • Beneficiary eligibility
  • Claims status
  • View and print Remittance Advices
  • Access to financial information
  • Submit Redetermination requests
  • Receive correspondence from CGS
  • Obtain a patient's Medicare Beneficiary Identifier (MBI)
  • Check eligibility dates for Medicare-covered preventive services
  • Determine Medicare Secondary Payer (MSP) status
  • Identify Medicare Advantage (MA) enrollment
  • Respond to claims and Medical Review Additional Documentation/Development Request (ADR) letters
  • Request Comparative Billing Reports (CBRs)
  • Submit roster claims for mass immunizers
  • And MUCH more!

Terms and Conditions

The Terms and Conditions provide privacy and security notices consistent with applicable federal laws, directives, and other federal guidance for accessing this Government system, which includes:

  1. This computer network,
  2. All computers connected to this network, and
  3. All devices and storage media attached to this network or to a computer on this network. 

This system is provided for Government-authorized use only.

Unauthorized or improper use of this system is prohibited and may result in disciplinary action and/or civil and criminal penalties.

Personal use of social media and networking sites on this system is limited as to not interfere with official work duties and is subject to monitoring.

By using this system, you understand and consent to the terms. To view the terms in its entirety, go to the myCGS Log-In pageExternal Website and click on “Terms” which is located in the lower-right corner.

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HIPAA Eligibility Transaction System (HETS) Inquiries Rules of Behavior

The Centers for Medicare & Medicaid Services (CMS) is committed to maintaining the integrity and security of health care data in accordance with applicable laws and regulations.

The HETS Rules of Behavior reiterates your responsibility in obtaining, disseminating, and using beneficiaries’ Medicare eligibility data. It further explains the expectations for using HETS. You must accept these HETS Rules of Behavior in order to gain access to the system.

HETS Rules of Behavior are available here.External PDF

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Why Use myCGS?

myCGS is THE solution to moving toward a totally automated office, focusing on efficiency and convenience.

The top reasons we reject claims is due to beneficiary eligibility issues. Using myCGS to query your patient's status will save you TONS of time and money by submitting claims to the correct payer the first time!

myCGS offers a wide range of information and features to make your Medicare lives a whole lot easier! Most functions are available to you 24 hours a day, seven days a week! And – it's completely FREE!

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myCGS Availability

myCGS will generally be available 24 hours a day, seven days a week. However, access to myCGS does not guarantee that all functions will be available. Refer to the availability times below for times when each function is available. myCGS scheduled maintenance times are also listed below.

Function Available Times (Monday – Friday)
Claims Data 6:00 a.m. - 7:00 p.m. ET
Remittances 6:00 a.m. - 7:00 p.m. ET
Beneficiary Eligibility 24/7 except during established myCGS and CMS scheduled maintenance
Financial Data 6:00 a.m. - 7:00 p.m. ET

If scheduled myCGS maintenance is required, it will be performed during the times listed below:

  • Monday - Friday: 6:00 a.m. - 8:00 a.m. ET
  • Saturday - Sunday: You may be able to login to myCGS; however, access to individual functions may not be available
  • Sunday: 5:00 p.m. - 10:00 p.m. ET

Our goal is to avoid any service interruptions during normal operating hours. However, unscheduled maintenance may be necessary in order to immediately address systems security threats or performance issues. When you access myCGS and it is not available, you should see a page that indicates maintenance is in progress.

Also, refer to the myCGS Status Page for updates known issues.

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System Requirements

To optimize usability of myCGS, we recommend that users verify their system adheres to the following requirements:

Operating System:

  • Windows 10 (latest security patches)
  •  Mac OS X 11.x or above

Supported Internet Browsers:

  • Microsoft Edge
  • Google Chrome: Version 98.x and above

Recommended Screen Resolution: 1024x 768

Additional Requirements:

  • Adobe Acrobat Reader Version DC or Adobe Acrobat Pro Version DC
  • JavaScript enabled
  • Compatibility view disabled
  • Pop-up blocker disabled
  • Use TLS 1.2 selected in browser settings

NOTE: Although myCGS may still be accessible without meeting these requirements, only the options above are supported. Failure to meet these requirements may adversely affect the functionality and layout of myCGS.

