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Region

Region D

Issue Title

SNF Consolidated Billing Payment

Number

 

Description

SNF Consolidated Billing 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 made through the fiscal intermediary (FI)/A/B Medicare Administrative 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.
Physician's professional services are excluded from this consolidated billing requirement; however, for physician services delivered to SNF inpatients, the technical component (representing the performance of the diagnostic procedure itself) is bundled into the Part A PPS payment and are not paid separately.

States

AK, AZ, CA, HI, IA, ID, KS, MO, MT, ND, NV, OR,SD, UT, WA, WY, Guam, American Samoa and Northern Marianas

Provider Type

DME Part B and Part A

Date of Service

Claims paid on or After October 1, 2007

References

Date Posted

 

Date Revised

 

More Information

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Attachments

Created at 6/5/2013 10:01 AM by Aaron Gough
Last modified at 6/5/2013 10:36 AM by Aaron Gough