Massachusetts practices, NGS rules first

Cardiology billing services in Massachusetts

Sources checked: 2026-09-30. Sources and review scope.

Cardiology billing services in Massachusetts start with NGS, your Medicare contractor for jurisdiction JK. Its published coverage policies are one part of Medicare claim requirements. Policies can overlap across contractors, so payment under one contractor doesn't guarantee payment under another. We're based in Texas, bill every state remotely, and bill cardiology only, at 3% of collections.

Talk to our team Explore pricing

3% of collectionsNo setup feeNo contract

Cardiology billing services in Massachusetts: the Boston skyline over the Charles River — Massachusetts claims go to NGS

01Medicare

How NGS pays cardiology in Massachusetts

National Government Services processes Medicare claims for jurisdiction JK. That covers Massachusetts, Connecticut, Maine, New Hampshire, New York, Rhode Island and Vermont. It writes its own local coverage policies for echo, nuclear imaging and cardiac monitoring. A study that pays under one contractor can be denied under another.

We check the applicable policy before filing. If documentation appears incomplete, we flag it for the practice to review before submission. Only the treating clinician can determine or change clinical documentation.

Held before submission

Claim 32114Event monitor · 93268

Documentation receivedClaim 32114

Record review

Documentation flagged for practice review

Our checkHeld

Practice reviewClaim 32114

Ready to submit

Practice confirms documentation

Claim statusReady

Indication documented before sending

02Payers

The Massachusetts payers we bill

Your schedule carries Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim and Tufts Health Plan. You also see Mass General Brigham Health Plan, UnitedHealthcare, Aetna and Cigna. Many HMO products here ask for a primary care referral before a specialist visit.

MassHealth, the state's Medicaid program, enrolls many members in accountable care organizations. Some MassHealth plans also need a primary care referral for specialist care. A visit billed without one can deny, so we check the referral before the claim goes out.

Referral checked first

Claim 32152Echo 93306 · MassHealth ACO

Patient's ACO or plan confirmedChecked
Primary care referral on fileChecked
Authorization checked for the studyChecked
Referral dates cover the visitChecked
Claim statusPaid

Referral on file before the visit

03Your city

Cardiology practices we serve in Boston, Worcester, Springfield, Lowell

We're built for independent practices of 1 to 10 cardiologists. Echo, vascular, nuclear, monitors or a device clinic run in the office.

Medicare pays Massachusetts in 2 localities: Metropolitan Boston and the rest of the state. The same echo pays differently in Boston and Worcester. We post each payment against the rate for your locality.

Posted at your rate

Payment 32171Echo 93306 · Worcester

Medicare rate for the rest of Massachusetts
Contract rate for the plan
Payment matched line by line

Payment checkMatched

Paid at your locality's rate

04Switching

Switching from a local biller

Leaving a local biller, or a biller who left? The switch runs on a 60-day plan. Your claims keep moving from day one, and we work the old A/R in parallel.

Your dedicated biller learns your payers, your EHR and your doctors, and stays with your practice.

Your first 60 days with us

No gap in claims

Your switch60-day plan

Day 1New claims go out daily
Weeks 1 to 8Old A/R worked in parallel
Day 60Your biller fully on the account

Claims keep moving from day one

05Questions

FAQ

Do you track MassHealth and HMO referrals?

Yes. We check that a referral is on file and covers the visit date before each claim goes out.

We see New Hampshire and Rhode Island patients. Can you bill their plans?

Yes. We bill in all 50 states, and both states sit under NGS for Medicare too.

What does it cost?

3% of collections. No setup fee, no contract, no per-claim charges.

Sources and review context

Checked on September 30, 2026. This administrative source check is not a clinical or credentialed coding review, legal opinion, payer-contract audit, or guarantee of coverage or payment.

Medicare contractor: CMS's JK jurisdiction page identifies Massachusetts and the other JK states. CMS's MAC directory links state provider websites.
Fee schedule and locality: CMS's CY 2026 Physician Fee Schedule locality data and CMS fee-schedule downloads and ZIP-to-locality guidance support checking a service ZIP and date.
MassHealth: MassHealth's Accountable Care Partnership Plan information describes one managed-care arrangement; provider billing and claims resources provide billing instructions. Referral and authorization requirements depend on the member's coverage.
Commercial payer: BCBSA's state company directory lists Blue Cross and Blue Shield of Massachusetts. It does not establish market share or a specific contract's terms; verify the member's product and provider agreement.

06Get in touch

Send us your last 90 days of claims

We review them by study and by payer, free, with no strings.

Talk to our team Explore pricing

3% of collectionsNo setup feeNo contract

Free, no strings

Your 90-day Massachusetts reviewLast 90 days

Every claim, by studyIncluded
MassHealth referrals on fileIncluded
Checked against NGS policyIncluded