0099-Skilled Nursing Facility (SNF) Consolidated Billing

Submitted by Matthew.Gregor… on Mon, 11/04/2019 - 07:45
Issue Number - Name
0099-Skilled Nursing Facility (SNF) Consolidated Billing
Review Type
Automated
Claim Type
Outpatient Facility
Region and State
RAC 1-4 <br/>All States
Date Approved
2018-06-12

Description

Payment for the majority of Skilled Nursing Facility (SNF) services provided to beneficiaries in a Medicare covered Part A SNF stay are included in a bundled prospective payment. Entities that provide these services should look to the SNF for payment. Under the consolidated billing requirement, the SNF must submit all Medicare claims for the entire package of care that residents receive during a covered Part A SNF stay.

Affected Code(s)

  • CPT/HCPCS codes listed in the SNF Consolidated Billing Table, Major Category I.F and V.A.

Applicable Policy References

  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 23, Section 30
  • Physician Fee Schedule, Addendum - MPFSDB Record Layouts