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Support

For questions or assistance with myCGS, contact the EDI Help Desk, available 7:00 a.m. – 4:30 p.m. CST (8:00 a.m. – 5:30 p.m. EST)

EDI Help Desk

  • Part A: 1.866.590.6703 (Option 2)
  • Part B: 1.866.276.9558 (Option 2)
  • Home Health and Hospice: 1.877.299.4500 (Option 2)

On each page in myCGS you will find the EDI Help Desk phone number for your line of business and a link to the myCGS User Manual.

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Did You Know?

To further assist, we offer the "Did You Know? Page, which is a dedicated set of Q&As specific to the navigation and function of myCGS.

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Registering for myCGS

In order to register for and use myCGS, a provider (each PTAN/NPI combination) must have a signed Electronic Data Interchange (EDI) Enrollment Agreement on file with CGS. A link to the EDI Enrollment Agreement is located on page 1 of the EDI Enrollment Packetscreenshot. If you do not already have an EDI Enrollment Agreement on file with CGS, please complete one before attempting to register for myCGS.

Registration Process

  1. Navigate to the myCGS Login page.
  2. Click on "Log In to J15 A/B/HHH MAC myCGS."

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  3. Click on "Create Your Account" button.

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  4. Review the Terms of Use. If you agree, click the "ACCEPT" button.
  5. myCGS will allow new users to choose a Username. Enter a username following the guidelines. Click the "Check Availability" button to ensure the username you've selected is not already in use.

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  6. After verifying your username, enter a password according to the password requirements noted on the screen. If you are in a secure environment, you may click the eye icon to see what you type. Also, if you prefer, you may use the password myCGS suggests. Click "Create My Account" when all fields are completed.

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  7. Complete the following on the myProfile page:
    1. First Name
    2. Last Name
    3. Email address
    4. Re-Enter email address
    5. Work Phone Number
    6. Extension
    7. Mobile Phone Number (Not required but will be an option to receive the Multi-factor Authentication (MFA) code.)
    8. Select the "Authenticator Setup" button if you are interested in a third option to receive the MFA code, Google Authenticator. (This can also be set up later under the My Account tab.)

    Click "Save & Proceed" to continue.

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  8. From the mySecurity page, select your security questions and answers. This is important should you forget your password and need to reset it. myCGS will ask you these questions as a way to confirm your identify.

    When done, click "save & Proceed."

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  9. You will receive an email that includes a 7-digit code.

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  10. Enter that code on the Verify My Email page. Click the "Verify My Email" button to continue.

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  11. myCGS will take you to the logon page, displaying a message to confirm your email has been verified.

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You are now registered for myCGS and may log into the portal.

To gain access to provider information, your Provider Administrator may assign permissions for you to access provider accounts. You may also send a request to the Provider Administrator from your My Account tab under the myProviders sub-tab. Click on the “Add a Provider” button to complete the request.

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Refer to the My Account/Add a Provider section of this manual for step-by-step instructions.

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Roles

myCGS users may have one of two roles: A Provider Administrator or a Provider User.

Provider Administrator

The first person who registers a provider's PTAN/NPI combination is considered the Provider Administrator. Provider Administrators will have access to all tabs and functions within myCGS. This person is responsible for maintaining the portal for the PTAN/NPI combination, which includes registering, granting permissions for, and deleting users.

NOTE: We suggest there be at least two Provider Administrators established for each provider office. This is especially important in the event a Provider Administrator is unable to log into myCGS on a regular basis or leaves the practice. If this happens and no one is assigned the role as an additional Provider Administrator, all established Provider Users may risk being deleted.

Provider User

Provider Users are established by the Provider Administrator and are granted rights to some/all tabs within myCGS. Those tabs for which Provider Users have not been granted access will be grayed out and will not be accessible. If you need access to tabs that are grayed out, you must request access from your Provider Administrator. (CGS does not determine access or security for Provider Users.) This is done under the My Account tab, myProviders sub-tab. (Refer to the My Account section below.) There is no limit to the number of Provider Users that can be established under the Provider Administrator.

