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Issue Number - Name
0138-SNF-Consolidated Billing for Therapies
Review Type
Automated
Claim Type
Physician/Non-physician Practitioner, Physical Therapist, Occupational Therapist, Speech-Language Pathologist
Region and State
RAC 1-4
All States
Date Approved
02/12/2019

Description

Physical therapy, Speech-language pathology services, and Occupational therapy are bundled into the SNF’s global per diem payment for a resident’s covered Part A stay. They are also subject to the SNF “Part B” consolidated billing requirement for services furnished to SNF Part B residents.

Affected Codes

Therapy CPT/HCPCS Codes 

SNF Part B Consolidated Billing Tables

Applicable Policy References

Title XVIII, Social Security Act: Section 1833(d)
CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 6; 10.1, 10.2, 10.3,20.5, 20.6
CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 7 10, 10.1, 110
SNF Consolidated Billing Tables