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Issue Number - Name
0110-Skilled Nursing Facility (SNF) Consolidated Billing Part B (Partial)
Review Type
Claim Type
Physician/Non-Physician Practitioner
Region and State
RACS 1-4
All States
Date Approved


Payment for the majority of Skilled Nursing Facility (SNF) services provided to beneficiaries in a Medicare covered Part A stay are included in a bundled prospective payment made through the fiscal intermediary (FI) A/B Medicare Admin. Contractor (MAC) to the SNF. These bundled services are to be billed by the SNF to the FI A/B MAC in a consolidated bill. The consolidated billing requirements confers on the SNF the billing responsibility for the entire package of care that residents receive during a covered Part A  SNF stay. 

Affected Codes

CPT/HCPCS codes listed on the CMS File 2 - Part A Stay - Professional components of services to be submitted with a 26 Modifier

Applicable Policy References

Social Security Act, Section 1833(e)
CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 6, Section 20.1.1
SNF Consolidated Billing - Part B Medicare Administrative Contractor (MAC) File Explanation