Billing Services:







EBS Brochure of Services

EBS Website Flier

EBS Employee Contact List



Electronic Forms:

Eligibility Request Form

Delivery Ticket (HME)

Beneficiary Authorization

Monthly Beneficiary Authorization for Non-Assigned Rentals

Advanced Beneficiary Notice

Immunization Administration


NCPDP Billing Services:

PCN List updated 042821 (1).pdf


Instructions for Submitting Claims for Diabetic Testing Supplies Through NCPDP


Auto-Pay:  Eliminate late fees by paying your EBS bill electronically!

ACH Agreement Form

Credit Card Authorization Form


 Enrollment:

Medicare Jurisdiction Map 

Medicare Enrollment Contractors

All Medicare Contractors by State

Interative Contractor Map

CMS Regional Offices

PECOS DME/POS Provider Enrollment/Registration

Medicare Revalidation List (Check to see if your PTAN is due for revalidation.)

NPPES-NPI Directory/Enrollment

CMS-855S DME/POS Medicare Enrollment

CMS-855I Immunization for a Sole Proprietor Enrollment Application

CMS-855B Immunization/DSMT for a Corporation Enrollment Application

Pay CMS Application Fee for New Enrollments or Revalidations

Immunization Participating Provider Agreement Form

CMS-588 Medicare Electronic Funds Transfer Agreement

W-9 Tax Number Certification for Private Insurance

DME POS Site Inspection Form

DME POS Site Visit Documents List

Request a Duplicate Medicare Welcome Letter

Medicare Supplier Database
 

Supplier Standards (English)

Supplier Standards Disclosure

Surety Bond Companies Approved by Medicare

Surety Bond Exemptions

Employee The Right People-Search OIG Exclusions Database




 
CLIA Waiver:




















COVID 19 Vaccine Program














Marketing (Health and Wellness)


Contracting:













Blue Cross Massachusetts (DME providers enroll as institutional)




Essence Healthcare Medicare HMO (Missouri)


Arkansas Medicaid MCO:




Louisianna Medicaid MCO:







Missouri Medicaid MCO:


New Jersey Medicaid MCO:














Insurance Commissioner Contacts:



Legislative Contacts:

Senate Listings

House Representative Listings

American Association for Homecare

CMS Employee Contact Information

Current Legislative Activities


Accreditation:


DME/POS Information for Pharmacies (Seeking Exemption from Accreditation)

DME Accreditation Organizations approved by CMS

ACHC - Accreditation Organization for DME/POS Suppliers

DME/POS Quality Standards

The Basics of DME/POS Accreditation


Diabetes Self Management Training:

Search for DSMT Accredited Facilities

How to Get Your DSMT Program Accredited Through AADE
 
DSMT Information on Getting Started
Competitive Bidding:


Find a Contract Supplier

Sign up to receive updated information regarding Competitive Bidding

Grandfathering Information

Subcontracting of DMEPOS Services

Licensure for Bidding Suppliers

Traveling Beneficaries


Exemptions to being a Contract Supplier:

Round 1 Rebid Contract Suppliers

Round 1 Payment Amounts - All Products

Round 2 Competitive Bidding Areas and National Mail-Order Competition

Round 2 Competitive Bidding Area Zip Codes (pdf)

Round 2 Competitive Bidding Area Zip Codes (Excel)  

Round 2 and NMO Contract Supplier List

Round 2 Single Payment Amounts

National Mail Order Diabetic Supply Single Payment Amounts

Round 1 Recompete Contract List 


CMS - Order Printed Educational Tools to Educate Your Beneficiaries



Medicare Part B Jurisdictional Carriers:

Noridian Healthcare Solutions Jurisdiction A

Cigna Government Services Jurisdiction B

Cigna Government Services Jurisdiction C

Noridian Healthcare Solutions Jurisdiction D



Medicare Part B Jurisdictional Carriers Tools:

Noridian Jurs A DME on Demand

Noridian Jurs A Forms


Cigna Jurs B myCGS Web Portal

Cigna Jurs B Online Education Center

Cigna Jurs B Online Tools


Cigna Jurs C myCGS Web Portal

Cigna Jurs C Online Education Center

Cigna Jurs C Online Tools

KE/KY Modifier Tool for Power Mobility
 

Noridian Jurs D Medicare Portal

Noridian Jurs D Denial Tools

Noridian Jurs D Forms


Noridian Jurs D DME on Demand


Link to Local Coverage Determinations (LCD's) and Policy Articles

DME

CGS Link to Local Coverage Determinations/Policy Articles

Noridian Link to Local Coverage Determinations/Policy Articles

Part B

Telehealth

DSMT and MNT Services


 Medicare Part B Consolidated Billing Tool:

