The Palmetto GBA Jurisdictions J Provider Contact Center (PCC) will be closed for staff training from 8 a.m. to 12 p.m. ET Friday, May 16, 2025. Please note the webchat feature will be unavailable at this time. However, during this closure, providers can use Sage, Palmetto GBAÔÇÖs chat self-service tool.

Physician-Supplier Guide

Published 01/01/2020

This guide provides a comprehensive overview of many aspects of the Medicare program. Whether you are new to Medicare, or looking for a concise explanation of Medicare guidelines, this publication is a great place to start.

 


5/1/2025
CMS Claim Filing Instructions
The instructions in this article have been developed as a guide for submitting the CMS-1500 claim form to Palmetto GBA.
5/1/2025
10/11/2022
Collecting From Medicare Patients
Like most other insurance plans, Medicare Parts A & B have deductibles that must be satisfied prior to a payment being made.
10/11/2022
11/18/2021
Fee-For-Time Compensation Arrangements (Formerly Locum Tenens Arrangements)
The SSA Act of 1994 allowed for payment to be made to a patient’s regular physician in the event that a fee-for-time compensation arrangement existed.
11/18/2021
5/20/2020
Remittance Advice
The remittance notice will contain detailed information that explains the Medicare allowed and paid amounts.
5/20/2020
2/7/2018
Eligibility for Medicare: Beneficiaries
There are three categories of individuals who are eligible to be insured by Medicare: aged individuals; disabled individuals and those with End Stage Renal Disease (ESRD).
2/7/2018
Fraud and Abuse
The CMS and Palmetto GBA are dedicated to saving taxpayers dollars through the prevention and early detection of fraud and abuse.
2/7/2018
Mandatory Claims Filing Requirements
Section 1848(g)(4) of the Social Security Act requires that you submit claims for all your Medicare patients for services rendered.
2/7/2018
Services Outside the United States
Medicare provides for limited coverage for medical services furnished outside the United States. In general, hospital or medical services are not covered outside the country, with a few exceptions.
2/7/2018
Signature Requirements on Claims: Medicare Patients
Signature requirements for Medicare patients apply to both assigned and nonassigned claims.
2/7/2018
Teaching Physicians
An attending physician’s services (other than an interns and residents) rendered to patients in a teaching setting are covered under Part B when properly documented.
2/7/2018
What Is Covered Under Medicare Part B
In general, the Medicare program is designed only to provide payment for services that are considered to be medically reasonable and necessary to the overall diagnosis and treatment of a patient's condition.
2/7/2018
1/29/2018
About Medicare
Medicare is a federal health insurance program that provides medical coverage for people 65 or older, for certain disabled people and for some people with end-stage renal disease (ESRD).
1/29/2018
1/10/2018
Federal Regulations: Anti-Kickback and Self-Referral
Section 1128 (b) of the Social Security Act (42 U.S.C 1320a '7b(b)), provides criminal penalties for knowingly offering, paying, or soliciting, remuneration in order to induce Medicare business.
1/10/2018

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