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Logging into myCGS

Once you have completed the registration process (see Registering for myCGS above), you can access myCGS at https://www.cgsmedicare.com/mycgs/index.html.

Click on the "Log In" link.

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Enter your Username and password in the appropriate fields and click "Log In."

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NOTE: If you experience problems logging into your account (e.g., inactive profile, temporary lockout, incorrect password, deactivated Username, etc.) a message code will display directing you to your registered email account for specifics.

CGS recommends that all Provider Administrators and all Provider Users sign into myCGS at least once every two weeks. You must log in every 30 days to avoid deactivation. For more information, refer to the User ID Disabled section.

Multi-Factor Authentication (MFA)

MFA is a CMS requirement that provides an additional form of security to safeguard provider and patient information. The MFA verification code is a 6- or 8-digit code that must be entered before gaining access to myCGS.

During the registration process, you entered your email address and had the option of adding your mobile number and setting up the Google Authenticator app.

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  • If you select either the text or email option to receive your MFA code, the 8-digit code is valid for up to 12 hours. You may reuse the same MFA code repeatedly within the 12-hour period. Enter the code and click "Submit."

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  • If using Google Authenticator to access myCGS, the app continuously changes to a new 6-digit code every 30 seconds. Enter the code and click "Submit." NOTE: This is THE fastest way to access the myCGS portal! For instructions, refer to Google Authenticator under the My Account section below.

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Before accessing myCGS, you must acknowledge the myCGS Terms of Use.

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myCGS Session Timeout

For security purposes, all myCGS sessions will automatically timeout after 15 minutes of inactivity. A notification box will display when you are approaching your inactivity limit. If you wish to continue your session, click 'Stay and Continue" and your session will be extended.

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If you are automatically logged out, you may log back in without delay.

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User ID Disabled

CMS and CGS are dedicated to keeping your information safe. To achieve this, access to myCGS must be limited to users who use the system on a regular basis.

As a result, a User ID will be disabled when it has not been used in 30 days. For this reason, CGS recommends that all Provider Administrators and all Provider Users sign into myCGS at least once every two weeks.

  • If you are a Provider User, contact your Provider Administrator if your User ID is disabled.
    • The Provider Administrator can unlock the account from the "Admin"tab and the "User Listing" sub-tab.
    • Locate the user on the "Provider User Listing" page.
    • Under the "Action" column, click on the gear icon on the line of the user.
    • Select "Unlock" to re-establish the user's access.

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  • If you are one of multiple Provider Administrators and your User ID is disabled, check with another Provider Administrator for assistance. If you are the only Provider Administrator, please contact the EDI Help Desk for assistance.

Disabled IDs that are not used will eventually be terminated for inactivity. If the terminated ID belongs to a Provider Administrator, not only will that ID be terminated, but so will all User IDs assigned by that Provider Administrator. (To avoid this, please be sure to have multiple Provider Administrators on the account.) Refer to 30-Day Lock-Out Notification Timer below for additional information.

  • Provider Administrators and Provider Users must register for myCGS again using a new Username.
  • Under the My Account tab, go to myProviders and click the "Add a Provider" button to add provider accounts. (Refer to the My Account section below for additional information.)

CGS encourages more than one Provider Administrator.

30-Day Lock-Out Notification Timer

So that all users know when their accounts are in jeopardy of being terminated due to inactivity of the Provider Administrator, myCGS will display a timer to notify you of this. The notification timer appears daily starting at day 15 through day 1.

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When you see this notification, immediately alert your Provider Administrator to log into myCGS to avoid terminating the entire account.

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Logging Out of myCGS

When you are done using myCGS, you must log out to end your session. To log out, click "Logout," which is located in the upper right of any screen in myCGS.

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For your security, if you do not log out, myCGS will automatically time out after 15 minutes of inactivity.

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You may log back in at any time.

 

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