DMEPOS Consolidated Billing Tool


Medicare Part B Jurisdictional (ALL) Carriers Questions and Answers:

2014 January

2014 April

2014 July

2014 October

2015 January

2015 April

2015 August

2015 October

2016 January

PMD Prior Authorization:

Jurisdiction A Prior Authorization Form

Jurisdiction B Prior Authorization Form

Jurisdiction C Prior Authorization Form

Jurisdiction D Prior Authorization Form

Power Mobility Devices (PMDs): Complying with Documentation & Coverage Requirements

Local Coverage Determination for PMDs

PMD Repair Modifier Tool

Diagnosis Coding

Convert ICD9 to ICD10 Lookup Tool

ICD 10 Look Up Tool

ICD 10 Index

ICD 10 Tabular Index

ICD 10 Neoplasm Index

ICD 10 External Causes Index

ICD 10 Drug and Chemical Index

CMN'S (Certificate of Medical Necessity):

Continuation Form

Enteral and Parenteral Nutrition

External Infusion Pumps

Osteogenesis Stimulators

Oxygen

Seat Lift Mechanisms

TENS Transcutaneous Electrical Nerve Stimulator

Group 1 Support Surfaces

Group 2 Support Surfaces


Clinician Education:


Face To Face Documentation Requirements Dear Physician Letter (April 2016)

Glucose Monitor and Supplies Medical Record Documentation July 2013

Physicians/Practitioners MUST Supply Medical Records at NO Cost to the Supplier or Beneficiary

Dear Physician Letter for Power Mobility Devices


Face to Face Documentation:

MM8304 Detailed Written Orders and Face to Face Encounter Requirements


Further Clarification of the DWO and Face to Face Requirements


Documentation Checklists

Documentation Checklists as published by CGS (Jurs C)

Documentation Checklists as published by Noridian (Jurs D)


MedLearn Matters Updates:

Wheelchair Impacted by Reclassification of Certain DME

 MedLearn Matters-MM8566

Purchase Option Letter
PECOS:

PECOS-Physician CMS Ordering and Referring for DME

PECOS-Physician CMS Ordering and Referring for Power Mobility Devices

PECOS- Physician Database Search Engine

PECOS-Physician and NonPhysician Enrollment/Registration

PECOS-DMEPOS Provider Enrollment/Registration

Dear Physician Letter 


Product Listing:

PDAC-Product Classification/HCPC Coding




Consolidated Billing Tool:



ABN-Advanced Beneficiary Notice:

ABN English CMS-R-131 (03/2020) PDF Format

ABN English CMS-R-131 (03/2020) FOR NON ASSIGNED CLAIMS ONLY PDF Format

ABN English CMS-R-131 (03/2020) Word Format

ABN English CMS-R-131 (03/2020) FOR NON ASSIGNED CLAIMS ONLY Word Format

ABN Spanish CMS-R-131 (03/2020) PDF Format

ABN Spanish CMS-R-131 (03/2020) Word Format

ABN - Instructions-Proper Use

ABN - Interactive Tutorial


Power Mobility Prior Authorization Request Form:

Jurs A Prior Authorization Request Coversheet

Jurs B Prior Authorization Request Coversheet

Jurs C Prior Authorization Request Coversheet
 

Remittance Advice Codes: 

Claim Adjustment Reason Codes

Remittance Advice Remark Codes



Diabetes Self Management Training (DSMT)

It has been confirmed as of 08/17/2016 that AR Medicaid does NOT cover DSMT.  The following list of states were provided by AADE and indicates states that have laws mandating coverage of DSMT services.  However, this does NOT mean that the coverage has been implemented.
DSMT Medicaid Coverage by State


Drug Rebates:



Units of Service Calculators:






Coding/Fee Schedule:

DSMT/MNT Fee Schedules:
2022 Diabetes Self Management Training/Education




Immunization Fee Schedule:


Find your Locality (This locality code identifies the fee schedule you will get for vaccine administration)

Administration 2022 Locality Rates (Use the locality code to find the allowable for vaccine administration in your area)

2019 Immunization Cheat Sheet with Administration Fees
Drug Fee Schedules:





2020 3rd Quarter Inhalation Drug Quick Reference Guide



Oral Anti Cancer Drug Fee Schedule:




Parenteral and Enteral Fee Schedules:

2018 Parenteral and Enteral Nutrition (PDF format) All States


DME/POS Fee Schedules and Rural Zip Code Search




 
 
 


Electronic Billing Services, Inc
138 N Prairie St
Sikeston, MO  63801
Phone: (573) 472-3613
info@ebsservice.com
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